61143-4Nurse Summary noteActive
Term Description
The eNursing Summary contains data sets related to specific clinical enviroment as a process to create safe, effective communication, ensuring continuity as the patient moves through care transitions. Transitions, or "hand-offs", occur multiple times each day in a hospital and at every change of care location.
Source: Regenstrief LOINC
Fully-Specified Name
- Component
- Summary note
- Property
- Find
- Time
- Pt
- System
- {Setting}
- Scale
- Doc
- Method
- Nurse
Additional Names
- Short Name
- Nurse Summary note
Associated Observations
| LOINC | Name | R/O/C | Cardinality | Example UCUM Units |
|---|---|---|---|---|
| 82811-1 | Nurse summary note - recommended sections | |||
| Indent48765-2 | Allergies and other adverse reactions | O | ||
| Indent42348-3 | Coded advanced directives | O | ||
| Indent51848-0 | Assessment | O | ||
| Indent11332-4 | Hx of cognitive function | O | ||
| Indent11450-4 | Active problems | O | ||
| Indent10154-3 | Chief complaint Narrative - Reported | O | ||
| Indent46241-6 | Hospital adm diagnosis | O | ||
| Indent11535-2 | Discharge diagnosis | O | ||
| Indent46264-8 | Medical devices | O | ||
| Indent30954-2 | Coded results | O | ||
| Indent18610-6 | Medications (administered) | O | ||
| Indent47519-4 | Procedures and interventions | O | ||
| Indent38212-7 | Pain assessment panel | O | ||
| Indent46209-3 | Provider orders | O | ||
| Indent18776-5 | Treatment plan | O | ||
| Indent8716-3 | Vital signs | O | ||
| Indent61144-2 | Diet and nutrition Narrative | O | ||
| Indent61148-3 | Fluid management note | O |
Basic Attributes
- Class
- DOC.ONTOLOGY
- Type
- Clinical
- First Released
- Version 2.34
- Last Updated
- Version 2.67
- Change Reason
- Previous Releases: Changed system from '^Patient' to represent current LOINC Document Ontology model.; Removed children and added them to associated oberservation panel 82811-1;
- Order vs. Observation
- Both
Member of these Groups
| LG41826-5 | {Setting}| |
| LG38952-4 | Nurse| |
| LG38844-3 | Summary note| |
Language Variants Get Info
- zh-CNChinese (China)
- 摘要:
发现: 时间点: {环境}: 文档型: 护士 - nl-NLDutch (Netherlands)
- samenvatting:
bevinding: moment: {instelling}: document: verpleegkundige - it-ITItalian (Italy)
- Nota di sintesi:
Osservazione: Pt: {Setting}: Doc: Infermiere - es-MXSpanish (Mexico)
- Nota resumida:
Tipo: Punto temporal: {Configuración}: Documento: Nurse
LOINC FHIR® API Example - CodeSystem Request Get Info
https://fhir.loinc.org/CodeSystem/$lookup?system=http://loinc.org&code=61143-4
LOINC Copyright
Copyright © 2022 Regenstrief Institute, Inc. All Rights Reserved. To the extent included herein, the LOINC table and LOINC codes are copyright