Key Neonatal Resource - Procedure
Base FHIR Definition here. : “An action that is or was performed on or for a patient. This can be a physical intervention like an operation, or less invasive like long-term services, counselling, or hypnotherapy.“
Generic Procedure resource to capture key procedures during a neonatal care episode.
FHIR Profile details here (Simplifier)
For an NNU-SYSTEM Spine Client, dedicated BadgerNet Notes are created to hold these generic Procedure FHIR Resource key details. Once saved, the business-logic rules will update other BadgerNet Forms based on the SNOMED code of the procedure given, along with the time point given in the Resource.
Key elements required
code : Expecting a single SNOMED Code that describes this single procedure. The SNOMED codes listed below will have added relevance to the BadgerNet Record and also national data collection requirements.
status: One of http://hl7.org/fhir/r4/valueset-event-status.html
statusReason: One of http://hl7.org/fhir/r4/valueset-procedure-not-performed-reason.html
category: Required to confirm if this procedure was surgical.
bodySite: (optional - use if relevant to the Procedure code. Required for ROP treatment detail)
performed - start + optional end time.
note - optional added free text.
(extension) PaediatricEpisodeTimePoint - optional code to record when this item is related in the care episode.
Procedure | XML Import Schema Attribute | SNOMED Code(s) | BadgerNet item |
|---|---|---|---|
Cord clamping
| NNUAdmission Details form - Labour and Birth tab:  238248005 - Umbilical cord clamping (procedure) Take the Procedure start time and use the Birth Time to calculate the values needed for the BNet fields above. | ||
Exchange transfusion
| FullExchangeTransfusion PartialExchangeTransfusion | Daily Summary Form:  180202002 - Neonatal exchange transfusion (procedure)Neonatal 233558007 - Dilutional exchange transfusion (procedure) | |
Peritoneal Dialysis
| PeritonealDialysis | Daily Summary Form:  71192002 : Peritoneal dialysis (procedure) | |
Intra-arterial catheter or chest drain
| DayChestDrain | 303727009 258643002 264957007 | CONFIRM BNET LOCATION 303727009 arterial catheter 258643002 Chest drain (physical object) 264957007 - Insertion of pleural tube drain (procedure) |
ROP Screening
| ROPScreenDuringStay ROPScreenFirstDate | BadgerNet has dedicated ad-hoc note for all ROP Screening events. At this stage, NNAP only need the date and time of each ROP Screen Event. 698349008 - Screening for retinopathy of prematurity (procedure) | |
Cranial Ultrasound
| Possibly include this one as well? 431756003431756003 | Ad-hoc cranial ultrasound performed input form:  169237004 - Ultrasound brain scan (procedure) (See also the use of CONDITION Resource with diagnosis codes for ICH Grades) | |
Exchange Transfusion
| FullExchangeTransfusion PartialExchangeTransfusion | or | NNU Daily Summary form:  Full Exchange Transfusion = 180202002 Partial = 233558007 |
Intravenous blood products
| IVDrugs IVDrugsInfused | 116762002 | NNU Daily Summary form - Transfusions tab:  Procedure code: 116762002 | Administration of blood product (procedure) procedure.usedcode options [1..*]: 71493000 | Transfusion of packed red blood cells (procedure) 346447007 | Fresh frozen plasma (product) 420599006 | Cryoprecipitate (substance) 16378004 | Platelet (cell structure). (???? confirm) 52454007 | Albumin (substance) |
Peritoneal Dialysis
| PeritonealDialysis | NNU Daily Summary form:  71192002 | Peritoneal dialysis (procedure) | |
Ward round / clincal review
| ParentPresentOnRound | 91485006 | From EPR Config: Ad-hoc Clinical Review:  Use Procedure.Performer[x].actor to reference RelatedPerson of mother or father from the Patient resource. This would indicate "parent present at ward round". Saving this note form will auto-populate the daily summary form (confirm!) as needed: From NNU Daily Summary:  |
Haemofiltration
| 233581009 | NNU Daily summary form - Gastrointestinal tab:  233581009 | Hemofiltration (procedure) | |
Barrier nursed
| BarrierNursed | 361233000 or 275830000 or 275823006 | NNU Daily Summary form - General Details tab:  SNOMED 361233000 - Barrier nursing (regime/therapy) SNOMED 275830000 - Reverse barrier nursing (procedure) Either of the above 2 codes links to "Barrier Nursing" check-box in BadgerNet form. SNOMED 275823006 - Isolation nursing (procedure) |
Phototherapy
| BarrierNursed | 35683002 | NNU Daily Summary Form - Metabolic tab:  35683002 | Phototherapy of newborn (procedure) |
CFAM Monitoring
| EEGCFAM | 252737003 or 54550000 | NNU Daily Summary Form - Neurology tab  252737003 | Continuous monitoring using cerebral function analysing monitor (procedure) 54550000 | Electroencephalogram (procedure) |
Cooling
| Cooled | 241741007 or 439472009 | NNU Daily Summary form - Neurology tab:  241741007 | Active cooling of patient (procedure) 439472009 | Passive cooling of patient (procedure) |
Any Surgery
| MajorSurgeryToday | ANY SNOMED CODE | NNU Daily Summary form - Diagnosis, Procedure, and Drugs tab:  Any SNOMED code is welcome, in the PROCEDURE FHIR Resource, but the procedure.category codable concept should be set to 387713003 (387713003 | Surgical procedure). This will indicate that this procedure is of a “surgical” nature and will set the BadgerNet daily summary value to YES. |
ROP Treatment / Surgery
| RopSurgeryToday | 1004045004 608849003 231760002 | ROP Screening Result note form:  1004045004 | Intravitreal injection of anti-vascular endothelial growth factor (procedure) | 608849003 | Surgical procedure on eye proper using laser (procedure) 231760002 | Cryotherapy to retina (procedure) Note, that [procedure.bodysite] should be set to one of the following two codes: 58443009 | Structure of retina of left eye (body structure) 5597008 | Structure of retina of right eye (body structure) or 1290041000 | Entire left eye proper (body structure) 1290043002 | Entire right eye proper (body structure) |