NICE-MedicationAdministration
Description
This profile is for submitting data to the NICE related to the admission of medication. The NICE needs information regarding:
- The date of administration
- The route it was administered in
- The dosage
- The rate of administration
Click here to go to the NICE-MedicationAdministration Simplifier page
NICE data dictionary links
Source
This profile is used to submit medication administration related information to the Dutch National Intensive Care Evaluation (NICE). It was derived from the Nictiz Health and Care Information Model (HCIM; Dutch: Zorginformatiebouwsteen or ZIB) MedicationAdministration, 2017 release version 3.1
MedicationAdministration | I | MedicationAdministration | Element idMedicationAdministration MedicationAdministration Alternate namesMedicatieToediening DefinitionMedication administration is the registration of the individual administrations of the medicine on the patient by the administrator (e.g. a nurse or patient themselves), in relation to the entered agreements. The NICE registration encompasses two types of data elements: (1) elements that require the amount of the administered product and (2) whether or not a specific kind of medication is administered to the patient. This profile can be used to submit both types. The WG will be updating the MedicationAdministration resource to adjust each affected resource to align with the workflow pattern (see workflow.html).
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id | Σ | 0..1 | id | There are no (further) constraints on this element Element idMedicationAdministration.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
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meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idMedicationAdministration.meta Metadata about the resource DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.
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implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idMedicationAdministration.implicitRules A set of rules under which this content was created DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.
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language | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationAdministration.language Language of the resource content DefinitionThe base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Common Languages (extensible)Constraints
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text | I | 0..1 | Narrative | There are no (further) constraints on this element Element idMedicationAdministration.text Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.
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contained | 0..* | Resource | There are no (further) constraints on this element Element idMedicationAdministration.contained Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.
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extension | I | 2..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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agreedDateTime | I | 0..* | Extension(dateTime) | There are no (further) constraints on this element Element idMedicationAdministration.extension:agreedDateTime AgreedDateTime Alternate namesextensions, user content, AfgesprokenDatumTijd DefinitionDate and time in the medication or administration agreement to which this administration pertains. Since multiple times can be indicated in one medication/administration agreement, this can be used to identify the agreed time in the event of e.g. early administration or a late administration. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://nictiz.nl/fhir/StructureDefinition/zib-MedicationAdministration-AgreedDateTime Constraints
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doubleCheckPerformed | I | 0..1 | Extension(boolean) | There are no (further) constraints on this element Element idMedicationAdministration.extension:doubleCheckPerformed DoubleCheckPerformed Alternate namesextensions, user content, DubbeleControleUitgevoerd DefinitionWas a double check performed prior to the administration? This is only legally required for certain medication. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://nictiz.nl/fhir/StructureDefinition/zib-MedicationAdministration-DoubleCheckPerformed Constraints
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medicationTreatment | I | 0..1 | Extension(Identifier) | There are no (further) constraints on this element Element idMedicationAdministration.extension:medicationTreatment Medicational Treatment Alternate namesextensions, user content, Medicamenteuze behandeling DefinitionThis extension is to describe which overarching medication treatment this information is part of. This is done by the use of an identifier of that medication treatment. No HCIM concept is available for this element. Therefore a mapping to the relevant element Medication Process data element is provided. http://nictiz.nl/fhir/StructureDefinition/zib-Medication-MedicationTreatment Constraints
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deviatingAdministration | I | 0..1 | Extension(Complex) | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Complex) Extension URLhttp://nictiz.nl/fhir/StructureDefinition/zib-MedicationAdministration-DeviatingAdministration Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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deviation | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:deviation DeviatingAdministration Alternate namesextensions, user content, AfwijkendeToediening DefinitionIn the administration, was there a deviation from the medication or administration agreement? This can be a deviation in product, time, amount, route of administration or administering speed or foregoing administration altogether There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:deviation.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:deviation.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:deviation.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
deviation
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valueBoolean | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:deviation.value[x]:valueBoolean Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).
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reasonForDeviation | I | 0..* | ExtensionBinding | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:reasonForDeviation MedicationAdministrationReasonForDeviation Alternate namesextensions, user content, MedicatieToedieningRedenVanAfwijken DefinitionReason why the medication was not taken or administered or was taken or administered differently. Here, you can choose to enter text or one of the codes. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. MedicatieToedieningRedenVanAfwijkenCodelijst (extensible) Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:reasonForDeviation.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:reasonForDeviation.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:reasonForDeviation.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
reasonForDeviation
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valueCodeableConcept | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:reasonForDeviation.value[x]:valueCodeableConcept Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://nictiz.nl/fhir/StructureDefinition/zib-MedicationAdministration-DeviatingAdministration
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value[x] | 0..0 | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.value[x] Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).
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ScoreDay | S I | 1..1 | Extension(Quantity) | Element idMedicationAdministration.extension:ScoreDay ScoreDay Alternate namesextensions, user content DefinitionExtension that is used to indicate the day of scoring. The first 24 hours after admission count as day 1. The next day starts from the first morning shift and lasts 24 hours, so until the start of the next morning shift. Note: Score day 1 can overlap with score day 2, and 'the first morning shift' is specified locally can differ between hospitals. ScoreDay SHALL be submitted if the instance is not about the historical use of the medication. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-ScoreDay-2022Q1 Constraints
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Verified | S I | 1..1 | Extension(CodeableConcept) | Element idMedicationAdministration.extension:Verified Is the instance validated by a medical professional? Alternate namesextensions, user content DefinitionExtension that is used to indicate whether the entire instance has been validated. Every instance shall be validated by a hospital member / datamanager. However, this is not always feasible in case of automated submission of NICE data elements. This extensions shall be used to indicate the validation status of the instance. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-Verified-2022Q1 Constraints
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modifierExtension | ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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identifier | 0..* | Identifier | There are no (further) constraints on this element Element idMedicationAdministration.identifier External identifier DefinitionExternal identifier - FHIR will generate its own internal identifiers (probably URLs) which do not need to be explicitly managed by the resource. The identifier here is one that would be used by another non-FHIR system - for example an automated medication pump would provide a record each time it operated; an administration while the patient was off the ward might be made with a different system and entered after the event. Particularly important if these records have to be updated.
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definition | Σ I | 0..* | Reference(PlanDefinition | ActivityDefinition) | There are no (further) constraints on this element Element idMedicationAdministration.definition Instantiates protocol or definition DefinitionA protocol, guideline, orderset or other definition that was adhered to in whole or in part by this event. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(PlanDefinition | ActivityDefinition) Constraints
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partOf | Σ I | 0..* | Reference(MedicationAdministration | Procedure) | There are no (further) constraints on this element Element idMedicationAdministration.partOf Part of referenced event DefinitionA larger event of which this particular event is a component or step. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(MedicationAdministration | Procedure) Constraints
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status | Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element idMedicationAdministration.status MedicationAdministrationStatus Alternate namesMedicatieToedieningStatus DefinitionThe status of the administration, as a description of the stage within the administering process. Only the status codes ‘completed’ and ‘cancelled’ apply to indivisible products (such as tablets or suppositories). For divisible products (such as infusions), doses can also be ‘suspended’ or ‘aborted’. When documenting this, the following interpretations are used: Active: The product is administered. Interrupted: Use has (temporarily) been interrupted, because of a side effect, for example. Later, the patient and/or doctor can decide whether or not to resume or discontinue use. Discontinued: Administration has stopped. Completed: Administration has been completed. Not started: The product was never administered. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. A set of codes indicating the current status of a MedicationAdministration. MedicationAdministrationStatus (required)Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.status.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.status.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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orderStatus | I | 0..1 | Extension(CodeableConcept) | There are no (further) constraints on this element Element idMedicationAdministration.status.extension:orderStatus OrderStatus Alternate namesextensions, user content, Bevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet., OrderStatus DefinitionThe status of the order / recommendation. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://nictiz.nl/fhir/StructureDefinition/code-specification Constraints
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value | 0..1 | There are no (further) constraints on this element Element idMedicationAdministration.status.value Primitive value for code DefinitionPrimitive value for code 1048576 | ||
category | 1..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idMedicationAdministration.category Type of medication usage DefinitionIndicates the type of medication administration and where the medication is expected to be consumed or administered. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. A coded concept describing where the medication administered is expected to occur MedicationAdministrationCategory (preferred)Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.category.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.category.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idMedicationAdministration.category.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Unordered, Open, by code(Value) Constraints
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MedicationAdministrationCode | Σ | 0..* | Coding | There are no (further) constraints on this element Element idMedicationAdministration.category.coding:MedicationAdministrationCode MedicationAdministrationCode DefinitionCategory snomed code used for indexing/retrieval of the ZIB MedicationAdministration. The SNOMED CT code 422037009 for this resource is stated in the Medication Process v09. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.category.coding:MedicationAdministrationCode.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.category.coding:MedicationAdministrationCode.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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system | Σ | 0..1 | uriFixed Value | There are no (further) constraints on this element Element idMedicationAdministration.category.coding:MedicationAdministrationCode.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
http://snomed.info/sct
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.category.coding:MedicationAdministrationCode.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
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code | Σ | 0..1 | codeFixed Value | There are no (further) constraints on this element Element idMedicationAdministration.category.coding:MedicationAdministrationCode.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings may not exceed 1MB in size
18629005
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.category.coding:MedicationAdministrationCode.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings may not exceed 1MB in size
Administration of drug or medicament (procedure)
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationAdministration.category.coding:MedicationAdministrationCode.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.category.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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medicationReference | Σ | 1..1 | Reference(HCIM PharmaceuticalProduct) | There are no (further) constraints on this element Element idMedicationAdministration.medication[x]:medicationReference AdministrationProduct Alternate namesProduct, Geneesmiddel, Toedieningsproduct DefinitionThe product taken or administered. This is usually medication. Food, blood products, aids and bandages do not strictly fall under the category of medication, but can be reported as well. In principle, this will be the prescribed product, but the administrator may substitute it by replacing the product with an equivalent product. For example: two 50mg tablets can be administered instead of one 100mg tablet. Reference(HCIM PharmaceuticalProduct) Constraints
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subject | Σ I | 1..1 | Reference(nl-core-patient | Group) | There are no (further) constraints on this element Element idMedicationAdministration.subject Who received medication DefinitionThe person or animal or group receiving the medication. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(nl-core-patient | Group) Constraints
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context | I | 0..1 | Reference(Encounter | EpisodeOfCare) | There are no (further) constraints on this element Element idMedicationAdministration.context Encounter or Episode of Care administered as part of DefinitionThe visit, admission or other contact between patient and health care provider the medication administration was performed as part of. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Encounter | EpisodeOfCare) Constraints
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supportingInformation | I | 0..* | Reference(Resource | HCIM Dispense | HCIM PharmaceuticalProduct | HCIM DispenseRequest | HCIM AdministrationAgreement | HCIM MedicationAgreement | HCIM MedicationAdministration) | There are no (further) constraints on this element Element idMedicationAdministration.supportingInformation RelatedAgreement / MedicationAgreement / AdministrationAgreement Alternate namesGerelateerdeAfspraak, Medicatieafspraak, Toedieningsafspraak DefinitionMedication or administration agreement on which this administration.is based. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Resource | HCIM Dispense | HCIM PharmaceuticalProduct | HCIM DispenseRequest | HCIM AdministrationAgreement | HCIM MedicationAgreement | HCIM MedicationAdministration) Constraints
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effective[x] | Σ | 1..1 | There are no (further) constraints on this element Element idMedicationAdministration.effective[x] AdministrationDateTime Alternate namesToedieningsDatumTijd DefinitionThe date and time at which the medication was administered.
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effectiveDateTime | dateTime | There are no (further) constraints on this element Data type | ||
effectivePeriod | Period | There are no (further) constraints on this element Data type | ||
performer | Σ | 0..* | BackboneElement | There are no (further) constraints on this element Element idMedicationAdministration.performer Administrator Alternate namesToediener DefinitionContainer of the Administrator concept. This container contains all data elements of the Administrator concept. The concept describes the person who administered the product. This is a professional authorised administrator, the patient themselves or the caregiver, for example.
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.performer.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.performer.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.performer.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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actor | Σ I | 1..1 | Reference(nl-core-practitioner | nl-core-patient | nl-core-relatedperson | Device) | There are no (further) constraints on this element Element idMedicationAdministration.performer.actor Individual who was performing DefinitionThe device, practitioner, etc. who performed the action. The health professional's specialty, role, and organization are captured and communicated through the PractitionerRole Resource based on the nl-core-practitionerrole profile. Reference(nl-core-practitioner | nl-core-patient | nl-core-relatedperson | Device) Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.performer.actor.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.performer.actor.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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practitionerRole | I | 0..1 | Extension(Reference(nl-core-practitionerrole)) | There are no (further) constraints on this element Element idMedicationAdministration.performer.actor.extension:practitionerRole Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Reference(nl-core-practitionerrole)) Extension URLhttp://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.performer.actor.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idMedicationAdministration.performer.actor.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.performer.actor.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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onBehalfOf | I | 0..1 | Reference(nl-core-organization) | There are no (further) constraints on this element Element idMedicationAdministration.performer.onBehalfOf Organization organization was acting for DefinitionThe organization the device or practitioner was acting on behalf of. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(nl-core-organization) Constraints
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notGiven | Σ ?! | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationAdministration.notGiven True if medication not administered DefinitionSet this to true if the record is saying that the medication was NOT administered. This element is labeled as a modifier because it indicates that a administration didn't happen. If this is missing, then the medication was administered
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reasonNotGiven | I | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationAdministration.reasonNotGiven Reason administration not performed DefinitionA code indicating why the administration was not performed. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. A set of codes indicating the reason why the MedicationAdministration is negated. SNOMED CT Reason Medication Not Given Codes (example)Constraints
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reasonCode | I | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationAdministration.reasonCode Reason administration performed DefinitionA code indicating why the medication was given. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. A set of codes indicating the reason why the MedicationAdministration was made. Reason Medication Given Codes (example)Constraints
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reasonReference | I | 0..* | Reference(Condition | Observation) | There are no (further) constraints on this element Element idMedicationAdministration.reasonReference Condition or Observation that supports why the medication was administered DefinitionCondition or observation that supports why the medication was administered. This is a reference to a condition that is the reason for the medication request. If only a code exists, use reasonCode. Reference(Condition | Observation) Constraints
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prescription | I | 0..1 | Reference(MedicationRequest) | There are no (further) constraints on this element Element idMedicationAdministration.prescription Request administration performed against DefinitionThe original request, instruction or authority to perform the administration. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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device | I | 0..* | Reference(Device) | There are no (further) constraints on this element Element idMedicationAdministration.device Device used to administer DefinitionThe device used in administering the medication to the patient. For example, a particular infusion pump. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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note | 0..* | Annotation | There are no (further) constraints on this element Element idMedicationAdministration.note Comment Alternate namesToelichting DefinitionComments on administering the medication. For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).
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dosage | I | 0..1 | BackboneElement | There are no (further) constraints on this element Element idMedicationAdministration.dosage Details of how medication was taken DefinitionDescribes the medication dosage information details e.g. dose, rate, site, route, etc.
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.dosage.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.dosage.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.dosage.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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text | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.dosage.text Free text dosage instructions e.g. SIG DefinitionFree text dosage can be used for cases where the dosage administered is too complex to code. When coded dosage is present, the free text dosage may still be present for display to humans. The dosage instructions should reflect the dosage of the medication that was administered. Note that FHIR strings may not exceed 1MB in size
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site | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationAdministration.dosage.site Body site administered to DefinitionA coded specification of the anatomic site where the medication first entered the body. For example, "left arm". If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension body-site-instance. May be a summary code, or a reference to a very precise definition of the location, or both. A coded concept describing the site location the medicine enters into or onto the body. SNOMED CT Anatomical Structure for Administration Site Codes (example)Constraints
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route | 1..1 | CodeableConceptBinding | Element idMedicationAdministration.dosage.route RouteOfAdministration Alternate namesToedieningsweg DefinitionThe route through which the medication is administered (oral, nasal, intravenous,...) The original Nictiz valueset describes that all values from the Dutch G-standaard (administration routes) can be submitted. However, NICE can only process the following codes (which is also due to the fact that NICE doens't have to know all specific administration routes):
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. MedicationAdministrationRouteCodeList NICE-AdministrationRouteCodeList (extensible)Constraints
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method | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationAdministration.dosage.method How drug was administered DefinitionA coded value indicating the method by which the medication is intended to be or was introduced into or on the body. This attribute will most often NOT be populated. It is most commonly used for injections. For example, Slow Push, Deep IV. One of the reasons this attribute is not used often, is that the method is often pre-coordinated with the route and/or form of administration. This means the codes used in route or form may pre-coordinate the method in the route code or the form code. The implementation decision about what coding system to use for route or form code will determine how frequently the method code will be populated e.g. if route or form code pre-coordinate method code, then this attribute will not be populated often; if there is no pre-coordination then method code may be used frequently. A coded concept describing the technique by which the medicine is administered. SNOMED CT Administration Method Codes (example)Constraints
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dose | I | 1..1 | SimpleQuantityBinding | Element idMedicationAdministration.dosage.dose AdministeredAmount Alternate namesToegediendeHoeveelheid DefinitionAmount of the administered product NOTE: NICE will not process exact dose values because they are not required to interpret the data dictionary elements. HOWEVER, when sending a MedicationAdministration record/instance this value shall NOT be 0 in order for NICE to process the instance. Otherwise the instance is marked as 'not administered'. If the administration is not instantaneous (rate is present), this can be specified to convey the total amount administered over period of time of a single administration. GstdTabel902 GstdTabel902 (required)Constraints
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rate[x] | I | 0..1 | Element idMedicationAdministration.dosage.rate[x] AdministeringSpeed Alternate namesToedieningssnelheid DefinitionThe administering speed is used in slow administration of liquid. In practice, the measuring unit is almost always ml/hour. For example, with an administering speed of 10ml/hour:
A hospital should only submit the highest dosage rate per ScoreDay as described in the data dictionary. Submission of multiple values will not be processed by NICE. Submitting the administering speed is only relevant for the NICE elements that require administration dosage:
If the rate changes over time, and you want to capture this in MedicationAdministration, then each change should be captured as a distinct MedicationAdministration, with a specific MedicationAdministration.dosage.rate, and the date time when the rate change occurred. Typically, the MedicationAdministration.dosage.rate element is not used to convey an average rate.
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rateRatio | Ratio | There are no (further) constraints on this element Data type | ||
rateQuantity | SimpleQuantity | There are no (further) constraints on this element Data type | ||
eventHistory | I | 0..* | Reference(Provenance) | There are no (further) constraints on this element Element idMedicationAdministration.eventHistory A list of events of interest in the lifecycle DefinitionA summary of the events of interest that have occurred, such as when the administration was verified. This may not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.
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MedicationAdministration | I | MedicationAdministration | Element idMedicationAdministration MedicationAdministration Alternate namesMedicatieToediening DefinitionMedication administration is the registration of the individual administrations of the medicine on the patient by the administrator (e.g. a nurse or patient themselves), in relation to the entered agreements. The NICE registration encompasses two types of data elements: (1) elements that require the amount of the administered product and (2) whether or not a specific kind of medication is administered to the patient. This profile can be used to submit both types. The WG will be updating the MedicationAdministration resource to adjust each affected resource to align with the workflow pattern (see workflow.html).
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id | Σ | 0..1 | id | There are no (further) constraints on this element Element idMedicationAdministration.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
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meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idMedicationAdministration.meta Metadata about the resource DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.
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implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idMedicationAdministration.implicitRules A set of rules under which this content was created DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.
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language | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationAdministration.language Language of the resource content DefinitionThe base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Common Languages (extensible)Constraints
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text | I | 0..1 | Narrative | There are no (further) constraints on this element Element idMedicationAdministration.text Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.
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contained | 0..* | Resource | There are no (further) constraints on this element Element idMedicationAdministration.contained Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.
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extension | I | 2..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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agreedDateTime | I | 0..* | Extension(dateTime) | There are no (further) constraints on this element Element idMedicationAdministration.extension:agreedDateTime AgreedDateTime Alternate namesextensions, user content, AfgesprokenDatumTijd DefinitionDate and time in the medication or administration agreement to which this administration pertains. Since multiple times can be indicated in one medication/administration agreement, this can be used to identify the agreed time in the event of e.g. early administration or a late administration. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://nictiz.nl/fhir/StructureDefinition/zib-MedicationAdministration-AgreedDateTime Constraints
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doubleCheckPerformed | I | 0..1 | Extension(boolean) | There are no (further) constraints on this element Element idMedicationAdministration.extension:doubleCheckPerformed DoubleCheckPerformed Alternate namesextensions, user content, DubbeleControleUitgevoerd DefinitionWas a double check performed prior to the administration? This is only legally required for certain medication. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://nictiz.nl/fhir/StructureDefinition/zib-MedicationAdministration-DoubleCheckPerformed Constraints
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medicationTreatment | I | 0..1 | Extension(Identifier) | There are no (further) constraints on this element Element idMedicationAdministration.extension:medicationTreatment Medicational Treatment Alternate namesextensions, user content, Medicamenteuze behandeling DefinitionThis extension is to describe which overarching medication treatment this information is part of. This is done by the use of an identifier of that medication treatment. No HCIM concept is available for this element. Therefore a mapping to the relevant element Medication Process data element is provided. http://nictiz.nl/fhir/StructureDefinition/zib-Medication-MedicationTreatment Constraints
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deviatingAdministration | I | 0..1 | Extension(Complex) | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Complex) Extension URLhttp://nictiz.nl/fhir/StructureDefinition/zib-MedicationAdministration-DeviatingAdministration Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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deviation | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:deviation DeviatingAdministration Alternate namesextensions, user content, AfwijkendeToediening DefinitionIn the administration, was there a deviation from the medication or administration agreement? This can be a deviation in product, time, amount, route of administration or administering speed or foregoing administration altogether There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:deviation.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:deviation.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:deviation.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
deviation
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valueBoolean | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:deviation.value[x]:valueBoolean Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).
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reasonForDeviation | I | 0..* | ExtensionBinding | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:reasonForDeviation MedicationAdministrationReasonForDeviation Alternate namesextensions, user content, MedicatieToedieningRedenVanAfwijken DefinitionReason why the medication was not taken or administered or was taken or administered differently. Here, you can choose to enter text or one of the codes. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. MedicatieToedieningRedenVanAfwijkenCodelijst (extensible) Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:reasonForDeviation.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:reasonForDeviation.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:reasonForDeviation.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
reasonForDeviation
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valueCodeableConcept | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:reasonForDeviation.value[x]:valueCodeableConcept Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://nictiz.nl/fhir/StructureDefinition/zib-MedicationAdministration-DeviatingAdministration
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value[x] | 0..0 | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.value[x] Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).
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ScoreDay | S I | 1..1 | Extension(Quantity) | Element idMedicationAdministration.extension:ScoreDay ScoreDay Alternate namesextensions, user content DefinitionExtension that is used to indicate the day of scoring. The first 24 hours after admission count as day 1. The next day starts from the first morning shift and lasts 24 hours, so until the start of the next morning shift. Note: Score day 1 can overlap with score day 2, and 'the first morning shift' is specified locally can differ between hospitals. ScoreDay SHALL be submitted if the instance is not about the historical use of the medication. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-ScoreDay-2022Q1 Constraints
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Verified | S I | 1..1 | Extension(CodeableConcept) | Element idMedicationAdministration.extension:Verified Is the instance validated by a medical professional? Alternate namesextensions, user content DefinitionExtension that is used to indicate whether the entire instance has been validated. Every instance shall be validated by a hospital member / datamanager. However, this is not always feasible in case of automated submission of NICE data elements. This extensions shall be used to indicate the validation status of the instance. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-Verified-2022Q1 Constraints
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modifierExtension | ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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identifier | 0..* | Identifier | There are no (further) constraints on this element Element idMedicationAdministration.identifier External identifier DefinitionExternal identifier - FHIR will generate its own internal identifiers (probably URLs) which do not need to be explicitly managed by the resource. The identifier here is one that would be used by another non-FHIR system - for example an automated medication pump would provide a record each time it operated; an administration while the patient was off the ward might be made with a different system and entered after the event. Particularly important if these records have to be updated.
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definition | Σ I | 0..* | Reference(PlanDefinition | ActivityDefinition) | There are no (further) constraints on this element Element idMedicationAdministration.definition Instantiates protocol or definition DefinitionA protocol, guideline, orderset or other definition that was adhered to in whole or in part by this event. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(PlanDefinition | ActivityDefinition) Constraints
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partOf | Σ I | 0..* | Reference(MedicationAdministration | Procedure) | There are no (further) constraints on this element Element idMedicationAdministration.partOf Part of referenced event DefinitionA larger event of which this particular event is a component or step. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(MedicationAdministration | Procedure) Constraints
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status | Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element idMedicationAdministration.status MedicationAdministrationStatus Alternate namesMedicatieToedieningStatus DefinitionThe status of the administration, as a description of the stage within the administering process. Only the status codes ‘completed’ and ‘cancelled’ apply to indivisible products (such as tablets or suppositories). For divisible products (such as infusions), doses can also be ‘suspended’ or ‘aborted’. When documenting this, the following interpretations are used: Active: The product is administered. Interrupted: Use has (temporarily) been interrupted, because of a side effect, for example. Later, the patient and/or doctor can decide whether or not to resume or discontinue use. Discontinued: Administration has stopped. Completed: Administration has been completed. Not started: The product was never administered. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. A set of codes indicating the current status of a MedicationAdministration. MedicationAdministrationStatus (required)Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.status.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.status.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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orderStatus | I | 0..1 | Extension(CodeableConcept) | There are no (further) constraints on this element Element idMedicationAdministration.status.extension:orderStatus OrderStatus Alternate namesextensions, user content, Bevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet., OrderStatus DefinitionThe status of the order / recommendation. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://nictiz.nl/fhir/StructureDefinition/code-specification Constraints
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value | 0..1 | There are no (further) constraints on this element Element idMedicationAdministration.status.value Primitive value for code DefinitionPrimitive value for code 1048576 | ||
category | 1..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idMedicationAdministration.category Type of medication usage DefinitionIndicates the type of medication administration and where the medication is expected to be consumed or administered. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. A coded concept describing where the medication administered is expected to occur MedicationAdministrationCategory (preferred)Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.category.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.category.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idMedicationAdministration.category.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Unordered, Open, by code(Value) Constraints
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MedicationAdministrationCode | Σ | 0..* | Coding | There are no (further) constraints on this element Element idMedicationAdministration.category.coding:MedicationAdministrationCode MedicationAdministrationCode DefinitionCategory snomed code used for indexing/retrieval of the ZIB MedicationAdministration. The SNOMED CT code 422037009 for this resource is stated in the Medication Process v09. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.category.coding:MedicationAdministrationCode.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.category.coding:MedicationAdministrationCode.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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system | Σ | 0..1 | uriFixed Value | There are no (further) constraints on this element Element idMedicationAdministration.category.coding:MedicationAdministrationCode.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
http://snomed.info/sct
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.category.coding:MedicationAdministrationCode.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
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code | Σ | 0..1 | codeFixed Value | There are no (further) constraints on this element Element idMedicationAdministration.category.coding:MedicationAdministrationCode.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings may not exceed 1MB in size
18629005
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.category.coding:MedicationAdministrationCode.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings may not exceed 1MB in size
Administration of drug or medicament (procedure)
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationAdministration.category.coding:MedicationAdministrationCode.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.category.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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medicationReference | Σ | 1..1 | Reference(HCIM PharmaceuticalProduct) | There are no (further) constraints on this element Element idMedicationAdministration.medication[x]:medicationReference AdministrationProduct Alternate namesProduct, Geneesmiddel, Toedieningsproduct DefinitionThe product taken or administered. This is usually medication. Food, blood products, aids and bandages do not strictly fall under the category of medication, but can be reported as well. In principle, this will be the prescribed product, but the administrator may substitute it by replacing the product with an equivalent product. For example: two 50mg tablets can be administered instead of one 100mg tablet. Reference(HCIM PharmaceuticalProduct) Constraints
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subject | Σ I | 1..1 | Reference(nl-core-patient | Group) | There are no (further) constraints on this element Element idMedicationAdministration.subject Who received medication DefinitionThe person or animal or group receiving the medication. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(nl-core-patient | Group) Constraints
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context | I | 0..1 | Reference(Encounter | EpisodeOfCare) | There are no (further) constraints on this element Element idMedicationAdministration.context Encounter or Episode of Care administered as part of DefinitionThe visit, admission or other contact between patient and health care provider the medication administration was performed as part of. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Encounter | EpisodeOfCare) Constraints
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supportingInformation | I | 0..* | Reference(Resource | HCIM Dispense | HCIM PharmaceuticalProduct | HCIM DispenseRequest | HCIM AdministrationAgreement | HCIM MedicationAgreement | HCIM MedicationAdministration) | There are no (further) constraints on this element Element idMedicationAdministration.supportingInformation RelatedAgreement / MedicationAgreement / AdministrationAgreement Alternate namesGerelateerdeAfspraak, Medicatieafspraak, Toedieningsafspraak DefinitionMedication or administration agreement on which this administration.is based. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Resource | HCIM Dispense | HCIM PharmaceuticalProduct | HCIM DispenseRequest | HCIM AdministrationAgreement | HCIM MedicationAgreement | HCIM MedicationAdministration) Constraints
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effective[x] | Σ | 1..1 | There are no (further) constraints on this element Element idMedicationAdministration.effective[x] AdministrationDateTime Alternate namesToedieningsDatumTijd DefinitionThe date and time at which the medication was administered.
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effectiveDateTime | dateTime | There are no (further) constraints on this element Data type | ||
effectivePeriod | Period | There are no (further) constraints on this element Data type | ||
performer | Σ | 0..* | BackboneElement | There are no (further) constraints on this element Element idMedicationAdministration.performer Administrator Alternate namesToediener DefinitionContainer of the Administrator concept. This container contains all data elements of the Administrator concept. The concept describes the person who administered the product. This is a professional authorised administrator, the patient themselves or the caregiver, for example.
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.performer.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.performer.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.performer.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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actor | Σ I | 1..1 | Reference(nl-core-practitioner | nl-core-patient | nl-core-relatedperson | Device) | There are no (further) constraints on this element Element idMedicationAdministration.performer.actor Individual who was performing DefinitionThe device, practitioner, etc. who performed the action. The health professional's specialty, role, and organization are captured and communicated through the PractitionerRole Resource based on the nl-core-practitionerrole profile. Reference(nl-core-practitioner | nl-core-patient | nl-core-relatedperson | Device) Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.performer.actor.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.performer.actor.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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practitionerRole | I | 0..1 | Extension(Reference(nl-core-practitionerrole)) | There are no (further) constraints on this element Element idMedicationAdministration.performer.actor.extension:practitionerRole Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Reference(nl-core-practitionerrole)) Extension URLhttp://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.performer.actor.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idMedicationAdministration.performer.actor.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.performer.actor.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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onBehalfOf | I | 0..1 | Reference(nl-core-organization) | There are no (further) constraints on this element Element idMedicationAdministration.performer.onBehalfOf Organization organization was acting for DefinitionThe organization the device or practitioner was acting on behalf of. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(nl-core-organization) Constraints
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notGiven | Σ ?! | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationAdministration.notGiven True if medication not administered DefinitionSet this to true if the record is saying that the medication was NOT administered. This element is labeled as a modifier because it indicates that a administration didn't happen. If this is missing, then the medication was administered
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reasonNotGiven | I | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationAdministration.reasonNotGiven Reason administration not performed DefinitionA code indicating why the administration was not performed. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. A set of codes indicating the reason why the MedicationAdministration is negated. SNOMED CT Reason Medication Not Given Codes (example)Constraints
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reasonCode | I | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationAdministration.reasonCode Reason administration performed DefinitionA code indicating why the medication was given. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. A set of codes indicating the reason why the MedicationAdministration was made. Reason Medication Given Codes (example)Constraints
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reasonReference | I | 0..* | Reference(Condition | Observation) | There are no (further) constraints on this element Element idMedicationAdministration.reasonReference Condition or Observation that supports why the medication was administered DefinitionCondition or observation that supports why the medication was administered. This is a reference to a condition that is the reason for the medication request. If only a code exists, use reasonCode. Reference(Condition | Observation) Constraints
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prescription | I | 0..1 | Reference(MedicationRequest) | There are no (further) constraints on this element Element idMedicationAdministration.prescription Request administration performed against DefinitionThe original request, instruction or authority to perform the administration. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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device | I | 0..* | Reference(Device) | There are no (further) constraints on this element Element idMedicationAdministration.device Device used to administer DefinitionThe device used in administering the medication to the patient. For example, a particular infusion pump. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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note | 0..* | Annotation | There are no (further) constraints on this element Element idMedicationAdministration.note Comment Alternate namesToelichting DefinitionComments on administering the medication. For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).
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dosage | I | 0..1 | BackboneElement | There are no (further) constraints on this element Element idMedicationAdministration.dosage Details of how medication was taken DefinitionDescribes the medication dosage information details e.g. dose, rate, site, route, etc.
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.dosage.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.dosage.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.dosage.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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text | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.dosage.text Free text dosage instructions e.g. SIG DefinitionFree text dosage can be used for cases where the dosage administered is too complex to code. When coded dosage is present, the free text dosage may still be present for display to humans. The dosage instructions should reflect the dosage of the medication that was administered. Note that FHIR strings may not exceed 1MB in size
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site | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationAdministration.dosage.site Body site administered to DefinitionA coded specification of the anatomic site where the medication first entered the body. For example, "left arm". If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension body-site-instance. May be a summary code, or a reference to a very precise definition of the location, or both. A coded concept describing the site location the medicine enters into or onto the body. SNOMED CT Anatomical Structure for Administration Site Codes (example)Constraints
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route | 1..1 | CodeableConceptBinding | Element idMedicationAdministration.dosage.route RouteOfAdministration Alternate namesToedieningsweg DefinitionThe route through which the medication is administered (oral, nasal, intravenous,...) The original Nictiz valueset describes that all values from the Dutch G-standaard (administration routes) can be submitted. However, NICE can only process the following codes (which is also due to the fact that NICE doens't have to know all specific administration routes):
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. MedicationAdministrationRouteCodeList NICE-AdministrationRouteCodeList (extensible)Constraints
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method | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationAdministration.dosage.method How drug was administered DefinitionA coded value indicating the method by which the medication is intended to be or was introduced into or on the body. This attribute will most often NOT be populated. It is most commonly used for injections. For example, Slow Push, Deep IV. One of the reasons this attribute is not used often, is that the method is often pre-coordinated with the route and/or form of administration. This means the codes used in route or form may pre-coordinate the method in the route code or the form code. The implementation decision about what coding system to use for route or form code will determine how frequently the method code will be populated e.g. if route or form code pre-coordinate method code, then this attribute will not be populated often; if there is no pre-coordination then method code may be used frequently. A coded concept describing the technique by which the medicine is administered. SNOMED CT Administration Method Codes (example)Constraints
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dose | I | 1..1 | SimpleQuantityBinding | Element idMedicationAdministration.dosage.dose AdministeredAmount Alternate namesToegediendeHoeveelheid DefinitionAmount of the administered product NOTE: NICE will not process exact dose values because they are not required to interpret the data dictionary elements. HOWEVER, when sending a MedicationAdministration record/instance this value shall NOT be 0 in order for NICE to process the instance. Otherwise the instance is marked as 'not administered'. If the administration is not instantaneous (rate is present), this can be specified to convey the total amount administered over period of time of a single administration. GstdTabel902 GstdTabel902 (required)Constraints
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rate[x] | I | 0..1 | Element idMedicationAdministration.dosage.rate[x] AdministeringSpeed Alternate namesToedieningssnelheid DefinitionThe administering speed is used in slow administration of liquid. In practice, the measuring unit is almost always ml/hour. For example, with an administering speed of 10ml/hour:
A hospital should only submit the highest dosage rate per ScoreDay as described in the data dictionary. Submission of multiple values will not be processed by NICE. Submitting the administering speed is only relevant for the NICE elements that require administration dosage:
If the rate changes over time, and you want to capture this in MedicationAdministration, then each change should be captured as a distinct MedicationAdministration, with a specific MedicationAdministration.dosage.rate, and the date time when the rate change occurred. Typically, the MedicationAdministration.dosage.rate element is not used to convey an average rate.
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rateRatio | Ratio | There are no (further) constraints on this element Data type | ||
rateQuantity | SimpleQuantity | There are no (further) constraints on this element Data type | ||
eventHistory | I | 0..* | Reference(Provenance) | There are no (further) constraints on this element Element idMedicationAdministration.eventHistory A list of events of interest in the lifecycle DefinitionA summary of the events of interest that have occurred, such as when the administration was verified. This may not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.
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MedicationAdministration | I | MedicationAdministration | Element idMedicationAdministration MedicationAdministration Alternate namesMedicatieToediening DefinitionMedication administration is the registration of the individual administrations of the medicine on the patient by the administrator (e.g. a nurse or patient themselves), in relation to the entered agreements. The NICE registration encompasses two types of data elements: (1) elements that require the amount of the administered product and (2) whether or not a specific kind of medication is administered to the patient. This profile can be used to submit both types. The WG will be updating the MedicationAdministration resource to adjust each affected resource to align with the workflow pattern (see workflow.html).
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id | Σ | 0..1 | id | There are no (further) constraints on this element Element idMedicationAdministration.id Logical id of this artifact DefinitionThe logical id of the resource, as used in the URL for the resource. Once assigned, this value never changes. The only time that a resource does not have an id is when it is being submitted to the server using a create operation.
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meta | Σ | 0..1 | Meta | There are no (further) constraints on this element Element idMedicationAdministration.meta Metadata about the resource DefinitionThe metadata about the resource. This is content that is maintained by the infrastructure. Changes to the content may not always be associated with version changes to the resource.
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implicitRules | Σ ?! | 0..1 | uri | There are no (further) constraints on this element Element idMedicationAdministration.implicitRules A set of rules under which this content was created DefinitionA reference to a set of rules that were followed when the resource was constructed, and which must be understood when processing the content. Asserting this rule set restricts the content to be only understood by a limited set of trading partners. This inherently limits the usefulness of the data in the long term. However, the existing health eco-system is highly fractured, and not yet ready to define, collect, and exchange data in a generally computable sense. Wherever possible, implementers and/or specification writers should avoid using this element. This element is labelled as a modifier because the implicit rules may provide additional knowledge about the resource that modifies it's meaning or interpretation.
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language | 0..1 | codeBinding | There are no (further) constraints on this element Element idMedicationAdministration.language Language of the resource content DefinitionThe base language in which the resource is written. Language is provided to support indexing and accessibility (typically, services such as text to speech use the language tag). The html language tag in the narrative applies to the narrative. The language tag on the resource may be used to specify the language of other presentations generated from the data in the resource Not all the content has to be in the base language. The Resource.language should not be assumed to apply to the narrative automatically. If a language is specified, it should it also be specified on the div element in the html (see rules in HTML5 for information about the relationship between xml:lang and the html lang attribute). A human language. Common Languages (extensible)Constraints
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text | I | 0..1 | Narrative | There are no (further) constraints on this element Element idMedicationAdministration.text Text summary of the resource, for human interpretation Alternate namesnarrative, html, xhtml, display DefinitionA human-readable narrative that contains a summary of the resource, and may be used to represent the content of the resource to a human. The narrative need not encode all the structured data, but is required to contain sufficient detail to make it "clinically safe" for a human to just read the narrative. Resource definitions may define what content should be represented in the narrative to ensure clinical safety. Contained resources do not have narrative. Resources that are not contained SHOULD have a narrative. In some cases, a resource may only have text with little or no additional discrete data (as long as all minOccurs=1 elements are satisfied). This may be necessary for data from legacy systems where information is captured as a "text blob" or where text is additionally entered raw or narrated and encoded in formation is added later.
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contained | 0..* | Resource | There are no (further) constraints on this element Element idMedicationAdministration.contained Contained, inline Resources Alternate namesinline resources, anonymous resources, contained resources DefinitionThese resources do not have an independent existence apart from the resource that contains them - they cannot be identified independently, and nor can they have their own independent transaction scope. This should never be done when the content can be identified properly, as once identification is lost, it is extremely difficult (and context dependent) to restore it again.
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extension | I | 2..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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agreedDateTime | I | 0..* | Extension(dateTime) | There are no (further) constraints on this element Element idMedicationAdministration.extension:agreedDateTime AgreedDateTime Alternate namesextensions, user content, AfgesprokenDatumTijd DefinitionDate and time in the medication or administration agreement to which this administration pertains. Since multiple times can be indicated in one medication/administration agreement, this can be used to identify the agreed time in the event of e.g. early administration or a late administration. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://nictiz.nl/fhir/StructureDefinition/zib-MedicationAdministration-AgreedDateTime Constraints
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doubleCheckPerformed | I | 0..1 | Extension(boolean) | There are no (further) constraints on this element Element idMedicationAdministration.extension:doubleCheckPerformed DoubleCheckPerformed Alternate namesextensions, user content, DubbeleControleUitgevoerd DefinitionWas a double check performed prior to the administration? This is only legally required for certain medication. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://nictiz.nl/fhir/StructureDefinition/zib-MedicationAdministration-DoubleCheckPerformed Constraints
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medicationTreatment | I | 0..1 | Extension(Identifier) | There are no (further) constraints on this element Element idMedicationAdministration.extension:medicationTreatment Medicational Treatment Alternate namesextensions, user content, Medicamenteuze behandeling DefinitionThis extension is to describe which overarching medication treatment this information is part of. This is done by the use of an identifier of that medication treatment. No HCIM concept is available for this element. Therefore a mapping to the relevant element Medication Process data element is provided. http://nictiz.nl/fhir/StructureDefinition/zib-Medication-MedicationTreatment Constraints
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deviatingAdministration | I | 0..1 | Extension(Complex) | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Complex) Extension URLhttp://nictiz.nl/fhir/StructureDefinition/zib-MedicationAdministration-DeviatingAdministration Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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deviation | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:deviation DeviatingAdministration Alternate namesextensions, user content, AfwijkendeToediening DefinitionIn the administration, was there a deviation from the medication or administration agreement? This can be a deviation in product, time, amount, route of administration or administering speed or foregoing administration altogether There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:deviation.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:deviation.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:deviation.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
deviation
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valueBoolean | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:deviation.value[x]:valueBoolean Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).
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reasonForDeviation | I | 0..* | ExtensionBinding | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:reasonForDeviation MedicationAdministrationReasonForDeviation Alternate namesextensions, user content, MedicatieToedieningRedenVanAfwijken DefinitionReason why the medication was not taken or administered or was taken or administered differently. Here, you can choose to enter text or one of the codes. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. MedicatieToedieningRedenVanAfwijkenCodelijst (extensible) Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:reasonForDeviation.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:reasonForDeviation.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:reasonForDeviation.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
reasonForDeviation
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valueCodeableConcept | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.extension:reasonForDeviation.value[x]:valueCodeableConcept Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).
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url | 1..1 | uriFixed Value | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.url identifies the meaning of the extension DefinitionSource of the definition for the extension code - a logical name or a URL. The definition may point directly to a computable or human-readable definition of the extensibility codes, or it may be a logical URI as declared in some other specification. The definition SHALL be a URI for the Structure Definition defining the extension.
http://nictiz.nl/fhir/StructureDefinition/zib-MedicationAdministration-DeviatingAdministration
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value[x] | 0..0 | There are no (further) constraints on this element Element idMedicationAdministration.extension:deviatingAdministration.value[x] Value of extension DefinitionValue of extension - may be a resource or one of a constrained set of the data types (see Extensibility in the spec for list).
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ScoreDay | S I | 1..1 | Extension(Quantity) | Element idMedicationAdministration.extension:ScoreDay ScoreDay Alternate namesextensions, user content DefinitionExtension that is used to indicate the day of scoring. The first 24 hours after admission count as day 1. The next day starts from the first morning shift and lasts 24 hours, so until the start of the next morning shift. Note: Score day 1 can overlap with score day 2, and 'the first morning shift' is specified locally can differ between hospitals. ScoreDay SHALL be submitted if the instance is not about the historical use of the medication. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-ScoreDay-2022Q1 Constraints
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Verified | S I | 1..1 | Extension(CodeableConcept) | Element idMedicationAdministration.extension:Verified Is the instance validated by a medical professional? Alternate namesextensions, user content DefinitionExtension that is used to indicate whether the entire instance has been validated. Every instance shall be validated by a hospital member / datamanager. However, this is not always feasible in case of automated submission of NICE data elements. This extensions shall be used to indicate the validation status of the instance. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-Verified-2022Q1 Constraints
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modifierExtension | ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the resource, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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identifier | 0..* | Identifier | There are no (further) constraints on this element Element idMedicationAdministration.identifier External identifier DefinitionExternal identifier - FHIR will generate its own internal identifiers (probably URLs) which do not need to be explicitly managed by the resource. The identifier here is one that would be used by another non-FHIR system - for example an automated medication pump would provide a record each time it operated; an administration while the patient was off the ward might be made with a different system and entered after the event. Particularly important if these records have to be updated.
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definition | Σ I | 0..* | Reference(PlanDefinition | ActivityDefinition) | There are no (further) constraints on this element Element idMedicationAdministration.definition Instantiates protocol or definition DefinitionA protocol, guideline, orderset or other definition that was adhered to in whole or in part by this event. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(PlanDefinition | ActivityDefinition) Constraints
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partOf | Σ I | 0..* | Reference(MedicationAdministration | Procedure) | There are no (further) constraints on this element Element idMedicationAdministration.partOf Part of referenced event DefinitionA larger event of which this particular event is a component or step. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(MedicationAdministration | Procedure) Constraints
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status | Σ ?! | 1..1 | codeBinding | There are no (further) constraints on this element Element idMedicationAdministration.status MedicationAdministrationStatus Alternate namesMedicatieToedieningStatus DefinitionThe status of the administration, as a description of the stage within the administering process. Only the status codes ‘completed’ and ‘cancelled’ apply to indivisible products (such as tablets or suppositories). For divisible products (such as infusions), doses can also be ‘suspended’ or ‘aborted’. When documenting this, the following interpretations are used: Active: The product is administered. Interrupted: Use has (temporarily) been interrupted, because of a side effect, for example. Later, the patient and/or doctor can decide whether or not to resume or discontinue use. Discontinued: Administration has stopped. Completed: Administration has been completed. Not started: The product was never administered. This element is labeled as a modifier because the status contains codes that mark the resource as not currently valid. A set of codes indicating the current status of a MedicationAdministration. MedicationAdministrationStatus (required)Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.status.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.status.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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orderStatus | I | 0..1 | Extension(CodeableConcept) | There are no (further) constraints on this element Element idMedicationAdministration.status.extension:orderStatus OrderStatus Alternate namesextensions, user content, Bevat de specifieke code conform de zib, bij een FHIR-element die een verplichte koppeling heeft met een bepaalde FHIR waardelijst of een FHIR element die niet gecodeerd is gedefinieerd, terwijl de zib dit wel doet., OrderStatus DefinitionThe status of the order / recommendation. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. http://nictiz.nl/fhir/StructureDefinition/code-specification Constraints
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value | 0..1 | There are no (further) constraints on this element Element idMedicationAdministration.status.value Primitive value for code DefinitionPrimitive value for code 1048576 | ||
category | 1..1 | CodeableConceptBinding | There are no (further) constraints on this element Element idMedicationAdministration.category Type of medication usage DefinitionIndicates the type of medication administration and where the medication is expected to be consumed or administered. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. A coded concept describing where the medication administered is expected to occur MedicationAdministrationCategory (preferred)Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.category.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.category.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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coding | Σ | 0..* | Coding | There are no (further) constraints on this element Element idMedicationAdministration.category.coding Code defined by a terminology system DefinitionA reference to a code defined by a terminology system. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true. Unordered, Open, by code(Value) Constraints
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MedicationAdministrationCode | Σ | 0..* | Coding | There are no (further) constraints on this element Element idMedicationAdministration.category.coding:MedicationAdministrationCode MedicationAdministrationCode DefinitionCategory snomed code used for indexing/retrieval of the ZIB MedicationAdministration. The SNOMED CT code 422037009 for this resource is stated in the Medication Process v09. Allows for translations and alternate encodings within a code system. Also supports communication of the same instance to systems requiring different encodings. Codes may be defined very casually in enumerations, or code lists, up to very formal definitions such as SNOMED CT - see the HL7 v3 Core Principles for more information. Ordering of codings is undefined and SHALL NOT be used to infer meaning. Generally, at most only one of the coding values will be labeled as UserSelected = true.
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.category.coding:MedicationAdministrationCode.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.category.coding:MedicationAdministrationCode.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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system | Σ | 0..1 | uriFixed Value | There are no (further) constraints on this element Element idMedicationAdministration.category.coding:MedicationAdministrationCode.system Identity of the terminology system DefinitionThe identification of the code system that defines the meaning of the symbol in the code. Need to be unambiguous about the source of the definition of the symbol. The URI may be an OID (urn:oid:...) or a UUID (urn:uuid:...). OIDs and UUIDs SHALL be references to the HL7 OID registry. Otherwise, the URI should come from HL7's list of FHIR defined special URIs or it should de-reference to some definition that establish the system clearly and unambiguously.
http://snomed.info/sct
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version | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.category.coding:MedicationAdministrationCode.version Version of the system - if relevant DefinitionThe version of the code system which was used when choosing this code. Note that a well-maintained code system does not need the version reported, because the meaning of codes is consistent across versions. However this cannot consistently be assured. and when the meaning is not guaranteed to be consistent, the version SHOULD be exchanged. Where the terminology does not clearly define what string should be used to identify code system versions, the recommendation is to use the date (expressed in FHIR date format) on which that version was officially published as the version date.
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code | Σ | 0..1 | codeFixed Value | There are no (further) constraints on this element Element idMedicationAdministration.category.coding:MedicationAdministrationCode.code Symbol in syntax defined by the system DefinitionA symbol in syntax defined by the system. The symbol may be a predefined code or an expression in a syntax defined by the coding system (e.g. post-coordination). Need to refer to a particular code in the system. Note that FHIR strings may not exceed 1MB in size
18629005
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.category.coding:MedicationAdministrationCode.display Representation defined by the system DefinitionA representation of the meaning of the code in the system, following the rules of the system. Need to be able to carry a human-readable meaning of the code for readers that do not know the system. Note that FHIR strings may not exceed 1MB in size
Administration of drug or medicament (procedure)
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userSelected | Σ | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationAdministration.category.coding:MedicationAdministrationCode.userSelected If this coding was chosen directly by the user DefinitionIndicates that this coding was chosen by a user directly - i.e. off a pick list of available items (codes or displays). This has been identified as a clinical safety criterium - that this exact system/code pair was chosen explicitly, rather than inferred by the system based on some rules or language processing. Amongst a set of alternatives, a directly chosen code is the most appropriate starting point for new translations. There is some ambiguity about what exactly 'directly chosen' implies, and trading partner agreement may be needed to clarify the use of this element and its consequences more completely.
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text | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.category.text Plain text representation of the concept DefinitionA human language representation of the concept as seen/selected/uttered by the user who entered the data and/or which represents the intended meaning of the user. The codes from the terminologies do not always capture the correct meaning with all the nuances of the human using them, or sometimes there is no appropriate code at all. In these cases, the text is used to capture the full meaning of the source. Very often the text is the same as a displayName of one of the codings.
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medicationReference | Σ | 1..1 | Reference(HCIM PharmaceuticalProduct) | There are no (further) constraints on this element Element idMedicationAdministration.medication[x]:medicationReference AdministrationProduct Alternate namesProduct, Geneesmiddel, Toedieningsproduct DefinitionThe product taken or administered. This is usually medication. Food, blood products, aids and bandages do not strictly fall under the category of medication, but can be reported as well. In principle, this will be the prescribed product, but the administrator may substitute it by replacing the product with an equivalent product. For example: two 50mg tablets can be administered instead of one 100mg tablet. Reference(HCIM PharmaceuticalProduct) Constraints
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subject | Σ I | 1..1 | Reference(nl-core-patient | Group) | There are no (further) constraints on this element Element idMedicationAdministration.subject Who received medication DefinitionThe person or animal or group receiving the medication. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(nl-core-patient | Group) Constraints
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context | I | 0..1 | Reference(Encounter | EpisodeOfCare) | There are no (further) constraints on this element Element idMedicationAdministration.context Encounter or Episode of Care administered as part of DefinitionThe visit, admission or other contact between patient and health care provider the medication administration was performed as part of. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Encounter | EpisodeOfCare) Constraints
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supportingInformation | I | 0..* | Reference(Resource | HCIM Dispense | HCIM PharmaceuticalProduct | HCIM DispenseRequest | HCIM AdministrationAgreement | HCIM MedicationAgreement | HCIM MedicationAdministration) | There are no (further) constraints on this element Element idMedicationAdministration.supportingInformation RelatedAgreement / MedicationAgreement / AdministrationAgreement Alternate namesGerelateerdeAfspraak, Medicatieafspraak, Toedieningsafspraak DefinitionMedication or administration agreement on which this administration.is based. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(Resource | HCIM Dispense | HCIM PharmaceuticalProduct | HCIM DispenseRequest | HCIM AdministrationAgreement | HCIM MedicationAgreement | HCIM MedicationAdministration) Constraints
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effective[x] | Σ | 1..1 | There are no (further) constraints on this element Element idMedicationAdministration.effective[x] AdministrationDateTime Alternate namesToedieningsDatumTijd DefinitionThe date and time at which the medication was administered.
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effectiveDateTime | dateTime | There are no (further) constraints on this element Data type | ||
effectivePeriod | Period | There are no (further) constraints on this element Data type | ||
performer | Σ | 0..* | BackboneElement | There are no (further) constraints on this element Element idMedicationAdministration.performer Administrator Alternate namesToediener DefinitionContainer of the Administrator concept. This container contains all data elements of the Administrator concept. The concept describes the person who administered the product. This is a professional authorised administrator, the patient themselves or the caregiver, for example.
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.performer.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.performer.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.performer.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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actor | Σ I | 1..1 | Reference(nl-core-practitioner | nl-core-patient | nl-core-relatedperson | Device) | There are no (further) constraints on this element Element idMedicationAdministration.performer.actor Individual who was performing DefinitionThe device, practitioner, etc. who performed the action. The health professional's specialty, role, and organization are captured and communicated through the PractitionerRole Resource based on the nl-core-practitionerrole profile. Reference(nl-core-practitioner | nl-core-patient | nl-core-relatedperson | Device) Constraints
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.performer.actor.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.performer.actor.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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practitionerRole | I | 0..1 | Extension(Reference(nl-core-practitionerrole)) | There are no (further) constraints on this element Element idMedicationAdministration.performer.actor.extension:practitionerRole Optional Extensions Element Alternate namesextensions, user content DefinitionOptional Extension Element - found in all resources. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Extension(Reference(nl-core-practitionerrole)) Extension URLhttp://nictiz.nl/fhir/StructureDefinition/practitionerrole-reference Constraints
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reference | Σ I | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.performer.actor.reference Literal reference, Relative, internal or absolute URL DefinitionA reference to a location at which the other resource is found. The reference may be a relative reference, in which case it is relative to the service base URL, or an absolute URL that resolves to the location where the resource is found. The reference may be version specific or not. If the reference is not to a FHIR RESTful server, then it should be assumed to be version specific. Internal fragment references (start with '#') refer to contained resources. Using absolute URLs provides a stable scalable approach suitable for a cloud/web context, while using relative/logical references provides a flexible approach suitable for use when trading across closed eco-system boundaries. Absolute URLs do not need to point to a FHIR RESTful server, though this is the preferred approach. If the URL conforms to the structure "/[type]/[id]" then it should be assumed that the reference is to a FHIR RESTful server.
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identifier | Σ | 0..1 | Identifier | There are no (further) constraints on this element Element idMedicationAdministration.performer.actor.identifier Logical reference, when literal reference is not known DefinitionAn identifier for the other resource. This is used when there is no way to reference the other resource directly, either because the entity is not available through a FHIR server, or because there is no way for the author of the resource to convert a known identifier to an actual location. There is no requirement that a Reference.identifier point to something that is actually exposed as a FHIR instance, but it SHALL point to a business concept that would be expected to be exposed as a FHIR instance, and that instance would need to be of a FHIR resource type allowed by the reference. When an identifier is provided in place of a reference, any system processing the reference will only be able to resolve the identifier to a reference if it understands the business context in which the identifier is used. Sometimes this is global (e.g. a national identifier) but often it is not. For this reason, none of the useful mechanisms described for working with references (e.g. chaining, includes) are possible, nor should servers be expected to be able resolve the reference. Servers may accept an identifier based reference untouched, resolve it, and/or reject it - see CapabilityStatement.rest.resource.referencePolicy. When both an identifier and a literal reference are provided, the literal reference is preferred. Applications processing the resource are allowed - but not required - to check that the identifier matches the literal reference Applications converting a logical reference to a literal reference may choose to leave the logical reference present, or remove it.
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display | Σ | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.performer.actor.display Text alternative for the resource DefinitionPlain text narrative that identifies the resource in addition to the resource reference. This is generally not the same as the Resource.text of the referenced resource. The purpose is to identify what's being referenced, not to fully describe it.
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onBehalfOf | I | 0..1 | Reference(nl-core-organization) | There are no (further) constraints on this element Element idMedicationAdministration.performer.onBehalfOf Organization organization was acting for DefinitionThe organization the device or practitioner was acting on behalf of. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository. Reference(nl-core-organization) Constraints
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notGiven | Σ ?! | 0..1 | boolean | There are no (further) constraints on this element Element idMedicationAdministration.notGiven True if medication not administered DefinitionSet this to true if the record is saying that the medication was NOT administered. This element is labeled as a modifier because it indicates that a administration didn't happen. If this is missing, then the medication was administered
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reasonNotGiven | I | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationAdministration.reasonNotGiven Reason administration not performed DefinitionA code indicating why the administration was not performed. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. A set of codes indicating the reason why the MedicationAdministration is negated. SNOMED CT Reason Medication Not Given Codes (example)Constraints
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reasonCode | I | 0..* | CodeableConcept | There are no (further) constraints on this element Element idMedicationAdministration.reasonCode Reason administration performed DefinitionA code indicating why the medication was given. Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. A set of codes indicating the reason why the MedicationAdministration was made. Reason Medication Given Codes (example)Constraints
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reasonReference | I | 0..* | Reference(Condition | Observation) | There are no (further) constraints on this element Element idMedicationAdministration.reasonReference Condition or Observation that supports why the medication was administered DefinitionCondition or observation that supports why the medication was administered. This is a reference to a condition that is the reason for the medication request. If only a code exists, use reasonCode. Reference(Condition | Observation) Constraints
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prescription | I | 0..1 | Reference(MedicationRequest) | There are no (further) constraints on this element Element idMedicationAdministration.prescription Request administration performed against DefinitionThe original request, instruction or authority to perform the administration. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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device | I | 0..* | Reference(Device) | There are no (further) constraints on this element Element idMedicationAdministration.device Device used to administer DefinitionThe device used in administering the medication to the patient. For example, a particular infusion pump. References SHALL be a reference to an actual FHIR resource, and SHALL be resolveable (allowing for access control, temporary unavailability, etc). Resolution can be either by retrieval from the URL, or, where applicable by resource type, by treating an absolute reference as a canonical URL and looking it up in a local registry/repository.
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note | 0..* | Annotation | There are no (further) constraints on this element Element idMedicationAdministration.note Comment Alternate namesToelichting DefinitionComments on administering the medication. For systems that do not have structured annotations, they can simply communicate a single annotation with no author or time. This element may need to be included in narrative because of the potential for modifying information. Annotations SHOULD NOT be used to communicate "modifying" information that could be computable. (This is a SHOULD because enforcing user behavior is nearly impossible).
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dosage | I | 0..1 | BackboneElement | There are no (further) constraints on this element Element idMedicationAdministration.dosage Details of how medication was taken DefinitionDescribes the medication dosage information details e.g. dose, rate, site, route, etc.
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id | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.dosage.id xml:id (or equivalent in JSON) Definitionunique id for the element within a resource (for internal references). This may be any string value that does not contain spaces. Note that FHIR strings may not exceed 1MB in size
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extension | I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.dosage.extension Additional Content defined by implementations Alternate namesextensions, user content DefinitionMay be used to represent additional information that is not part of the basic definition of the element. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone. Unordered, Open, by url(Value) Extensions are always sliced by (at least) url Constraints
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modifierExtension | Σ ?! I | 0..* | Extension | There are no (further) constraints on this element Element idMedicationAdministration.dosage.modifierExtension Extensions that cannot be ignored Alternate namesextensions, user content, modifiers DefinitionMay be used to represent additional information that is not part of the basic definition of the element, and that modifies the understanding of the element that contains it. Usually modifier elements provide negation or qualification. In order to make the use of extensions safe and manageable, there is a strict set of governance applied to the definition and use of extensions. Though any implementer is allowed to define an extension, there is a set of requirements that SHALL be met as part of the definition of the extension. Applications processing a resource are required to check for modifier extensions. There can be no stigma associated with the use of extensions by any application, project, or standard - regardless of the institution or jurisdiction that uses or defines the extensions. The use of extensions is what allows the FHIR specification to retain a core level of simplicity for everyone.
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text | 0..1 | string | There are no (further) constraints on this element Element idMedicationAdministration.dosage.text Free text dosage instructions e.g. SIG DefinitionFree text dosage can be used for cases where the dosage administered is too complex to code. When coded dosage is present, the free text dosage may still be present for display to humans. The dosage instructions should reflect the dosage of the medication that was administered. Note that FHIR strings may not exceed 1MB in size
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site | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationAdministration.dosage.site Body site administered to DefinitionA coded specification of the anatomic site where the medication first entered the body. For example, "left arm". If the use case requires attributes from the BodySite resource (e.g. to identify and track separately) then use the standard extension body-site-instance. May be a summary code, or a reference to a very precise definition of the location, or both. A coded concept describing the site location the medicine enters into or onto the body. SNOMED CT Anatomical Structure for Administration Site Codes (example)Constraints
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route | 1..1 | CodeableConceptBinding | Element idMedicationAdministration.dosage.route RouteOfAdministration Alternate namesToedieningsweg DefinitionThe route through which the medication is administered (oral, nasal, intravenous,...) The original Nictiz valueset describes that all values from the Dutch G-standaard (administration routes) can be submitted. However, NICE can only process the following codes (which is also due to the fact that NICE doens't have to know all specific administration routes):
Not all terminology uses fit this general pattern. In some cases, models should not use CodeableConcept and use Coding directly and provide their own structure for managing text, codings, translations and the relationship between elements and pre- and post-coordination. MedicationAdministrationRouteCodeList NICE-AdministrationRouteCodeList (extensible)Constraints
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method | 0..1 | CodeableConcept | There are no (further) constraints on this element Element idMedicationAdministration.dosage.method How drug was administered DefinitionA coded value indicating the method by which the medication is intended to be or was introduced into or on the body. This attribute will most often NOT be populated. It is most commonly used for injections. For example, Slow Push, Deep IV. One of the reasons this attribute is not used often, is that the method is often pre-coordinated with the route and/or form of administration. This means the codes used in route or form may pre-coordinate the method in the route code or the form code. The implementation decision about what coding system to use for route or form code will determine how frequently the method code will be populated e.g. if route or form code pre-coordinate method code, then this attribute will not be populated often; if there is no pre-coordination then method code may be used frequently. A coded concept describing the technique by which the medicine is administered. SNOMED CT Administration Method Codes (example)Constraints
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dose | I | 1..1 | SimpleQuantityBinding | Element idMedicationAdministration.dosage.dose AdministeredAmount Alternate namesToegediendeHoeveelheid DefinitionAmount of the administered product NOTE: NICE will not process exact dose values because they are not required to interpret the data dictionary elements. HOWEVER, when sending a MedicationAdministration record/instance this value shall NOT be 0 in order for NICE to process the instance. Otherwise the instance is marked as 'not administered'. If the administration is not instantaneous (rate is present), this can be specified to convey the total amount administered over period of time of a single administration. GstdTabel902 GstdTabel902 (required)Constraints
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rate[x] | I | 0..1 | Element idMedicationAdministration.dosage.rate[x] AdministeringSpeed Alternate namesToedieningssnelheid DefinitionThe administering speed is used in slow administration of liquid. In practice, the measuring unit is almost always ml/hour. For example, with an administering speed of 10ml/hour:
A hospital should only submit the highest dosage rate per ScoreDay as described in the data dictionary. Submission of multiple values will not be processed by NICE. Submitting the administering speed is only relevant for the NICE elements that require administration dosage:
If the rate changes over time, and you want to capture this in MedicationAdministration, then each change should be captured as a distinct MedicationAdministration, with a specific MedicationAdministration.dosage.rate, and the date time when the rate change occurred. Typically, the MedicationAdministration.dosage.rate element is not used to convey an average rate.
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rateRatio | Ratio | There are no (further) constraints on this element Data type | ||
rateQuantity | SimpleQuantity | There are no (further) constraints on this element Data type | ||
eventHistory | I | 0..* | Reference(Provenance) | There are no (further) constraints on this element Element idMedicationAdministration.eventHistory A list of events of interest in the lifecycle DefinitionA summary of the events of interest that have occurred, such as when the administration was verified. This may not include provenances for all versions of the request – only those deemed “relevant” or important. This SHALL NOT include the Provenance associated with this current version of the resource. (If that provenance is deemed to be a “relevant” change, it will need to be added as part of a later update. Until then, it can be queried directly as the Provenance that points to this version using _revinclude All Provenances should have some historical version of this Request as their subject.
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Mapping FHIR profile NICE data dictionary
Path | identity | map | comment |
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MedicationAdministration.dosage.route | NICE-Datadictionary-MDS | https://www.stichting-nice.nl/dd/#432 | Vasoactive medication |
MedicationAdministration.dosage.route | NICE-Datadictionary-Capacity | https://www.stichting-nice.nl/dd/#576 | Administration of arterial medication |
MedicationAdministration.dosage.route | NICE-Datadictionary-Capacity | https://www.stichting-nice.nl/dd/#572 | Continuous intravenous administration of antiarrythmics |
MedicationAdministration.dosage.route | NICE-Datadictionary-Capacity | https://www.stichting-nice.nl/dd/#599 | Anticoagulation |
MedicationAdministration.dosage.route | NICE-Datadictionary-Capacity | https://www.stichting-nice.nl/dd/#611 | Nutrition - parenteral |
MedicationAdministration.dosage.route | NICE-Datadictionary-Capacity | https://www.stichting-nice.nl/dd/#625 | Antibiotics (IV) |
MedicationAdministration.dosage.rate[x] | NICE-Datadictionary-SOFA | https://www.stichting-nice.nl/dd/#18 | Highest adrenaline speed (SOFA) |
MedicationAdministration.dosage.rate[x] | NICE-Datadictionary-SOFA | https://www.stichting-nice.nl/dd/#224 | Highest noradrenaline speed (SOFA) |
MedicationAdministration.dosage.rate[x] | NICE-Datadictionary-SOFA | https://www.stichting-nice.nl/dd/#94 | Highest dopamine speed |
MedicationAdministration.dosage.rate[x] | NICE-Datadictionary-Sepsis | https://www.stichting-nice.nl/dd/#740 | Highest dopamine speed (Sepsis) |
MedicationAdministration.dosage.rate[x] | NICE-Datadictionary-Sepsis | https://www.stichting-nice.nl/dd/#744 | Highest adrenaline speed (Sepsis) |
MedicationAdministration.dosage.rate[x] | NICE-Datadictionary-Sepsis | https://www.stichting-nice.nl/dd/#745 | Highest noradrenaline speed (Sepsis) |
{ "resourceType": "MedicationAdministration", "id": "NICE-MedicationAdministration-Example-01", "meta": { "profile": [ "https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-MedicationAdministration-2022Q1" ] }, "text": { --- We have skipped the narrative for better readability of the resource --- }, "extension": [ { "url": "https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-Verified-2022Q1", "valueCodeableConcept": { "coding": [ { "system": "http://terminology.hl7.org/ValueSet/v2-0532", "code": "Y", "display": "Yes" } ] } }, { "url": "https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-ScoreDay-2022Q1", "valueInteger": 2 } ], "status": "completed", "category": { "coding": [ { "system": "http://snomed.info/sct", "code": "18629005", "display": "Administration of medication" } ] }, "medicationReference": { "reference": "Medication/NICE-Medication-Example-01", "display": "dobutamine (C01CA07)" }, "subject": { "reference": "Patient/NICE-Patient-01", "display": "P. Petersen" }, "effectiveDateTime": "2022-01-07", "dosage": { "route": { "coding": [ { "system": "https://www.z-index.nl/g-standaard", "code": "75", "display": "Intraveneus" } ] }, "dose": { "value": 1, "unit": "stuk", "system": "urn:oid:2.16.840.1.113883.2.4.4.1.900.2", "code": "245" }, "rateRatio": { "numerator": { "value": 10, "unit": "milliliter", "system": "urn:oid:2.16.840.1.113883.2.4.4.1.900.2", "code": "233" }, "denominator": { "value": 1, "unit": "uur", "system": "http://unitsofmeasure.org", "code": "h" } } } }
<MedicationAdministration xmlns="http://hl7.org/fhir"> <id value="NICE-MedicationAdministration-Example-01" /> <meta> <profile value="https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-MedicationAdministration-2022Q1" /> </meta> <text> <status /> --- We have skipped the narrative for better readability of the resource --- </text> <extension url="https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-Verified-2022Q1"> <valueCodeableConcept> <coding> <system value="http://terminology.hl7.org/ValueSet/v2-0532" /> <code value="Y" /> <display value="Yes" /> </coding> </valueCodeableConcept> </extension> <extension url="https://fhir.stichting-nice.nl/STU3/StructureDefinition/NICE-ScoreDay-2022Q1"> <valueInteger value="2" /> </extension> <status value="completed" /> <category> <coding> <system value="http://snomed.info/sct" /> <code value="18629005" /> <display value="Administration of medication" /> </coding> </category> <medicationReference> <reference value="Medication/NICE-Medication-Example-01" /> <display value="dobutamine (C01CA07)" /> </medicationReference> <subject> <reference value="Patient/NICE-Patient-01" /> <display value="P. Petersen" /> </subject> <effectiveDateTime value="2022-01-07" /> <dosage> <route> <coding> <system value="https://www.z-index.nl/g-standaard" /> <code value="75" /> <display value="Intraveneus" /> </coding> </route> <dose> <value value="1" /> <unit value="stuk" /> <system value="urn:oid:2.16.840.1.113883.2.4.4.1.900.2" /> <code value="245" /> </dose> <rateRatio> <numerator> <value value="10" /> <unit value="milliliter" /> <system value="urn:oid:2.16.840.1.113883.2.4.4.1.900.2" /> <code value="233" /> </numerator> <denominator> <value value="1" /> <unit value="uur" /> <system value="http://unitsofmeasure.org" /> <code value="h" /> </denominator> </rateRatio> </dosage> </MedicationAdministration>