---
type: "resource"
title: "NutritionOrder"
resource: "NutritionOrder"
---
# NutritionOrder
## Introduction
## Scope and Usage
> **Note to Balloters:** To ensure this resource is ready for Normative status, we are seeking ballot comment on the substantive content. The key changes made since R5 include:
>
> - Removed the instantiates workflow elements NutritionOrder.instantiatesCanonical, NutritionOrder.instantiatesUri and NutritionOrder.instantiates; and advise implementers to use the [workflow instantiates extensions](workflow-extensions)
> - Renamed NutritionOrder.orderer to NutritionOrder.requester to align with the workflow pattern
> - Renamed NutritionOrder.oralDiet.texture.foodType to NutritionOrder.oralDiet.texture.type
> - Removed NutritionOrder.oralDiet.fluidConsistencyType
> - Added NutritionOrder.oralDiet.caloricDensity and NutritionOrder.supplement.caloricDensity
> - Updated NutritionOrder.enteralFormula backbone
> - Pulled NutritionOrder.additive into its own backbone (previously part of NutritionOrder.enteralFormula)
> **Note to Implementers:** For an overview of this resource and others in the Nutrition domain, also see the [module page](nutrition-module).
The NutritionOrder resource describes a request for oral diets (including general diets such as General Healthy diet, or therapeutic diets such as Consistent Carbohydrate, 2-gram Sodium, or Fluid Restricted), oral nutrition supplements (such as nutritionally complete pre-packed drinks), enteral nutrition (tube feedings) and infant formula which govern the distribution of food and nutritional products used to feed patients within a patient setting. It does not cover orders for parenteral (IV) nutrition which are typically filled by pharmacy. These nutrition orders are combined with information on a patient's food allergies and intolerances, and ethnic or cultural food preferences (e.g. Kosher or Vegetarian) to inform healthcare personnel about the type, texture, and/or quantity of foods that the patient should receive or consume.
Enteral orders are distinguished from supplements because they have some unique attributes and typically include administration information whereas oral nutritional supplements may simply be supplied (e.g. home health or outpatient settings). In a simple case, the requestor may designate the type of product, product name, and the route of administration along with free text instructions without having to complete the additional structured details.
This resource is intended to be used by practitioners from a variety of specialties such as physicians, dietitians/nutritionists, or speech therapists. One practitioner may simply order a base element oral diet such as General Healthful diet. Another practitioner, based on the scope of practice, may use other elements to communicate additional therapeutic needs or patient preferences. The optionality included gives an ordering practitioner the capability to write a simple order for an oral diet, nutritional supplement or formula with minimal requirements beyond that of specifying the diet, supplement or formula product, but also supports the ability to provide more detailed information that may be further augmented by a dietitian or nutrition specialist. For example, a physician may order a 2 g sodium diet. A speech therapist, based on the results of a swallowing evaluation, then orders an International Dysphagia Diet Standardisation Initiative Framework - Soft and Bite-Sized Level 6 food (regime/therapy).
## Boundaries and Relationships
The NutritionOrder resource is used for requesting oral diets, oral nutrition supplements, enteral feedings, and infant formula. The [MedicationRequest](medicationrequest) resource should be used for requesting parenteral (IV) nutrition and prescribing dietary supplements such as vitamin or mineral supplements.
The Nutrition Order is a record of the request for the supply of a diet, oral supplement, enteral formulas, and infant formula for a patient. However, to initiate the request requires the use of the [Task](task) resource and its associated workflow with the Nutrition Order referenced from Task.basedOn, or by using the nutrition Task resource in the context of a messaging or service workflow where the request is explicit or implicit. For further information about this separation of responsibilities, refer to the [Fulfillment/Execution section](request#fulfillment) of the Request pattern.
## Notes
## Notes:
### Enteral continuous vs. intermittent tube feedings
Tube feedings can be administered via continuous drip using a pump or via intermittent feedings, using gravity drip or a pump. The examples [Nutrition Order Enteral Bolus Feeding Example](nutritionorder-example-enteralbolus) and [Nutrition Order Enteral Cycled Feeding Example](nutritionorder-example-enteralcycled) show how this resource can be used to order both kinds of enteral feeding using the structured data elements. The continuous feeding typically specifies rate of administration and a maximum volume of delivery using the enteralFormula.administration.rate and enteralFormula.maxVolumeToDeliver elements. On the other hand, the intermittent feeding typically specifies the amount and frequency of administration using the enteralFormula.administration.quantity and enteralFormula.schedule elements. In both cases, to vary the rate or quantity over time the enteralFormula.administration element can be repeated.
### Note about the examples
The examples associated with this resource demonstrate the core elements and do not necessarily reflect real-world implementations that may be constrained by future profiles for a given implementation or setting. For example, a renal diet is often comprised of pre-coordinated components including common nutrient modifications such as protein, potassium and phosphorus to assist with the speed of entry of complex diet orders.
## StructureDefinition
### Elements (Simplified)
- **[NutritionOrder](/nutritionorder-definitions#NutritionOrder)** [0..*]: - Diet, formula or nutritional supplement request
- **[NutritionOrder.identifier](/nutritionorder-definitions#NutritionOrder.identifier)** [0..*]: [Identifier](/Identifier) Identifiers assigned to this order
- **[NutritionOrder.basedOn](/nutritionorder-definitions#NutritionOrder.basedOn)** [0..*]: [Reference(CarePlan](/Reference(CarePlan), [NutritionOrder](/NutritionOrder), [ServiceRequest](/ServiceRequest), [RequestOrchestration)](/RequestOrchestration)) What this order fulfills
- **[NutritionOrder.groupIdentifier](/nutritionorder-definitions#NutritionOrder.groupIdentifier)** [0..1]: [Identifier](/Identifier) Composite Request ID
- **[NutritionOrder.status](/nutritionorder-definitions#NutritionOrder.status)** [1..1]: [code](/code) required:[request-status](/valueset-request-status) draft | active | on-hold | entered-in-error | ended | completed | revoked | unknown
- **[NutritionOrder.intent](/nutritionorder-definitions#NutritionOrder.intent)** [1..1]: [code](/code) required:[request-intent](/valueset-request-intent) proposal | solicit-offer | offer-response | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
- **[NutritionOrder.priority](/nutritionorder-definitions#NutritionOrder.priority)** [0..1]: [code](/code) required:[request-priority|6.0.0](/valueset-request-priority|6.0.0) routine | urgent | asap | stat
- **[NutritionOrder.subject](/nutritionorder-definitions#NutritionOrder.subject)** [1..1]: [Reference(Patient](/Reference(Patient), [Group)](/Group)) Who requires the diet, formula or nutritional supplement
- **[NutritionOrder.encounter](/nutritionorder-definitions#NutritionOrder.encounter)** [0..1]: Reference([Encounter](/Encounter)) The encounter associated with this nutrition order
- **[NutritionOrder.supportingInformation](/nutritionorder-definitions#NutritionOrder.supportingInformation)** [0..*]: Reference([Resource](/Resource)) Information to support fulfilling of the nutrition order
- **[NutritionOrder.dateTime](/nutritionorder-definitions#NutritionOrder.dateTime)** [1..1]: [dateTime](/dateTime) Date and time the nutrition order was requested
- **[NutritionOrder.requester](/nutritionorder-definitions#NutritionOrder.requester)** [0..1]: [Reference(Practitioner](/Reference(Practitioner), [PractitionerRole)](/PractitionerRole)) Who ordered the diet, formula or nutritional supplement
- **[NutritionOrder.performer](/nutritionorder-definitions#NutritionOrder.performer)** [0..*]: [CodeableReference](/CodeableReference) Who is intended to perform the administration of the nutrition order
- **[NutritionOrder.allergyIntolerance](/nutritionorder-definitions#NutritionOrder.allergyIntolerance)** [0..*]: Reference([AllergyIntolerance](/AllergyIntolerance)) List of the patient's food and nutrition-related allergies and intolerances
- **[NutritionOrder.foodPreferenceModifier](/nutritionorder-definitions#NutritionOrder.foodPreferenceModifier)** [0..*]: [CodeableConcept](/CodeableConcept) preferred:[edible-substance-type](/valueset-edible-substance-type) Order-specific modifier about the type of food that should be given
- **[NutritionOrder.excludeFoodModifier](/nutritionorder-definitions#NutritionOrder.excludeFoodModifier)** [0..*]: [CodeableConcept](/CodeableConcept) preferred:[edible-substance-type](/valueset-edible-substance-type) Food that should not be given
- **[NutritionOrder.outsideFoodAllowed](/nutritionorder-definitions#NutritionOrder.outsideFoodAllowed)** [0..1]: [boolean](/boolean) Capture if patient is permitted to consume food from outside of current setting brought by the patient, family, and/or caregiver
- **[NutritionOrder.oralDiet](/nutritionorder-definitions#NutritionOrder.oralDiet)** [0..1]: [BackboneElement](/BackboneElement) Oral diet components
- **[NutritionOrder.oralDiet.type](/nutritionorder-definitions#NutritionOrder.oralDiet.type)** [0..*]: [CodeableConcept](/CodeableConcept) preferred:[diet-type](/valueset-diet-type) Type of oral diet or diet restrictions that can be consumed orally
- **[NutritionOrder.oralDiet.schedule](/nutritionorder-definitions#NutritionOrder.oralDiet.schedule)** [0..1]: [BackboneElement](/BackboneElement) Scheduling information for oral diets
- **[NutritionOrder.oralDiet.schedule.timing](/nutritionorder-definitions#NutritionOrder.oralDiet.schedule.timing)** [0..*]: [Timing](/Timing) Scheduled frequency of diet
- **[NutritionOrder.oralDiet.schedule.asNeeded](/nutritionorder-definitions#NutritionOrder.oralDiet.schedule.asNeeded)** [0..1]: [boolean](/boolean) Take 'as needed'
- **[NutritionOrder.oralDiet.schedule.asNeededFor](/nutritionorder-definitions#NutritionOrder.oralDiet.schedule.asNeededFor)** [0..1]: [CodeableConcept](/CodeableConcept) example:[medication-as-needed-reason](/valueset-medication-as-needed-reason) Take 'as needed' for x
- **[NutritionOrder.oralDiet.nutrient](/nutritionorder-definitions#NutritionOrder.oralDiet.nutrient)** [0..*]: [BackboneElement](/BackboneElement) The nutrient that is modified and the quantity in the diet
- **[NutritionOrder.oralDiet.nutrient.modifier](/nutritionorder-definitions#NutritionOrder.oralDiet.nutrient.modifier)** [0..1]: [CodeableConcept](/CodeableConcept) preferred:[nutrient-code](/valueset-nutrient-code) Nutrient modified in the oral diet type
- **[NutritionOrder.oralDiet.nutrient.amount](/nutritionorder-definitions#NutritionOrder.oralDiet.nutrient.amount)** [0..1]: [Quantity](/Quantity) Quantity of the specified nutrient
- **[NutritionOrder.oralDiet.texture](/nutritionorder-definitions#NutritionOrder.oralDiet.texture)** [0..*]: [BackboneElement](/BackboneElement) Texture modifications in addition to the oral diet type
- **[NutritionOrder.oralDiet.texture.modifier](/nutritionorder-definitions#NutritionOrder.oralDiet.texture.modifier)** [0..1]: [CodeableConcept](/CodeableConcept) preferred:[texture-code](/valueset-texture-code) Food (i.e. solid and/or liquid) texture modifications in addition to those in the oral diet type
- **[NutritionOrder.oralDiet.texture.type](/nutritionorder-definitions#NutritionOrder.oralDiet.texture.type)** [0..1]: [CodeableConcept](/CodeableConcept) preferred:[modified-foodtype](/valueset-modified-foodtype) Food (i.e. solid and/or liquid) types that undergo texture alteration
- **[NutritionOrder.oralDiet.instruction](/nutritionorder-definitions#NutritionOrder.oralDiet.instruction)** [0..1]: [string](/string) Instructions or additional information about the oral diet
- **[NutritionOrder.oralDiet.caloricDensity](/nutritionorder-definitions#NutritionOrder.oralDiet.caloricDensity)** [0..1]: [Quantity](/Quantity) Amount of energy per specified volume of oral diet
- **[NutritionOrder.supplement](/nutritionorder-definitions#NutritionOrder.supplement)** [0..*]: [BackboneElement](/BackboneElement) Supplement components
- **[NutritionOrder.supplement.type](/nutritionorder-definitions#NutritionOrder.supplement.type)** [0..1]: [CodeableReference](/CodeableReference) preferred:[supplement-type](/valueset-supplement-type) Type of supplement product requested
- **[NutritionOrder.supplement.productName](/nutritionorder-definitions#NutritionOrder.supplement.productName)** [0..1]: [string](/string) Product or brand name of the nutritional supplement
- **[NutritionOrder.supplement.schedule](/nutritionorder-definitions#NutritionOrder.supplement.schedule)** [0..1]: [BackboneElement](/BackboneElement) Scheduling information for supplements
- **[NutritionOrder.supplement.schedule.timing](/nutritionorder-definitions#NutritionOrder.supplement.schedule.timing)** [0..*]: [Timing](/Timing) Scheduled frequency of supplement
- **[NutritionOrder.supplement.schedule.asNeeded](/nutritionorder-definitions#NutritionOrder.supplement.schedule.asNeeded)** [0..1]: [boolean](/boolean) Take 'as needed'
- **[NutritionOrder.supplement.schedule.asNeededFor](/nutritionorder-definitions#NutritionOrder.supplement.schedule.asNeededFor)** [0..1]: [CodeableConcept](/CodeableConcept) example:[medication-as-needed-reason](/valueset-medication-as-needed-reason) Take 'as needed' for x
- **[NutritionOrder.supplement.quantity](/nutritionorder-definitions#NutritionOrder.supplement.quantity)** [0..1]: [Quantity](/Quantity) Amount of the nutritional supplement
- **[NutritionOrder.supplement.instruction](/nutritionorder-definitions#NutritionOrder.supplement.instruction)** [0..1]: [string](/string) Instructions or additional information about the oral supplement
- **[NutritionOrder.supplement.caloricDensity](/nutritionorder-definitions#NutritionOrder.supplement.caloricDensity)** [0..1]: [Quantity](/Quantity) Amount of energy per specified volume of supplement that is required
- **[NutritionOrder.enteralFormula](/nutritionorder-definitions#NutritionOrder.enteralFormula)** [0..1]: [BackboneElement](/BackboneElement) Enteral formula product
- **[NutritionOrder.enteralFormula.type](/nutritionorder-definitions#NutritionOrder.enteralFormula.type)** [0..1]: [CodeableReference](/CodeableReference) preferred:[entformula-type](/valueset-entformula-type) Type of patient enteral feeding
- **[NutritionOrder.enteralFormula.productName](/nutritionorder-definitions#NutritionOrder.enteralFormula.productName)** [0..1]: [string](/string) Product or brand name of the enteral feeding
- **[NutritionOrder.enteralFormula.deliveryDevice[x]](/nutritionorder-definitions#NutritionOrder.enteralFormula.deliveryDevice%5Bx%5D)** [0..1]: [CodeableConcept](/CodeableConcept), [canonical](/canonical) example:[deliverydevice-code](/valueset-deliverydevice-code) Intended type of device for the enteral feeding administration
- **[NutritionOrder.enteralFormula.caloricDensity](/nutritionorder-definitions#NutritionOrder.enteralFormula.caloricDensity)** [0..1]: [Quantity](/Quantity) Amount of energy per specified volume of feeding that is required
- **[NutritionOrder.enteralFormula.routeOfAdministration](/nutritionorder-definitions#NutritionOrder.enteralFormula.routeOfAdministration)** [0..*]: [CodeableConcept](/CodeableConcept) extensible:[enteral-route](/valueset-enteral-route) How the enteral feeding should enter the patient's gastrointestinal tract
- **[NutritionOrder.enteralFormula.administration](/nutritionorder-definitions#NutritionOrder.enteralFormula.administration)** [0..*]: [BackboneElement](/BackboneElement) Formula feeding instruction as structured data
- **[NutritionOrder.enteralFormula.administration.schedule](/nutritionorder-definitions#NutritionOrder.enteralFormula.administration.schedule)** [0..1]: [BackboneElement](/BackboneElement) Scheduling information for enteral feeding products
- **[NutritionOrder.enteralFormula.administration.schedule.timing](/nutritionorder-definitions#NutritionOrder.enteralFormula.administration.schedule.timing)** [0..*]: [Timing](/Timing) Scheduled frequency of enteral feeding
- **[NutritionOrder.enteralFormula.administration.schedule.asNeeded](/nutritionorder-definitions#NutritionOrder.enteralFormula.administration.schedule.asNeeded)** [0..1]: [boolean](/boolean) Take 'as needed'
- **[NutritionOrder.enteralFormula.administration.schedule.asNeededFor](/nutritionorder-definitions#NutritionOrder.enteralFormula.administration.schedule.asNeededFor)** [0..1]: [CodeableConcept](/CodeableConcept) example:[medication-as-needed-reason](/valueset-medication-as-needed-reason) Take 'as needed' for x
- **[NutritionOrder.enteralFormula.administration.quantity](/nutritionorder-definitions#NutritionOrder.enteralFormula.administration.quantity)** [0..1]: [Quantity](/Quantity) The volume of formula feeding to provide
- **[NutritionOrder.enteralFormula.administration.rate[x]](/nutritionorder-definitions#NutritionOrder.enteralFormula.administration.rate%5Bx%5D)** [0..1]: [Quantity](/Quantity), [Ratio](/Ratio) Speed with which the formula feeding is provided per period of time
- **[NutritionOrder.enteralFormula.maxVolumeToAdminister](/nutritionorder-definitions#NutritionOrder.enteralFormula.maxVolumeToAdminister)** [0..1]: [Quantity](/Quantity) Upper limit on formula feeding volume per unit of time
- **[NutritionOrder.enteralFormula.administrationInstruction](/nutritionorder-definitions#NutritionOrder.enteralFormula.administrationInstruction)** [0..1]: [markdown](/markdown) Formula feeding instructions expressed as text
- **[NutritionOrder.additive](/nutritionorder-definitions#NutritionOrder.additive)** [0..*]: [BackboneElement](/BackboneElement) Modular additive to add to the oral diet, supplement, and/or enteral feeding
- **[NutritionOrder.additive.modularType](/nutritionorder-definitions#NutritionOrder.additive.modularType)** [0..1]: [CodeableReference](/CodeableReference) preferred:[entformula-additive](/valueset-entformula-additive) Type of modular component to add to the oral diet, supplement, and/or enteral feeding
- **[NutritionOrder.additive.productName](/nutritionorder-definitions#NutritionOrder.additive.productName)** [0..1]: [string](/string) Product or brand name of the modular additive
- **[NutritionOrder.additive.quantity](/nutritionorder-definitions#NutritionOrder.additive.quantity)** [0..1]: [Quantity](/Quantity) Amount of additive to be given or mixed in with the oral diet, supplement, and/or enteral feeding
- **[NutritionOrder.additive.routeOfAdministration](/nutritionorder-definitions#NutritionOrder.additive.routeOfAdministration)** [0..*]: [CodeableConcept](/CodeableConcept) extensible:[enteral-route](/valueset-enteral-route) How the additive should enter the patient's gastrointestinal tract
- **[NutritionOrder.note](/nutritionorder-definitions#NutritionOrder.note)** [0..*]: [Annotation](/Annotation) Comments
## Mappings
- [NutritionOrder Mappings](/nutritionorder-mappings) — 124 mapping entries
## Implementation Guide
### implementationguide-NutritionOrder-core.xml
```xml
```
## Resource Packs
### list-NutritionOrder-packs.xml
```xml
-
```
## Search Parameters
- [additive](/nutritionorder-search#additive) — **token** — Type of module component to add to the diet — `NutritionOrder.additive.modularType.concept`
- [datetime](/nutritionorder-search#datetime) — **date** — Return nutrition orders requested on this date — `NutritionOrder.dateTime`
- [encounter](/nutritionorder-search#encounter) — **reference** — Return nutrition orders with this encounter identifier — `NutritionOrder.encounter`
- [formula](/nutritionorder-search#formula) — **token** — Type of enteral or infant formula — `NutritionOrder.enteralFormula.type.concept`
- [identifier](/nutritionorder-search#identifier) — **token** — Return nutrition orders with this external identifier — `NutritionOrder.identifier`
- [oraldiet](/nutritionorder-search#oraldiet) — **token** — Type of diet that can be consumed orally (i.e., take via the mouth). — `NutritionOrder.oralDiet.type`
- [subject](/nutritionorder-search#subject) — **reference** — The identity of the individual or set of individuals who requires the diet, formula or nutritional supplement — `NutritionOrder.subject`
- [patient](/nutritionorder-search#patient) — **reference** — The identity of the individual or set of individuals who requires the diet, formula or nutritional supplement — `NutritionOrder.subject.where(resolve() is Patient)`
- [requester](/nutritionorder-search#requester) — **reference** — The identity of the provider who placed the nutrition order — `NutritionOrder.requester`
- [status](/nutritionorder-search#status) — **token** — Status of the nutrition order. — `NutritionOrder.status`
- [supplement](/nutritionorder-search#supplement) — **token** — Type of supplement product requested — `NutritionOrder.supplement.type.concept`
- [group-identifier](/nutritionorder-search#group-identifier) — **token** — Composite Request ID — `NutritionOrder.groupIdentifier`
[Full Search Parameters](/nutritionorder-search)
## Examples
- [ambulatory-outpatient](/nutritionorder-example-ambulatory-outpatient) — nutritionorder-example-ambulatory-outpatient — Ambulatory Outpatient Example
- [carbcountdiet](/nutritionorder-example-carbcountdiet) — nutritionorder-example-carbcountdiet — Nutrition Order Consistent Carb Diet Example
- [chfdiet](/nutritionorder-example-chfdiet) — nutritionorder-example-chfdiet — Nutrition Order Low Sodium and Fluid Restricted Diet Example
- [diabeticsupplement](/nutritionorder-example-diabeticsupplement) — nutritionorder-example-diabeticsupplement — Nutrition Order Diabetic Supplement Example
- [energysupplement](/nutritionorder-example-energysupplement) — nutritionorder-example-energysupplement — Nutrition Order Energy/Protein Supplement Example
- [enteralbolus](/nutritionorder-example-enteralbolus) — nutritionorder-example-enteralbolus — Nutrition Order Enteral Bolus Feeding Example
- [enteralcycled](/nutritionorder-example-enteralcycled) — nutritionorder-example-enteralcycled — Nutrition Order Enteral Cycled Feeding Example
- [fiberrestricteddiet](/nutritionorder-example-fiberrestricteddiet) — nutritionorder-example-fiberrestricteddiet — Nutrition Order Low Fat and Fiber Restricted Diet Example
- [heart-failure](/nutritionorder-example-heart-failure) — nutritionorder-example-heart-failure — Heart Failure Patient Example
- [infantenteral](/nutritionorder-example-infantenteral) — nutritionorder-example-infantenteral — Nutrition Order Infant Enteral Feeding Example
- [malnutritionlongtermcare](/nutritionorder-example-malnutritionlongtermcare) — nutritionorder-example-malnutrition — Malnutrition Long Term Care Example
- [nutritionorder-example](/nutritionorder-example-nutritionorder-example) — nutritionorder-example
- [nutritionorder-example-ambulatory-outpatient](/nutritionorder-example-nutritionorder-example-ambulatory-outpatient) — nutritionorder-example-ambulatory-outpatient
- [nutritionorder-example-carbcountdiet](/nutritionorder-example-nutritionorder-example-carbcountdiet) — nutritionorder-example-carbcountdiet
- [nutritionorder-example-chfdiet](/nutritionorder-example-nutritionorder-example-chfdiet) — nutritionorder-example-chfdiet
- [nutritionorder-example-diabeticsupplement](/nutritionorder-example-nutritionorder-example-diabeticsupplement) — nutritionorder-example-diabeticsupplement
- [nutritionorder-example-energysupplement](/nutritionorder-example-nutritionorder-example-energysupplement) — nutritionorder-example-energysupplement
- [nutritionorder-example-enteralbolus](/nutritionorder-example-nutritionorder-example-enteralbolus) — nutritionorder-example-enteralbolus
- [nutritionorder-example-enteralcycled](/nutritionorder-example-nutritionorder-example-enteralcycled) — nutritionorder-example-enteralcycled
- [nutritionorder-example-fiberrestricteddiet](/nutritionorder-example-nutritionorder-example-fiberrestricteddiet) — nutritionorder-example-fiberrestricteddiet
- [nutritionorder-example-heart-failure](/nutritionorder-example-nutritionorder-example-heart-failure) — nutritionorder-example-heart-failure
- [nutritionorder-example-infantenteral](/nutritionorder-example-nutritionorder-example-infantenteral) — nutritionorder-example-infantenteral
- [nutritionorder-example-malnutrition](/nutritionorder-example-nutritionorder-example-malnutrition) — nutritionorder-example-malnutrition
- [nutritionorder-example-proteinsupplement](/nutritionorder-example-nutritionorder-example-proteinsupplement) — nutritionorder-example-proteinsupplement
- [nutritionorder-example-pureeddiet](/nutritionorder-example-nutritionorder-example-pureeddiet) — nutritionorder-example-pureeddiet
- [nutritionorder-example-pureeddiet-simple](/nutritionorder-example-nutritionorder-example-pureeddiet-simple) — nutritionorder-example-pureeddiet-simple
- [nutritionorder-example-renaldiet](/nutritionorder-example-nutritionorder-example-renaldiet) — nutritionorder-example-renaldiet
- [nutritionorder-example-texture-modified](/nutritionorder-example-nutritionorder-example-texture-modified) — nutritionorder-example-texture-modified
- [nutritionorder-examples-header](/nutritionorder-example-nutritionorder-examples-header) — nutritionorder-examples-header
- [proteinsupplement](/nutritionorder-example-proteinsupplement) — nutritionorder-example-proteinsupplement — Nutrition Order Protein Supplement Example
- [pureeddiet](/nutritionorder-example-pureeddiet) — nutritionorder-example-pureeddiet — Nutrition Order Pureed Diet Example
- [pureeddiet-simple](/nutritionorder-example-pureeddiet-simple) — nutritionorder-example-pureeddiet-simple — Nutrition Order Pureed Diet and Energy/Protein Supplement Simple Example
- [renaldiet](/nutritionorder-example-renaldiet) — nutritionorder-example-renaldiet — Nutrition Order Renal Diet Example
- [texturemodified](/nutritionorder-example-texturemodified) — nutritionorder-example-texture-modified — Nutrition Order Texture Modified Diet Example
[Full Examples](/nutritionorder-examples)
## Mapping Exceptions
### nutritionorder-fivews-mapping-exceptions.xml
### Divergent Elements
- **FiveWs.class** → **NutritionOrder.intent**
- **FiveWs.what[x]** → **NutritionOrder.oralDiet.type**
### Unmapped Elements
- **FiveWs.actor** — Unknown
- **FiveWs.cause** — Unknown
- **FiveWs.version** — Unknown
- **FiveWs.witness** — Unknown
- **FiveWs.where** — Unknown
- **FiveWs.init** — Unknown
- **FiveWs.why** — Unknown
- **FiveWs.source** — Unknown
- **FiveWs.who** — Unknown
- **FiveWs.planned** — Unknown
- **FiveWs.done** — Unknown
### nutritionorder-request-mapping-exceptions.xml
### Divergent Elements
- **Request.identifier** → **NutritionOrder.identifier**
- summary | reason=Unknown | pattern=true
- shortUnmatched | reason=Unknown | pattern=Business Identifier for nutrition order | resource=Identifiers assigned to this order
- definitionUnmatched | reason=Unknown | pattern=Business identifiers assigned to this nutrition order by the author and/or other systems. These identifiers remain constant as the resource is updated and propagates from server to server. | resource=Identifiers assigned to this order by the order sender or by the order receiver.
- commentsUnmatched | reason=Unknown | pattern=The identifier.type element is used to distinguish between the identifiers assigned by the requester/placer and the performer/filler.
Note: This is a business identifier, not a resource identifier (see [discussion](resource.html#identifiers)). It is best practice for the identifier to only appear on a single resource instance, however business practices may occasionally dictate that multiple resource instances with the same identifier can exist - possibly even with different resource types. For example, multiple Patient and a Person resource instance might share the same social insurance number. | resource=The Identifier.type element can be to indicate filler vs. placer if needed. This is explained in further detail [here](servicerequest.html#notes).
- requirementsUnmatched | reason=Unknown | pattern=Allows identification of the nutrition order as it is known by various participating systems and in a way that remains consistent across servers.
- **Request.basedOn** → **NutritionOrder.basedOn**
- missingTypes | reason=Unknown | pattern=Reference(Request)
- extraTypes | reason=Unknown
- summary | reason=Unknown | pattern=true
- shortUnmatched | reason=Unknown | pattern=Fulfills plan, proposal or order | resource=What this order fulfills
- definitionUnmatched | reason=Unknown | pattern=A higher-level request resource (i.e. a plan, proposal or order) that is fulfilled in whole or in part by this nutrition order. Authorization from the 'basedOn' request flows through to the referencing nutrition order. | resource=A plan or request that is fulfilled in whole or in part by this nutrition order.
- commentsUnmatched | reason=Unknown | pattern=basedOn represents the 'authorization' chain for an action, not the 'reason for action'. For example, an order might be placed on hold under the authorization for a surgery. However the 'reason' for placing the hold is "to avoid interaction with anesthesia medications"
.
- requirementsUnmatched | reason=Unknown | pattern=Allows tracing of authorization for the request and tracking whether proposals/recommendations were acted upon.
- **Request.groupIdentifier** → **NutritionOrder.groupIdentifier**
- shortUnmatched | reason=Unknown | pattern=Composite request this is part of | resource=Composite Request ID
- definitionUnmatched | reason=Unknown | pattern=A shared identifier common to all requests that were authorized more or less simultaneously by a single author, representing the identifier of the requisition, prescription or similar form. | resource=A shared identifier common to all nutrition orders that were authorized more or less simultaneously by a single author, representing the composite or group identifier.
- commentsUnmatched | reason=Unknown | pattern=Requests are linked either by a "basedOn" relationship (i.e. one request is fulfilling another) or by having a common requisition. Requests that are part of the same requisition are generally treated independently from the perspective of changing their state or maintaining them after initial creation.
- requirementsUnmatched | reason=Unknown | pattern=Some business processes need to know if multiple items were ordered as part of the same "prescription" or "requisition" for billing or other purposes.
- **Request.status** → **NutritionOrder.status**
- shortUnmatched | reason=Unknown | pattern=draft | active | on-hold | revoked | completed | entered-in-error | unknown | resource=draft | active | on-hold | entered-in-error | ended | completed | revoked | unknown
- definitionUnmatched | reason=Unknown | pattern=The current state of the nutrition order. | resource=The workflow status of the nutrition order/request.
- commentsUnmatched | reason=Unknown | pattern=The status is generally fully in the control of the requester - they determine whether the order is draft or active and, after it has been activated, completed, cancelled or suspended. States relating to the activities of the performer are reflected on either the corresponding]](s) or using the]] resource. A nominal state-transition diagram can be found in the] documentation Unknown does not represent "other" - one of the defined statuses must apply. Unknown is used when the authoring system is not sure what the current status is. A status of 'active' when doNotPerform is true means that the request to not perform is currently in force.
A status of completed for a "doNotPerform" request indicates that the period of non-performance is now satisfied and the request no longer holds. | resource=Typically the system placing the order sets the status to "requested". Thereafter, the order is maintained by the receiver that updates the status as the request is handled. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid.
- **Request.intent** → **NutritionOrder.intent**
- shortUnmatched | reason=Unknown | pattern=proposal | plan | order (immutable) | resource=proposal | solicit-offer | offer-response | plan | directive | order | original-order | reflex-order | filler-order | instance-order | option
- definitionUnmatched | reason=Unknown | pattern=Indicates the level of authority/intentionality associated with the nutrition order and where the request fits into the workflow chain. | resource=Indicates the level of authority/intentionality associated with the NutrionOrder and where the request fits into the workflow chain.
- commentsUnmatched | reason=Unknown | pattern=This element is expected to be immutable. E.g. A "proposal" instance should never change to be a "plan" instance or "order" instance. Instead, a new instance 'basedOn' the prior instance should be created with the new 'intent' value.
One exception to this is that the granularity of Request.intent is allowed to change. For example, a Request identified as an "order" might later be clarified to be a "filler-order". Or, in rarer cases (to meet recipient constraints), the reverse might also occur.
When resources map to this element, they are free to define as many codes as necessary to cover their space and will map to "proposal, plan or order". Can have multiple codes that map to one of these. E.g. "original order", "encoded order", "reflex order" would all map to "order". Expectation is that the set of codes is mutually exclusive or a strict all-encompassing hierarchy. | resource=When resources map to this element, they are free to define as many codes as necessary to cover their space and will map to "proposal, plan or order". Can have multiple codes that map to one of these. E.g. "original order", "encoded order", "reflex order" would all map to "order". Expectation is that the set of codes is mutually exclusive or a strict all-encompassing hierarchy.
- **Request.priority** → **NutritionOrder.priority**
- summary | reason=Unknown | pattern=true
- definitionUnmatched | reason=Unknown | pattern=Indicates how quickly the nutrition order should be addressed with respect to other requests. | resource=Indicates how quickly the Nutrition Order should be addressed with respect to other requests.
- **Request.code** → **NutritionOrder.oralDiet.type**
- shortUnmatched | reason=Unknown | pattern=Service requested/ordered | resource=Type of oral diet or diet restrictions that can be consumed orally
- definitionUnmatched | reason=Unknown | pattern=A code that identifies the specific service or action being asked to be done (or not done). | resource=The kind of diet or dietary restriction such as fiber restricted diet or diet for diabetes.
- **Request.code** → **NutritionOrder.oralDiet.nutrient.modifier**
- summary | reason=Unknown | pattern=true
- shortUnmatched | reason=Unknown | pattern=Service requested/ordered | resource=Nutrient modified in the oral diet type
- definitionUnmatched | reason=Unknown | pattern=A code that identifies the specific service or action being asked to be done (or not done). | resource=The nutrient that is being modified such as carbohydrate or sodium.
- **Request.code** → **NutritionOrder.oralDiet.texture.modifier**
- summary | reason=Unknown | pattern=true
- shortUnmatched | reason=Unknown | pattern=Service requested/ordered | resource=Food (i.e. solid and/or liquid) texture modifications in addition to those in the oral diet type
- definitionUnmatched | reason=Unknown | pattern=A code that identifies the specific service or action being asked to be done (or not done). | resource=Texture modifications in the addition to the oral diet type that should be made, e.g. easy to chew, chopped, ground, and pureed.
- **Request.code** → **NutritionOrder.oralDiet.texture.type**
- summary | reason=Unknown | pattern=true
- shortUnmatched | reason=Unknown | pattern=Service requested/ordered | resource=Food (i.e. solid and/or liquid) types that undergo texture alteration
- definitionUnmatched | reason=Unknown | pattern=A code that identifies the specific service or action being asked to be done (or not done). | resource=The food (i.e. solid and/or liquid) type(s) (e.g. meats, all foods) that the texture modification applies to.
- **Request.product** → **NutritionOrder.supplement.type**
- shortUnmatched | reason=Unknown | pattern=Product requested/ordered | resource=Type of supplement product requested
- definitionUnmatched | reason=Unknown | pattern=Indicates the product whose supply or manipulation is authorized by this nutrition order. | resource=The kind of nutritional supplement product required such as a high protein or pediatric clear liquid supplement.
- **Request.product** → **NutritionOrder.enteralFormula.type**
- shortUnmatched | reason=Unknown | pattern=Product requested/ordered | resource=Type of patient enteral feeding
- definitionUnmatched | reason=Unknown | pattern=Indicates the product whose supply or manipulation is authorized by this nutrition order. | resource=The type of adult or pediatric enteral feeding such as an adult standard formula with fiber or a soy-based infant feeding.
- **Request.product** → **NutritionOrder.additive.modularType**
- summary | reason=Unknown | pattern=true
- shortUnmatched | reason=Unknown | pattern=Product requested/ordered | resource=Type of modular component to add to the oral diet, supplement, and/or enteral feeding
- definitionUnmatched | reason=Unknown | pattern=Indicates the product whose supply or manipulation is authorized by this nutrition order. | resource=Indicates the type of modular component such as protein, carbohydrate, fat or fiber to be provided in addition to or mixed with the oral diet, supplement, and/or enteral feeding.
- **Request.subject** → **NutritionOrder.subject**
- shortUnmatched | reason=Unknown | pattern=Individual the service is ordered/prohibited for | resource=Who requires the diet, formula or nutritional supplement
- definitionUnmatched | reason=Unknown | pattern=The individual or set of individuals the action is to be performed/not performed on or for. | resource=The person or set of individuals who needs the nutrition order for an oral diet, nutritional supplement and/or enteral or formula feeding.
- requirementsUnmatched | reason=Unknown | pattern=Links the request to the Patient context.
- **Request.encounter** → **NutritionOrder.encounter**
- summary | reason=Unknown | pattern=true
- shortUnmatched | reason=Unknown | pattern=Encounter the nutrition order is tied to | resource=The encounter associated with this nutrition order
- definitionUnmatched | reason=Unknown | pattern=The Encounter during which this nutrition order was created or to which the creation of this record is tightly associated. | resource=An encounter that provides additional information about the healthcare context in which this request is made.
- commentsUnmatched | reason=Unknown | pattern=This will typically be the encounter during which the nutrition order was created. However, some {{title}s may be initiated prior to or after the official completion of an encounter but still be tied to the context of the encounter (e.g. pre-admission activities).
- requirementsUnmatched | reason=Unknown | pattern=Links the nutrition order to the Encounter context.
- **Request.occurrence[x]** → **NutritionOrder.oralDiet.schedule.timing**
- missingTypes | reason=Unknown | pattern=dateTime, Period
- summary | reason=Unknown | pattern=true
- shortUnmatched | reason=Unknown | pattern=When service should (not) occur | resource=Scheduled frequency of diet
- definitionUnmatched | reason=Unknown | pattern=The date or time(s) at which the activity or service is desired to occur or not occur. | resource=The time period and frequency at which the diet should be given. The diet should be given for the combination of all schedules if more than one schedule is present.
- **Request.occurrence[x]** → **NutritionOrder.supplement.schedule.timing**
- missingTypes | reason=Unknown | pattern=dateTime, Period
- summary | reason=Unknown | pattern=true
- shortUnmatched | reason=Unknown | pattern=When service should (not) occur | resource=Scheduled frequency of supplement
- definitionUnmatched | reason=Unknown | pattern=The date or time(s) at which the activity or service is desired to occur or not occur. | resource=The time period and frequency at which the supplement should be given. The supplement should be given for the combination of all schedules if more than one schedule is present.
- **Request.occurrence[x]** → **NutritionOrder.enteralFormula.administration.schedule.timing**
- missingTypes | reason=Unknown | pattern=dateTime, Period
- summary | reason=Unknown | pattern=true
- shortUnmatched | reason=Unknown | pattern=When service should (not) occur | resource=Scheduled frequency of enteral feeding
- definitionUnmatched | reason=Unknown | pattern=The date or time(s) at which the activity or service is desired to occur or not occur. | resource=The time period and frequency at which the enteral feeding should be given. The enteral feeding should be given for the combination of all schedules if more than one schedule is present.
- **Request.authoredOn** → **NutritionOrder.dateTime**
- shortUnmatched | reason=Unknown | pattern=When request was created/transitioned to active | resource=Date and time the nutrition order was requested
- definitionUnmatched | reason=Unknown | pattern=For draft nutrition orders, indicates the date of initial creation. For requests with other statuses, indicates the date of activation. | resource=The date and time that this nutrition order was requested.
- **Request.requester** → **NutritionOrder.requester**
- missingTypes | reason=Unknown | pattern=Reference(Organization, Patient, RelatedPerson, Device)
- shortUnmatched | reason=Unknown | pattern=Who/what is requesting service | resource=Who ordered the diet, formula or nutritional supplement
- definitionUnmatched | reason=Unknown | pattern=Who initiated the {{request}} and has responsibility for its activation. | resource=The practitioner that holds legal responsibility for ordering the diet, nutritional supplement, or formula feedings.
- **Request.performer** → **NutritionOrder.performer**
- missingTypes | reason=Unknown | pattern=Reference(Practitioner, PractitionerRole, Organization, CareTeam, HealthcareService, Patient, Device, RelatedPerson)
- extraTypes | reason=Unknown
- summary | reason=Unknown | pattern=true
- shortUnmatched | reason=Unknown | pattern=Specific desired (non)performer | resource=Who is intended to perform the administration of the nutrition order
- definitionUnmatched | reason=Unknown | pattern=Indicates who or what is being asked to perform (or not perform) the {{request}}. | resource=The specified desired performer of the nutrition order.
- **Request.supportingInfo** → **NutritionOrder.oralDiet.instruction**
- missingTypes | reason=Unknown | pattern=Reference(Any)
- extraTypes | reason=Unknown
- summary | reason=Unknown | pattern=false
- shortUnmatched | reason=Unknown | pattern=Extra information to use in performing request | resource=Instructions or additional information about the oral diet
- definitionUnmatched | reason=Unknown | pattern=Information that may be needed by/relevant to the performer in their execution of this nutrition order. | resource=Free text or additional instructions or information pertaining to the oral diet.
- commentsUnmatched | reason=Unknown | pattern=See guidance on [notes vs. supportingInfo](request.html#notes). | resource=Free text diet instructions can be used for cases where the instructions are too complex to code.
- **Request.supportingInfo** → **NutritionOrder.supplement.instruction**
- missingTypes | reason=Unknown | pattern=Reference(Any)
- extraTypes | reason=Unknown
- summary | reason=Unknown | pattern=false
- shortUnmatched | reason=Unknown | pattern=Extra information to use in performing request | resource=Instructions or additional information about the oral supplement
- definitionUnmatched | reason=Unknown | pattern=Information that may be needed by/relevant to the performer in their execution of this nutrition order. | resource=Free text or additional instructions or information pertaining to the oral supplement.
- commentsUnmatched | reason=Unknown | pattern=See guidance on [notes vs. supportingInfo](request.html#notes). | resource=Free text dosage instructions can be used for cases where the instructions are too complex to code.
- **Request.supportingInfo** → **NutritionOrder.enteralFormula.administrationInstruction**
- missingTypes | reason=Unknown | pattern=Reference(Any)
- extraTypes | reason=Unknown
- summary | reason=Unknown | pattern=false
- shortUnmatched | reason=Unknown | pattern=Extra information to use in performing request | resource=Formula feeding instructions expressed as text
- definitionUnmatched | reason=Unknown | pattern=Information that may be needed by/relevant to the performer in their execution of this nutrition order. | resource=Free text formula administration, feeding instructions or additional instructions or information.
- commentsUnmatched | reason=Unknown | pattern=See guidance on [notes vs. supportingInfo](request.html#notes). | resource=Free text dosage instructions can be used for cases where the instructions are too complex to code.
- **Request.note** → **NutritionOrder.note**
- shortUnmatched | reason=Unknown | pattern=Comments made about nutrition order | resource=Comments
- commentsUnmatched | reason=Unknown | pattern=See guidance on [notes vs. supportingInfo](request.html#notes). | resource=This element SHALL NOT be used to supply free text instructions for the diet which are represented in the `.oralDiet.instruction`, `supplement.instruction`, or `enteralFormula.administrationInstruction` elements.
### Unmapped Elements
- **Request.insurance** — Unknown
- **Request.deliverTo** — Unknown
- **Request.replaces** — Unknown
- **Request.category** — Unknown
- **Request.reason** — Unknown
- **Request.reported** — Unknown
- **Request.relevantHistory** — Unknown
- **Request.statusReason** — Unknown
- **Request.performerType** — Unknown
- **Request.doNotPerform** — Unknown