Dosage Examples - Infusions
To illustrate how the FHIR Dosage
structure should be used for inpatient infusion use cases.
Infusions are complex because they may be dispensed and prepared in three ways;
- Dispensed and prepared by the hospital pharmacy and delivered to the ward
- Dispensed by the hospital pharmacy and prepared on the ward
- Dispensed by the hospital pharmacy as a pre-prepared and dm+d coded product for the ward
This difference changes the use of the MedicationDispense
resources. The initiating MedicationRequest
and any resulting MedicationAdministration
resource should not be different due to the above but we will verify this as part of creating these implementation guidance examples.
Ceftriaxone continuous infusion
Clinical Scenario
The patient requires 1 gram of Ceftriaxone to be infused over 30 minutes, once a day, for 5 days, for pneumonia.
Prescribing Event
This MedicationRequest
is created by the EPMA system for the prescription/order for Ceftriaxone via an infusion. This resource would be made available to the hospital pharmacy.
<MedicationRequest xmlns="http://hl7.org/fhir"> <id value="34eb3c92-76e6-48c2-9691-aa1f0b58369b" /> <meta> <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" /> </meta> <medicationCodeableConcept> <coding> <system value="https://dmd.nhs.uk" /> <code value="19841008" /> <display value="Ceftriaxone" /> </coding> </medicationCodeableConcept> <subject> <reference value="Patient/UKCore-Patient-RichardSmith-Example" /> </subject> <reasonCode> <coding> <system value="http://snomed.info/sct" /> <code value="233604007" /> <display value="Pneumonia" /> </coding> </reasonCode> <dosageInstruction> <text value="Continuous infusion 1 gram - Intravenous - over 30 minutes - daily - for 5 days" /> <timing> <repeat> <boundsDuration> <value value="5" /> <unit value="day" /> <system value="http://unitsofmeasure.org" /> <code value="d" /> </boundsDuration> <duration value="30" /> <durationUnit value="min" /> <frequency value="1" /> <period value="1" /> <periodUnit value="d" /> </repeat> </timing> <route> <coding> <system value="https://dmd.nhs.uk" /> <code value="47625008" /> <display value="Intravenous" /> </coding> </route> <method> <coding> <system value="http://snomed.info/sct" /> <code value="261754007" /> <display value="Continuous infusion" /> </coding> </method> <doseAndRate> <doseQuantity> <value value="1" /> <unit value="gram" /> <system value="http://unitsofmeasure.org" /> <code value="g" /> </doseQuantity> </doseAndRate> </dosageInstruction> </MedicationRequest>
{ "resourceType": "MedicationRequest", "id": "34eb3c92-76e6-48c2-9691-aa1f0b58369b", "meta": { "profile": [ "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" ] }, "subject": { "reference": "Patient/UKCore-Patient-RichardSmith-Example" }, "medicationCodeableConcept": { "coding": [ { "system": "https://dmd.nhs.uk", "code": "19841008", "display": "Ceftriaxone" } ] }, "reasonCode": [ { "coding": [ { "system": "http://snomed.info/sct", "code": "233604007", "display": "Pneumonia" } ] } ], "dosageInstruction": [ { "text": "Continuous infusion 1 gram - Intravenous - over 30 minutes - daily - for 5 days", "timing": { "repeat": { "boundsDuration": { "value": 5, "unit": "day", "system": "http://unitsofmeasure.org", "code": "d" }, "duration": 30, "durationUnit": "min", "frequency": 1, "period": 1, "periodUnit": "d" } }, "method": { "coding": [ { "system": "http://snomed.info/sct", "code": "261754007", "display": "Continuous infusion" } ] }, "route": { "coding": [ { "system": "https://dmd.nhs.uk", "code": "47625008", "display": "Intravenous" } ] }, "doseAndRate": [ { "doseQuantity": { "value": 1, "unit": "gram", "system": "http://unitsofmeasure.org", "code": "g" } } ] } ] }
MedicationRequest.id[0] | 34eb3c92-76e6-48c2-9691-aa1f0b58369b |
MedicationRequest.meta[0].profile[0] | https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest |
MedicationRequest.medication[0].coding[0].system[0] | https://dmd.nhs.uk |
MedicationRequest.medication[0].coding[0].code[0] | 19841008 |
MedicationRequest.medication[0].coding[0].display[0] | Ceftriaxone |
MedicationRequest.subject[0].reference[0] | Patient/UKCore-Patient-RichardSmith-Example |
MedicationRequest.reasonCode[0].coding[0].system[0] | http://snomed.info/sct |
MedicationRequest.reasonCode[0].coding[0].code[0] | 233604007 |
MedicationRequest.reasonCode[0].coding[0].display[0] | Pneumonia |
MedicationRequest.dosageInstruction[0].text[0] | Continuous infusion 1 gram - Intravenous - over 30 minutes - daily - for 5 days |
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].value[0] | 5 |
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].unit[0] | day |
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].system[0] | http://unitsofmeasure.org |
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].bounds[0].code[0] | d |
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].duration[0] | 30 |
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].durationUnit[0] | min |
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].frequency[0] | 1 |
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].period[0] | 1 |
MedicationRequest.dosageInstruction[0].timing[0].repeat[0].periodUnit[0] | d |
MedicationRequest.dosageInstruction[0].route[0].coding[0].system[0] | https://dmd.nhs.uk |
MedicationRequest.dosageInstruction[0].route[0].coding[0].code[0] | 47625008 |
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0] | Intravenous |
MedicationRequest.dosageInstruction[0].method[0].coding[0].system[0] | http://snomed.info/sct |
MedicationRequest.dosageInstruction[0].method[0].coding[0].code[0] | 261754007 |
MedicationRequest.dosageInstruction[0].method[0].coding[0].display[0] | Continuous infusion |
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].value[0] | 1 |
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].unit[0] | gram |
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].system[0] | http://unitsofmeasure.org |
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].code[0] | g |
MedicationRequest |
id : 34eb3c92-76e6-48c2-9691-aa1f0b58369b |
meta |
profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest |
subject |
reference : Patient/UKCore-Patient-RichardSmith-Example |
medication |
coding |
system : https://dmd.nhs.uk |
code : 19841008 |
display : Ceftriaxone |
reasonCode |
coding |
system : http://snomed.info/sct |
code : 233604007 |
display : Pneumonia |
dosageInstruction |
text : Continuous infusion 1 gram - Intravenous - over 30 minutes - daily - for 5 days |
timing |
repeat |
bounds |
value : 5 |
unit : day |
system : http://unitsofmeasure.org |
code : d |
duration : 30 |
durationUnit : min |
frequency : 1 |
period : 1 |
periodUnit : d |
method |
coding |
system : http://snomed.info/sct |
code : 261754007 |
display : Continuous infusion |
route |
coding |
system : https://dmd.nhs.uk |
code : 47625008 |
display : Intravenous |
doseAndRate |
dose |
value : 1 |
unit : gram |
system : http://unitsofmeasure.org |
code : g |
Dispensing Event: Prepared by Pharmacy
If the infusion is to be prepared by the hospital pharamcy team.
This Bundle
is created by the pharmacy system for what has been dispensed. A bundle is used in this example because it contains two resources. A Medication
resource details the two ingredients that have been used to prepare the infusion. A MedicationDispense
references the Medication
and details the dosing instruction for the infusion. This bundle would be made available to the ward EPMA system.
<Bundle xmlns="http://hl7.org/fhir"> <type value="message" /> <entry> <fullUrl value="urn:uuid:682858a9-3942-412d-9ae5-71a2f17f7c5b" /> <resource> <MessageHeader> <id value="682858a9-3942-412d-9ae5-71a2f17f7c5b" /> <eventCoding> <system value="http://snomed.info/sct" /> <code value="373784005" /> <display value="Dispensing medication" /> </eventCoding> <source> <endpoint value="https://myendpoint.nhs.uk/" /> </source> <focus> <reference value="7b36eb7b-ea3f-44fb-87c9-dfa51e4b6d5b" /> <type value="MedicationDispense" /> </focus> </MessageHeader> </resource> </entry> <entry> <fullUrl value="urn:uuid:11dc9519-b6e8-41bb-bce5-f6f724b743bc" /> <resource> <Medication> <id value="11dc9519-b6e8-41bb-bce5-f6f724b743bc" /> <meta> <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication" /> </meta> <code> <text value="Ceftriaxone 1g in 50mL Sodium chloride 0.9% solution for infusion" /> </code> <form> <coding> <system value="https://dmd.nhs.uk" /> <code value="385229008" /> <display value="Solution for infusion" /> </coding> </form> <ingredient> <itemCodeableConcept> <coding> <system value="https://dmd.nhs.uk" /> <code value="22824911000001102" /> <display value="Ceftriaxone 1g powder for solution for infusion vials (Kent Pharma (UK) Ltd)" /> </coding> </itemCodeableConcept> <strength> <numerator> <value value="1" /> <unit value="gram" /> <system value="http://unitsofmeasure.org" /> <code value="g" /> </numerator> <denominator> <value value="1" /> </denominator> </strength> </ingredient> <ingredient> <itemCodeableConcept> <coding> <system value="https://dmd.nhs.uk" /> <code value="4880711000001109" /> <display value="Sodium chloride 0.9% infusion 50ml Mini-Bag Viaflex bags (Baxter Healthcare Ltd)" /> </coding> </itemCodeableConcept> <strength> <numerator> <value value="50" /> <unit value="millilitre" /> <system value="http://unitsofmeasure.org" /> <code value="ml" /> </numerator> <denominator> <value value="1" /> </denominator> </strength> </ingredient> </Medication> </resource> </entry> <entry> <fullUrl value="urn:uuid:7b36eb7b-ea3f-44fb-87c9-dfa51e4b6d5b" /> <resource> <MedicationDispense> <id value="7b36eb7b-ea3f-44fb-87c9-dfa51e4b6d5b" /> <meta> <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense" /> </meta> <status value="completed" /> <medicationReference> <reference value="11dc9519-b6e8-41bb-bce5-f6f724b743bc" /> <type value="Medication" /> </medicationReference> <subject> <reference value="Patient/UKCore-Patient-RichardSmith-Example" /> </subject> <authorizingPrescription> <reference value="34eb3c92-76e6-48c2-9691-aa1f0b58369b" /> <type value="MedicationRequest" /> </authorizingPrescription> <quantity> <value value="5" /> <unit value="bag" /> <system value="http://snomed.info/sct" /> <code value="428672001" /> </quantity> <dosageInstruction> <text value="Continuous infusion 50 millilitre - Intravenous - over 30 minutes - daily - for 5 days" /> <timing> <repeat> <boundsDuration> <value value="5" /> <unit value="day" /> <system value="http://unitsofmeasure.org" /> <code value="d" /> </boundsDuration> <duration value="30" /> <durationUnit value="min" /> <frequency value="1" /> <period value="1" /> <periodUnit value="d" /> </repeat> </timing> <route> <coding> <system value="https://dmd.nhs.uk" /> <code value="47625008" /> <display value="Intravenous" /> </coding> </route> <method> <coding> <system value="http://snomed.info/sct" /> <code value="261754007" /> <display value="Continuous infusion" /> </coding> </method> <doseAndRate> <doseQuantity> <value value="50" /> <unit value="millilitre" /> <system value="http://unitsofmeasure.org" /> <code value="ml" /> </doseQuantity> </doseAndRate> </dosageInstruction> </MedicationDispense> </resource> </entry> </Bundle>
{ "resourceType": "Bundle", "type": "message", "entry": [ { "fullUrl": "urn:uuid:682858a9-3942-412d-9ae5-71a2f17f7c5b", "resource": { "resourceType": "MessageHeader", "id": "682858a9-3942-412d-9ae5-71a2f17f7c5b", "eventCoding": { "system": "http://snomed.info/sct", "code": "373784005", "display": "Dispensing medication" }, "source": { "endpoint": "https://myendpoint.nhs.uk/" }, "focus": [ { "reference": "7b36eb7b-ea3f-44fb-87c9-dfa51e4b6d5b", "type": "MedicationDispense" } ] } }, { "fullUrl": "urn:uuid:11dc9519-b6e8-41bb-bce5-f6f724b743bc", "resource": { "resourceType": "Medication", "id": "11dc9519-b6e8-41bb-bce5-f6f724b743bc", "meta": { "profile": [ "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication" ] }, "form": { "coding": [ { "system": "https://dmd.nhs.uk", "code": "385229008", "display": "Solution for infusion" } ] }, "code": { "text": "Ceftriaxone 1g in 50mL Sodium chloride 0.9% solution for infusion" }, "ingredient": [ { "itemCodeableConcept": { "coding": [ { "system": "https://dmd.nhs.uk", "code": "22824911000001102", "display": "Ceftriaxone 1g powder for solution for infusion vials (Kent Pharma (UK) Ltd)" } ] }, "strength": { "numerator": { "value": 1, "unit": "gram", "system": "http://unitsofmeasure.org", "code": "g" }, "denominator": { "value": 1 } } }, { "itemCodeableConcept": { "coding": [ { "system": "https://dmd.nhs.uk", "code": "4880711000001109", "display": "Sodium chloride 0.9% infusion 50ml Mini-Bag Viaflex bags (Baxter Healthcare Ltd)" } ] }, "strength": { "numerator": { "value": 50, "unit": "millilitre", "system": "http://unitsofmeasure.org", "code": "ml" }, "denominator": { "value": 1 } } } ] } }, { "fullUrl": "urn:uuid:7b36eb7b-ea3f-44fb-87c9-dfa51e4b6d5b", "resource": { "resourceType": "MedicationDispense", "id": "7b36eb7b-ea3f-44fb-87c9-dfa51e4b6d5b", "meta": { "profile": [ "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense" ] }, "subject": { "reference": "Patient/UKCore-Patient-RichardSmith-Example" }, "status": "completed", "medicationReference": { "reference": "11dc9519-b6e8-41bb-bce5-f6f724b743bc", "type": "Medication" }, "authorizingPrescription": [ { "reference": "34eb3c92-76e6-48c2-9691-aa1f0b58369b", "type": "MedicationRequest" } ], "quantity": { "value": 5, "unit": "bag", "system": "http://snomed.info/sct", "code": "428672001" }, "dosageInstruction": [ { "text": "Continuous infusion 50 millilitre - Intravenous - over 30 minutes - daily - for 5 days", "timing": { "repeat": { "boundsDuration": { "value": 5, "unit": "day", "system": "http://unitsofmeasure.org", "code": "d" }, "duration": 30, "durationUnit": "min", "frequency": 1, "period": 1, "periodUnit": "d" } }, "method": { "coding": [ { "system": "http://snomed.info/sct", "code": "261754007", "display": "Continuous infusion" } ] }, "route": { "coding": [ { "system": "https://dmd.nhs.uk", "code": "47625008", "display": "Intravenous" } ] }, "doseAndRate": [ { "doseQuantity": { "value": 50, "unit": "millilitre", "system": "http://unitsofmeasure.org", "code": "ml" } } ] } ] } } ] }
Bundle.type[0] | message |
Bundle.entry[0].fullUrl[0] | urn:uuid:682858a9-3942-412d-9ae5-71a2f17f7c5b |
Bundle.entry[0].resource[0].id[0] | 682858a9-3942-412d-9ae5-71a2f17f7c5b |
Bundle.entry[0].resource[0].event[0].system[0] | http://snomed.info/sct |
Bundle.entry[0].resource[0].event[0].code[0] | 373784005 |
Bundle.entry[0].resource[0].event[0].display[0] | Dispensing medication |
Bundle.entry[0].resource[0].source[0].endpoint[0] | https://myendpoint.nhs.uk/ |
Bundle.entry[0].resource[0].focus[0].reference[0] | 7b36eb7b-ea3f-44fb-87c9-dfa51e4b6d5b |
Bundle.entry[0].resource[0].focus[0].type[0] | MedicationDispense |
Bundle.entry[1].fullUrl[0] | urn:uuid:11dc9519-b6e8-41bb-bce5-f6f724b743bc |
Bundle.entry[1].resource[0].id[0] | 11dc9519-b6e8-41bb-bce5-f6f724b743bc |
Bundle.entry[1].resource[0].meta[0].profile[0] | https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication |
Bundle.entry[1].resource[0].code[0].text[0] | Ceftriaxone 1g in 50mL Sodium chloride 0.9% solution for infusion |
Bundle.entry[1].resource[0].form[0].coding[0].system[0] | https://dmd.nhs.uk |
Bundle.entry[1].resource[0].form[0].coding[0].code[0] | 385229008 |
Bundle.entry[1].resource[0].form[0].coding[0].display[0] | Solution for infusion |
Bundle.entry[1].resource[0].ingredient[0].item[0].coding[0].system[0] | https://dmd.nhs.uk |
Bundle.entry[1].resource[0].ingredient[0].item[0].coding[0].code[0] | 22824911000001102 |
Bundle.entry[1].resource[0].ingredient[0].item[0].coding[0].display[0] | Ceftriaxone 1g powder for solution for infusion vials (Kent Pharma (UK) Ltd) |
Bundle.entry[1].resource[0].ingredient[0].strength[0].numerator[0].value[0] | 1 |
Bundle.entry[1].resource[0].ingredient[0].strength[0].numerator[0].unit[0] | gram |
Bundle.entry[1].resource[0].ingredient[0].strength[0].numerator[0].system[0] | http://unitsofmeasure.org |
Bundle.entry[1].resource[0].ingredient[0].strength[0].numerator[0].code[0] | g |
Bundle.entry[1].resource[0].ingredient[0].strength[0].denominator[0].value[0] | 1 |
Bundle.entry[1].resource[0].ingredient[1].item[0].coding[0].system[0] | https://dmd.nhs.uk |
Bundle.entry[1].resource[0].ingredient[1].item[0].coding[0].code[0] | 4880711000001109 |
Bundle.entry[1].resource[0].ingredient[1].item[0].coding[0].display[0] | Sodium chloride 0.9% infusion 50ml Mini-Bag Viaflex bags (Baxter Healthcare Ltd) |
Bundle.entry[1].resource[0].ingredient[1].strength[0].numerator[0].value[0] | 50 |
Bundle.entry[1].resource[0].ingredient[1].strength[0].numerator[0].unit[0] | millilitre |
Bundle.entry[1].resource[0].ingredient[1].strength[0].numerator[0].system[0] | http://unitsofmeasure.org |
Bundle.entry[1].resource[0].ingredient[1].strength[0].numerator[0].code[0] | ml |
Bundle.entry[1].resource[0].ingredient[1].strength[0].denominator[0].value[0] | 1 |
Bundle.entry[2].fullUrl[0] | urn:uuid:7b36eb7b-ea3f-44fb-87c9-dfa51e4b6d5b |
Bundle.entry[2].resource[0].id[0] | 7b36eb7b-ea3f-44fb-87c9-dfa51e4b6d5b |
Bundle.entry[2].resource[0].meta[0].profile[0] | https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense |
Bundle.entry[2].resource[0].status[0] | completed |
Bundle.entry[2].resource[0].medication[0].reference[0] | 11dc9519-b6e8-41bb-bce5-f6f724b743bc |
Bundle.entry[2].resource[0].medication[0].type[0] | Medication |
Bundle.entry[2].resource[0].subject[0].reference[0] | Patient/UKCore-Patient-RichardSmith-Example |
Bundle.entry[2].resource[0].authorizingPrescription[0].reference[0] | 34eb3c92-76e6-48c2-9691-aa1f0b58369b |
Bundle.entry[2].resource[0].authorizingPrescription[0].type[0] | MedicationRequest |
Bundle.entry[2].resource[0].quantity[0].value[0] | 5 |
Bundle.entry[2].resource[0].quantity[0].unit[0] | bag |
Bundle.entry[2].resource[0].quantity[0].system[0] | http://snomed.info/sct |
Bundle.entry[2].resource[0].quantity[0].code[0] | 428672001 |
Bundle.entry[2].resource[0].dosageInstruction[0].text[0] | Continuous infusion 50 millilitre - Intravenous - over 30 minutes - daily - for 5 days |
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].value[0] | 5 |
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].unit[0] | day |
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].system[0] | http://unitsofmeasure.org |
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].code[0] | d |
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].duration[0] | 30 |
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].durationUnit[0] | min |
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].frequency[0] | 1 |
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].period[0] | 1 |
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].periodUnit[0] | d |
Bundle.entry[2].resource[0].dosageInstruction[0].route[0].coding[0].system[0] | https://dmd.nhs.uk |
Bundle.entry[2].resource[0].dosageInstruction[0].route[0].coding[0].code[0] | 47625008 |
Bundle.entry[2].resource[0].dosageInstruction[0].route[0].coding[0].display[0] | Intravenous |
Bundle.entry[2].resource[0].dosageInstruction[0].method[0].coding[0].system[0] | http://snomed.info/sct |
Bundle.entry[2].resource[0].dosageInstruction[0].method[0].coding[0].code[0] | 261754007 |
Bundle.entry[2].resource[0].dosageInstruction[0].method[0].coding[0].display[0] | Continuous infusion |
Bundle.entry[2].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].value[0] | 50 |
Bundle.entry[2].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].unit[0] | millilitre |
Bundle.entry[2].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].system[0] | http://unitsofmeasure.org |
Bundle.entry[2].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].code[0] | ml |
Bundle |
type : message |
entry |
fullUrl : urn:uuid:682858a9-3942-412d-9ae5-71a2f17f7c5b |
resource |
id : 682858a9-3942-412d-9ae5-71a2f17f7c5b |
event |
system : http://snomed.info/sct |
code : 373784005 |
display : Dispensing medication |
source |
endpoint : https://myendpoint.nhs.uk/ |
focus |
reference : 7b36eb7b-ea3f-44fb-87c9-dfa51e4b6d5b |
type : MedicationDispense |
entry |
fullUrl : urn:uuid:11dc9519-b6e8-41bb-bce5-f6f724b743bc |
resource |
id : 11dc9519-b6e8-41bb-bce5-f6f724b743bc |
meta |
profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication |
form |
coding |
system : https://dmd.nhs.uk |
code : 385229008 |
display : Solution for infusion |
code |
text : Ceftriaxone 1g in 50mL Sodium chloride 0.9% solution for infusion |
ingredient |
item |
coding |
system : https://dmd.nhs.uk |
code : 22824911000001102 |
display : Ceftriaxone 1g powder for solution for infusion vials (Kent Pharma (UK) Ltd) |
strength |
numerator |
value : 1 |
unit : gram |
system : http://unitsofmeasure.org |
code : g |
denominator |
value : 1 |
ingredient |
item |
coding |
system : https://dmd.nhs.uk |
code : 4880711000001109 |
display : Sodium chloride 0.9% infusion 50ml Mini-Bag Viaflex bags (Baxter Healthcare Ltd) |
strength |
numerator |
value : 50 |
unit : millilitre |
system : http://unitsofmeasure.org |
code : ml |
denominator |
value : 1 |
entry |
fullUrl : urn:uuid:7b36eb7b-ea3f-44fb-87c9-dfa51e4b6d5b |
resource |
id : 7b36eb7b-ea3f-44fb-87c9-dfa51e4b6d5b |
meta |
profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense |
subject |
reference : Patient/UKCore-Patient-RichardSmith-Example |
status : completed |
medication |
reference : 11dc9519-b6e8-41bb-bce5-f6f724b743bc |
type : Medication |
authorizingPrescription |
reference : 34eb3c92-76e6-48c2-9691-aa1f0b58369b |
type : MedicationRequest |
quantity |
value : 5 |
unit : bag |
system : http://snomed.info/sct |
code : 428672001 |
dosageInstruction |
text : Continuous infusion 50 millilitre - Intravenous - over 30 minutes - daily - for 5 days |
timing |
repeat |
bounds |
value : 5 |
unit : day |
system : http://unitsofmeasure.org |
code : d |
duration : 30 |
durationUnit : min |
frequency : 1 |
period : 1 |
periodUnit : d |
method |
coding |
system : http://snomed.info/sct |
code : 261754007 |
display : Continuous infusion |
route |
coding |
system : https://dmd.nhs.uk |
code : 47625008 |
display : Intravenous |
doseAndRate |
dose |
value : 50 |
unit : millilitre |
system : http://unitsofmeasure.org |
code : ml |
Dispensing Event: Prepared by Ward
If the infusion is to be prepared by the hospital ward team.
This Bundle
is created by the pharmacy system for what has been dispensed. A bundle is used in this example because it contains two MedicationDispense
resources. The first is for the Ceftriaxone powder. The second is for the Sodium chloride diluent. This bundle would be made available to the ward EPMA system. The infusion would be prepared on the ward.
<Bundle xmlns="http://hl7.org/fhir"> <type value="transaction" /> <entry> <fullUrl value="urn:uuid:b74a61af-3a12-4d55-9e7a-949fff9f713a" /> <resource> <MedicationDispense> <id value="b74a61af-3a12-4d55-9e7a-949fff9f713a" /> <meta> <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense" /> </meta> <status value="completed" /> <medicationCodeableConcept> <coding> <system value="https://dmd.nhs.uk" /> <code value="22824911000001102" /> <display value="Ceftriaxone 1g powder for solution for infusion vials (Kent Pharma (UK) Ltd)" /> </coding> </medicationCodeableConcept> <subject> <reference value="Patient/UKCore-Patient-RichardSmith-Example" /> </subject> <authorizingPrescription> <reference value="34eb3c92-76e6-48c2-9691-aa1f0b58369b" /> <type value="MedicationRequest" /> </authorizingPrescription> <quantity> <value value="5" /> <unit value="vial" /> <system value="http://snomed.info/sct" /> <code value="415818006" /> </quantity> <dosageInstruction> <text value="Continuous infusion 1 gram - Intravenous - over 30 minutes - daily - for 5 days" /> <timing> <repeat> <boundsDuration> <value value="5" /> <unit value="day" /> <system value="http://unitsofmeasure.org" /> <code value="d" /> </boundsDuration> <duration value="30" /> <durationUnit value="min" /> <frequency value="1" /> <period value="1" /> <periodUnit value="d" /> </repeat> </timing> <route> <coding> <system value="https://dmd.nhs.uk" /> <code value="47625008" /> <display value="Intravenous" /> </coding> </route> <method> <coding> <system value="http://snomed.info/sct" /> <code value="261754007" /> <display value="Continuous infusion" /> </coding> </method> <doseAndRate> <doseQuantity> <value value="1" /> <unit value="gram" /> <system value="http://unitsofmeasure.org" /> <code value="g" /> </doseQuantity> </doseAndRate> </dosageInstruction> </MedicationDispense> </resource> </entry> <entry> <fullUrl value="urn:uuid:0ec3b0f4-91fa-42eb-a324-a29ff01c71b4" /> <resource> <MedicationDispense> <id value="0ec3b0f4-91fa-42eb-a324-a29ff01c71b4" /> <meta> <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense" /> </meta> <status value="completed" /> <medicationCodeableConcept> <coding> <system value="https://dmd.nhs.uk" /> <code value="4880711000001109" /> <display value="Sodium chloride 0.9% infusion 50ml Mini-Bag Viaflex bags (Baxter Healthcare Ltd)" /> </coding> </medicationCodeableConcept> <authorizingPrescription> <reference value="34eb3c92-76e6-48c2-9691-aa1f0b58369b" /> <type value="MedicationRequest" /> </authorizingPrescription> <quantity> <value value="5" /> <unit value="bag" /> <system value="http://snomed.info/sct" /> <code value="428672001" /> </quantity> <dosageInstruction> <text value="Continuous infusion 100 millilitre - Intravenous - over 30 minutes - daily - for 5 days" /> <timing> <repeat> <boundsDuration> <value value="5" /> <unit value="day" /> <system value="http://unitsofmeasure.org" /> <code value="d" /> </boundsDuration> <duration value="30" /> <durationUnit value="min" /> <frequency value="1" /> <period value="1" /> <periodUnit value="d" /> </repeat> </timing> <route> <coding> <system value="https://dmd.nhs.uk" /> <code value="47625008" /> <display value="Intravenous" /> </coding> </route> <method> <coding> <system value="http://snomed.info/sct" /> <code value="261754007" /> <display value="Continuous infusion" /> </coding> </method> <doseAndRate> <doseQuantity> <value value="50" /> <unit value="millilitre" /> <system value="http://unitsofmeasure.org" /> <code value="ml" /> </doseQuantity> </doseAndRate> </dosageInstruction> </MedicationDispense> </resource> </entry> </Bundle>
{ "resourceType": "Bundle", "type": "transaction", "entry": [ { "fullUrl": "urn:uuid:b74a61af-3a12-4d55-9e7a-949fff9f713a", "resource": { "resourceType": "MedicationDispense", "id": "b74a61af-3a12-4d55-9e7a-949fff9f713a", "meta": { "profile": [ "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense" ] }, "subject": { "reference": "Patient/UKCore-Patient-RichardSmith-Example" }, "status": "completed", "medicationCodeableConcept": { "coding": [ { "system": "https://dmd.nhs.uk", "code": "22824911000001102", "display": "Ceftriaxone 1g powder for solution for infusion vials (Kent Pharma (UK) Ltd)" } ] }, "authorizingPrescription": [ { "reference": "34eb3c92-76e6-48c2-9691-aa1f0b58369b", "type": "MedicationRequest" } ], "quantity": { "value": 5, "unit": "vial", "system": "http://snomed.info/sct", "code": "415818006" }, "dosageInstruction": [ { "text": "Continuous infusion 1 gram - Intravenous - over 30 minutes - daily - for 5 days", "timing": { "repeat": { "boundsDuration": { "value": 5, "unit": "day", "system": "http://unitsofmeasure.org", "code": "d" }, "duration": 30, "durationUnit": "min", "frequency": 1, "period": 1, "periodUnit": "d" } }, "method": { "coding": [ { "system": "http://snomed.info/sct", "code": "261754007", "display": "Continuous infusion" } ] }, "route": { "coding": [ { "system": "https://dmd.nhs.uk", "code": "47625008", "display": "Intravenous" } ] }, "doseAndRate": [ { "doseQuantity": { "value": 1, "unit": "gram", "system": "http://unitsofmeasure.org", "code": "g" } } ] } ] } }, { "fullUrl": "urn:uuid:0ec3b0f4-91fa-42eb-a324-a29ff01c71b4", "resource": { "resourceType": "MedicationDispense", "id": "0ec3b0f4-91fa-42eb-a324-a29ff01c71b4", "meta": { "profile": [ "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense" ] }, "status": "completed", "medicationCodeableConcept": { "coding": [ { "system": "https://dmd.nhs.uk", "code": "4880711000001109", "display": "Sodium chloride 0.9% infusion 50ml Mini-Bag Viaflex bags (Baxter Healthcare Ltd)" } ] }, "authorizingPrescription": [ { "reference": "34eb3c92-76e6-48c2-9691-aa1f0b58369b", "type": "MedicationRequest" } ], "quantity": { "value": 5, "unit": "bag", "system": "http://snomed.info/sct", "code": "428672001" }, "dosageInstruction": [ { "text": "Continuous infusion 100 millilitre - Intravenous - over 30 minutes - daily - for 5 days", "timing": { "repeat": { "boundsDuration": { "value": 5, "unit": "day", "system": "http://unitsofmeasure.org", "code": "d" }, "duration": 30, "durationUnit": "min", "frequency": 1, "period": 1, "periodUnit": "d" } }, "method": { "coding": [ { "system": "http://snomed.info/sct", "code": "261754007", "display": "Continuous infusion" } ] }, "route": { "coding": [ { "system": "https://dmd.nhs.uk", "code": "47625008", "display": "Intravenous" } ] }, "doseAndRate": [ { "doseQuantity": { "value": 50, "unit": "millilitre", "system": "http://unitsofmeasure.org", "code": "ml" } } ] } ] } } ] }
Bundle.type[0] | transaction |
Bundle.entry[0].fullUrl[0] | urn:uuid:b74a61af-3a12-4d55-9e7a-949fff9f713a |
Bundle.entry[0].resource[0].id[0] | b74a61af-3a12-4d55-9e7a-949fff9f713a |
Bundle.entry[0].resource[0].meta[0].profile[0] | https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense |
Bundle.entry[0].resource[0].status[0] | completed |
Bundle.entry[0].resource[0].medication[0].coding[0].system[0] | https://dmd.nhs.uk |
Bundle.entry[0].resource[0].medication[0].coding[0].code[0] | 22824911000001102 |
Bundle.entry[0].resource[0].medication[0].coding[0].display[0] | Ceftriaxone 1g powder for solution for infusion vials (Kent Pharma (UK) Ltd) |
Bundle.entry[0].resource[0].subject[0].reference[0] | Patient/UKCore-Patient-RichardSmith-Example |
Bundle.entry[0].resource[0].authorizingPrescription[0].reference[0] | 34eb3c92-76e6-48c2-9691-aa1f0b58369b |
Bundle.entry[0].resource[0].authorizingPrescription[0].type[0] | MedicationRequest |
Bundle.entry[0].resource[0].quantity[0].value[0] | 5 |
Bundle.entry[0].resource[0].quantity[0].unit[0] | vial |
Bundle.entry[0].resource[0].quantity[0].system[0] | http://snomed.info/sct |
Bundle.entry[0].resource[0].quantity[0].code[0] | 415818006 |
Bundle.entry[0].resource[0].dosageInstruction[0].text[0] | Continuous infusion 1 gram - Intravenous - over 30 minutes - daily - for 5 days |
Bundle.entry[0].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].value[0] | 5 |
Bundle.entry[0].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].unit[0] | day |
Bundle.entry[0].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].system[0] | http://unitsofmeasure.org |
Bundle.entry[0].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].code[0] | d |
Bundle.entry[0].resource[0].dosageInstruction[0].timing[0].repeat[0].duration[0] | 30 |
Bundle.entry[0].resource[0].dosageInstruction[0].timing[0].repeat[0].durationUnit[0] | min |
Bundle.entry[0].resource[0].dosageInstruction[0].timing[0].repeat[0].frequency[0] | 1 |
Bundle.entry[0].resource[0].dosageInstruction[0].timing[0].repeat[0].period[0] | 1 |
Bundle.entry[0].resource[0].dosageInstruction[0].timing[0].repeat[0].periodUnit[0] | d |
Bundle.entry[0].resource[0].dosageInstruction[0].route[0].coding[0].system[0] | https://dmd.nhs.uk |
Bundle.entry[0].resource[0].dosageInstruction[0].route[0].coding[0].code[0] | 47625008 |
Bundle.entry[0].resource[0].dosageInstruction[0].route[0].coding[0].display[0] | Intravenous |
Bundle.entry[0].resource[0].dosageInstruction[0].method[0].coding[0].system[0] | http://snomed.info/sct |
Bundle.entry[0].resource[0].dosageInstruction[0].method[0].coding[0].code[0] | 261754007 |
Bundle.entry[0].resource[0].dosageInstruction[0].method[0].coding[0].display[0] | Continuous infusion |
Bundle.entry[0].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].value[0] | 1 |
Bundle.entry[0].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].unit[0] | gram |
Bundle.entry[0].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].system[0] | http://unitsofmeasure.org |
Bundle.entry[0].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].code[0] | g |
Bundle.entry[1].fullUrl[0] | urn:uuid:0ec3b0f4-91fa-42eb-a324-a29ff01c71b4 |
Bundle.entry[1].resource[0].id[0] | 0ec3b0f4-91fa-42eb-a324-a29ff01c71b4 |
Bundle.entry[1].resource[0].meta[0].profile[0] | https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense |
Bundle.entry[1].resource[0].status[0] | completed |
Bundle.entry[1].resource[0].medication[0].coding[0].system[0] | https://dmd.nhs.uk |
Bundle.entry[1].resource[0].medication[0].coding[0].code[0] | 4880711000001109 |
Bundle.entry[1].resource[0].medication[0].coding[0].display[0] | Sodium chloride 0.9% infusion 50ml Mini-Bag Viaflex bags (Baxter Healthcare Ltd) |
Bundle.entry[1].resource[0].authorizingPrescription[0].reference[0] | 34eb3c92-76e6-48c2-9691-aa1f0b58369b |
Bundle.entry[1].resource[0].authorizingPrescription[0].type[0] | MedicationRequest |
Bundle.entry[1].resource[0].quantity[0].value[0] | 5 |
Bundle.entry[1].resource[0].quantity[0].unit[0] | bag |
Bundle.entry[1].resource[0].quantity[0].system[0] | http://snomed.info/sct |
Bundle.entry[1].resource[0].quantity[0].code[0] | 428672001 |
Bundle.entry[1].resource[0].dosageInstruction[0].text[0] | Continuous infusion 100 millilitre - Intravenous - over 30 minutes - daily - for 5 days |
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].value[0] | 5 |
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].unit[0] | day |
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].system[0] | http://unitsofmeasure.org |
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].code[0] | d |
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].duration[0] | 30 |
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].durationUnit[0] | min |
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].frequency[0] | 1 |
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].period[0] | 1 |
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].periodUnit[0] | d |
Bundle.entry[1].resource[0].dosageInstruction[0].route[0].coding[0].system[0] | https://dmd.nhs.uk |
Bundle.entry[1].resource[0].dosageInstruction[0].route[0].coding[0].code[0] | 47625008 |
Bundle.entry[1].resource[0].dosageInstruction[0].route[0].coding[0].display[0] | Intravenous |
Bundle.entry[1].resource[0].dosageInstruction[0].method[0].coding[0].system[0] | http://snomed.info/sct |
Bundle.entry[1].resource[0].dosageInstruction[0].method[0].coding[0].code[0] | 261754007 |
Bundle.entry[1].resource[0].dosageInstruction[0].method[0].coding[0].display[0] | Continuous infusion |
Bundle.entry[1].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].value[0] | 50 |
Bundle.entry[1].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].unit[0] | millilitre |
Bundle.entry[1].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].system[0] | http://unitsofmeasure.org |
Bundle.entry[1].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].code[0] | ml |
Bundle |
type : transaction |
entry |
fullUrl : urn:uuid:b74a61af-3a12-4d55-9e7a-949fff9f713a |
resource |
id : b74a61af-3a12-4d55-9e7a-949fff9f713a |
meta |
profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense |
subject |
reference : Patient/UKCore-Patient-RichardSmith-Example |
status : completed |
medication |
coding |
system : https://dmd.nhs.uk |
code : 22824911000001102 |
display : Ceftriaxone 1g powder for solution for infusion vials (Kent Pharma (UK) Ltd) |
authorizingPrescription |
reference : 34eb3c92-76e6-48c2-9691-aa1f0b58369b |
type : MedicationRequest |
quantity |
value : 5 |
unit : vial |
system : http://snomed.info/sct |
code : 415818006 |
dosageInstruction |
text : Continuous infusion 1 gram - Intravenous - over 30 minutes - daily - for 5 days |
timing |
repeat |
bounds |
value : 5 |
unit : day |
system : http://unitsofmeasure.org |
code : d |
duration : 30 |
durationUnit : min |
frequency : 1 |
period : 1 |
periodUnit : d |
method |
coding |
system : http://snomed.info/sct |
code : 261754007 |
display : Continuous infusion |
route |
coding |
system : https://dmd.nhs.uk |
code : 47625008 |
display : Intravenous |
doseAndRate |
dose |
value : 1 |
unit : gram |
system : http://unitsofmeasure.org |
code : g |
entry |
fullUrl : urn:uuid:0ec3b0f4-91fa-42eb-a324-a29ff01c71b4 |
resource |
id : 0ec3b0f4-91fa-42eb-a324-a29ff01c71b4 |
meta |
profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense |
status : completed |
medication |
coding |
system : https://dmd.nhs.uk |
code : 4880711000001109 |
display : Sodium chloride 0.9% infusion 50ml Mini-Bag Viaflex bags (Baxter Healthcare Ltd) |
authorizingPrescription |
reference : 34eb3c92-76e6-48c2-9691-aa1f0b58369b |
type : MedicationRequest |
quantity |
value : 5 |
unit : bag |
system : http://snomed.info/sct |
code : 428672001 |
dosageInstruction |
text : Continuous infusion 100 millilitre - Intravenous - over 30 minutes - daily - for 5 days |
timing |
repeat |
bounds |
value : 5 |
unit : day |
system : http://unitsofmeasure.org |
code : d |
duration : 30 |
durationUnit : min |
frequency : 1 |
period : 1 |
periodUnit : d |
method |
coding |
system : http://snomed.info/sct |
code : 261754007 |
display : Continuous infusion |
route |
coding |
system : https://dmd.nhs.uk |
code : 47625008 |
display : Intravenous |
doseAndRate |
dose |
value : 50 |
unit : millilitre |
system : http://unitsofmeasure.org |
code : ml |
Dispensing Event: Dispensed by Pharmacy using a pre-prepared product
Pre-prepared and dm+d coded Ceftriaxone 1g/50ml infusion bags
products are dispensed to the ward.
<Bundle xmlns="http://hl7.org/fhir"> <type value="message" /> <entry> <fullUrl value="urn:uuid:ee6f0a35-4e84-4b75-8b22-c2111878e548" /> <resource> <MessageHeader> <id value="ee6f0a35-4e84-4b75-8b22-c2111878e548" /> <eventCoding> <system value="http://snomed.info/sct" /> <code value="373784005" /> <display value="Dispensing medication" /> </eventCoding> <source> <endpoint value="https://myendpoint.nhs.uk/" /> </source> <focus> <reference value="b74a61af-3a12-4d55-9e7a-949fff9f713a" /> <type value="MedicationDispense" /> </focus> </MessageHeader> </resource> </entry> <entry> <fullUrl value="urn:uuid:b74a61af-3a12-4d55-9e7a-949fff9f713a" /> <resource> <MedicationDispense> <id value="b74a61af-3a12-4d55-9e7a-949fff9f713a" /> <meta> <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense" /> </meta> <status value="completed" /> <medicationCodeableConcept> <coding> <system value="https://dmd.nhs.uk" /> <code value="22102811000001100" /> <display value="Ceftriaxone 1g/50ml infusion bags (Special Order)" /> </coding> </medicationCodeableConcept> <subject> <reference value="Patient/UKCore-Patient-RichardSmith-Example" /> </subject> <authorizingPrescription> <reference value="34eb3c92-76e6-48c2-9691-aa1f0b58369b" /> <type value="MedicationRequest" /> </authorizingPrescription> <quantity> <value value="5" /> <unit value="bag" /> <system value="http://snomed.info/sct" /> <code value="428672001" /> </quantity> <dosageInstruction> <text value="Continuous infusion 1 gram - Intravenous - over 30 minutes - daily - for 5 days" /> <timing> <repeat> <boundsDuration> <value value="5" /> <unit value="day" /> <system value="http://unitsofmeasure.org" /> <code value="d" /> </boundsDuration> <duration value="30" /> <durationUnit value="min" /> <frequency value="1" /> <period value="1" /> <periodUnit value="d" /> </repeat> </timing> <route> <coding> <system value="https://dmd.nhs.uk" /> <code value="47625008" /> <display value="Intravenous" /> </coding> </route> <method> <coding> <system value="http://snomed.info/sct" /> <code value="261754007" /> <display value="Continuous infusion" /> </coding> </method> <doseAndRate> <doseQuantity> <value value="1" /> <unit value="bag" /> <system value="http://snomed.info/sct" /> <code value="428672001" /> </doseQuantity> </doseAndRate> </dosageInstruction> </MedicationDispense> </resource> </entry> </Bundle>
{ "resourceType": "Bundle", "type": "message", "entry": [ { "fullUrl": "urn:uuid:ee6f0a35-4e84-4b75-8b22-c2111878e548", "resource": { "resourceType": "MessageHeader", "id": "ee6f0a35-4e84-4b75-8b22-c2111878e548", "eventCoding": { "system": "http://snomed.info/sct", "code": "373784005", "display": "Dispensing medication" }, "source": { "endpoint": "https://myendpoint.nhs.uk/" }, "focus": [ { "reference": "b74a61af-3a12-4d55-9e7a-949fff9f713a", "type": "MedicationDispense" } ] } }, { "fullUrl": "urn:uuid:b74a61af-3a12-4d55-9e7a-949fff9f713a", "resource": { "resourceType": "MedicationDispense", "id": "b74a61af-3a12-4d55-9e7a-949fff9f713a", "meta": { "profile": [ "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense" ] }, "status": "completed", "medicationCodeableConcept": { "coding": [ { "system": "https://dmd.nhs.uk", "code": "22102811000001100", "display": "Ceftriaxone 1g/50ml infusion bags (Special Order)" } ] }, "subject": { "reference": "Patient/UKCore-Patient-RichardSmith-Example" }, "authorizingPrescription": [ { "reference": "34eb3c92-76e6-48c2-9691-aa1f0b58369b", "type": "MedicationRequest" } ], "quantity": { "value": 5, "unit": "bag", "system": "http://snomed.info/sct", "code": "428672001" }, "dosageInstruction": [ { "text": "Continuous infusion 1 gram - Intravenous - over 30 minutes - daily - for 5 days", "timing": { "repeat": { "boundsDuration": { "value": 5, "unit": "day", "system": "http://unitsofmeasure.org", "code": "d" }, "duration": 30, "durationUnit": "min", "frequency": 1, "period": 1, "periodUnit": "d" } }, "route": { "coding": [ { "system": "https://dmd.nhs.uk", "code": "47625008", "display": "Intravenous" } ] }, "method": { "coding": [ { "system": "http://snomed.info/sct", "code": "261754007", "display": "Continuous infusion" } ] }, "doseAndRate": [ { "doseQuantity": { "value": 1, "unit": "bag", "system": "http://snomed.info/sct", "code": "428672001" } } ] } ] } } ] }
Bundle.type[0] | message |
Bundle.entry[0].fullUrl[0] | urn:uuid:ee6f0a35-4e84-4b75-8b22-c2111878e548 |
Bundle.entry[0].resource[0].id[0] | ee6f0a35-4e84-4b75-8b22-c2111878e548 |
Bundle.entry[0].resource[0].event[0].system[0] | http://snomed.info/sct |
Bundle.entry[0].resource[0].event[0].code[0] | 373784005 |
Bundle.entry[0].resource[0].event[0].display[0] | Dispensing medication |
Bundle.entry[0].resource[0].source[0].endpoint[0] | https://myendpoint.nhs.uk/ |
Bundle.entry[0].resource[0].focus[0].reference[0] | b74a61af-3a12-4d55-9e7a-949fff9f713a |
Bundle.entry[0].resource[0].focus[0].type[0] | MedicationDispense |
Bundle.entry[1].fullUrl[0] | urn:uuid:b74a61af-3a12-4d55-9e7a-949fff9f713a |
Bundle.entry[1].resource[0].id[0] | b74a61af-3a12-4d55-9e7a-949fff9f713a |
Bundle.entry[1].resource[0].meta[0].profile[0] | https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense |
Bundle.entry[1].resource[0].status[0] | completed |
Bundle.entry[1].resource[0].medication[0].coding[0].system[0] | https://dmd.nhs.uk |
Bundle.entry[1].resource[0].medication[0].coding[0].code[0] | 22102811000001100 |
Bundle.entry[1].resource[0].medication[0].coding[0].display[0] | Ceftriaxone 1g/50ml infusion bags (Special Order) |
Bundle.entry[1].resource[0].subject[0].reference[0] | Patient/UKCore-Patient-RichardSmith-Example |
Bundle.entry[1].resource[0].authorizingPrescription[0].reference[0] | 34eb3c92-76e6-48c2-9691-aa1f0b58369b |
Bundle.entry[1].resource[0].authorizingPrescription[0].type[0] | MedicationRequest |
Bundle.entry[1].resource[0].quantity[0].value[0] | 5 |
Bundle.entry[1].resource[0].quantity[0].unit[0] | bag |
Bundle.entry[1].resource[0].quantity[0].system[0] | http://snomed.info/sct |
Bundle.entry[1].resource[0].quantity[0].code[0] | 428672001 |
Bundle.entry[1].resource[0].dosageInstruction[0].text[0] | Continuous infusion 1 gram - Intravenous - over 30 minutes - daily - for 5 days |
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].value[0] | 5 |
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].unit[0] | day |
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].system[0] | http://unitsofmeasure.org |
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].bounds[0].code[0] | d |
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].duration[0] | 30 |
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].durationUnit[0] | min |
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].frequency[0] | 1 |
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].period[0] | 1 |
Bundle.entry[1].resource[0].dosageInstruction[0].timing[0].repeat[0].periodUnit[0] | d |
Bundle.entry[1].resource[0].dosageInstruction[0].route[0].coding[0].system[0] | https://dmd.nhs.uk |
Bundle.entry[1].resource[0].dosageInstruction[0].route[0].coding[0].code[0] | 47625008 |
Bundle.entry[1].resource[0].dosageInstruction[0].route[0].coding[0].display[0] | Intravenous |
Bundle.entry[1].resource[0].dosageInstruction[0].method[0].coding[0].system[0] | http://snomed.info/sct |
Bundle.entry[1].resource[0].dosageInstruction[0].method[0].coding[0].code[0] | 261754007 |
Bundle.entry[1].resource[0].dosageInstruction[0].method[0].coding[0].display[0] | Continuous infusion |
Bundle.entry[1].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].value[0] | 1 |
Bundle.entry[1].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].unit[0] | bag |
Bundle.entry[1].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].system[0] | http://snomed.info/sct |
Bundle.entry[1].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].code[0] | 428672001 |
Bundle |
type : message |
entry |
fullUrl : urn:uuid:ee6f0a35-4e84-4b75-8b22-c2111878e548 |
resource |
id : ee6f0a35-4e84-4b75-8b22-c2111878e548 |
event |
system : http://snomed.info/sct |
code : 373784005 |
display : Dispensing medication |
source |
endpoint : https://myendpoint.nhs.uk/ |
focus |
reference : b74a61af-3a12-4d55-9e7a-949fff9f713a |
type : MedicationDispense |
entry |
fullUrl : urn:uuid:b74a61af-3a12-4d55-9e7a-949fff9f713a |
resource |
id : b74a61af-3a12-4d55-9e7a-949fff9f713a |
meta |
profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationDispense |
status : completed |
subject |
reference : Patient/UKCore-Patient-RichardSmith-Example |
medication |
coding |
system : https://dmd.nhs.uk |
code : 22102811000001100 |
display : Ceftriaxone 1g/50ml infusion bags (Special Order) |
authorizingPrescription |
reference : 34eb3c92-76e6-48c2-9691-aa1f0b58369b |
type : MedicationRequest |
quantity |
value : 5 |
unit : bag |
system : http://snomed.info/sct |
code : 428672001 |
dosageInstruction |
text : Continuous infusion 1 gram - Intravenous - over 30 minutes - daily - for 5 days |
timing |
repeat |
bounds |
value : 5 |
unit : day |
system : http://unitsofmeasure.org |
code : d |
duration : 30 |
durationUnit : min |
frequency : 1 |
period : 1 |
periodUnit : d |
route |
coding |
system : https://dmd.nhs.uk |
code : 47625008 |
display : Intravenous |
method |
coding |
system : http://snomed.info/sct |
code : 261754007 |
display : Continuous infusion |
doseAndRate |
dose |
value : 1 |
unit : bag |
system : http://snomed.info/sct |
code : 428672001 |
Administration Event: Using infusion prepared by pharmacy or ward
An administration record using an infusion prepared either by the pharmacy or on the ward. There would be five administration records, one for each infusion, on each day.
<Bundle xmlns="http://hl7.org/fhir"> <type value="message" /> <entry> <fullUrl value="urn:uuid:682858a9-3942-412d-9ae5-71a2f17f7c5b" /> <resource> <MessageHeader> <id value="682858a9-3942-412d-9ae5-71a2f17f7c5b" /> <eventCoding> <system value="http://snomed.info/sct" /> <code value="18629005" /> <display value="Administration of medication" /> </eventCoding> <source> <endpoint value="https://myendpoint.nhs.uk/" /> </source> <focus> <reference value="843b54b7-1479-43a3-9931-99f10d621181" /> <type value="MedicationAdministration" /> </focus> </MessageHeader> </resource> </entry> <entry> <fullUrl value="urn:uuid:11dc9519-b6e8-41bb-bce5-f6f724b743bc" /> <resource> <Medication> <id value="11dc9519-b6e8-41bb-bce5-f6f724b743bc" /> <meta> <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication" /> </meta> <code> <text value="Ceftriaxone 1g in 50mL Sodium chloride 0.9% solution for infusion" /> </code> <form> <coding> <system value="https://dmd.nhs.uk" /> <code value="385229008" /> <display value="Solution for infusion" /> </coding> </form> <ingredient> <itemCodeableConcept> <coding> <system value="https://dmd.nhs.uk" /> <code value="22824911000001102" /> <display value="Ceftriaxone 1g powder for solution for infusion vials (Kent Pharma (UK) Ltd)" /> </coding> </itemCodeableConcept> <strength> <numerator> <value value="1" /> <unit value="gram" /> <system value="http://unitsofmeasure.org" /> <code value="g" /> </numerator> <denominator> <value value="1" /> </denominator> </strength> </ingredient> <ingredient> <itemCodeableConcept> <coding> <system value="https://dmd.nhs.uk" /> <code value="4880711000001109" /> <display value="Sodium chloride 0.9% infusion 50ml Mini-Bag Viaflex bags (Baxter Healthcare Ltd)" /> </coding> </itemCodeableConcept> <strength> <numerator> <value value="50" /> <unit value="millilitre" /> <system value="http://unitsofmeasure.org" /> <code value="ml" /> </numerator> <denominator> <value value="1" /> </denominator> </strength> </ingredient> </Medication> </resource> </entry> <entry> <fullUrl value="urn:uuid:7b36eb7b-ea3f-44fb-87c9-dfa51e4b6d5b" /> <resource> <MedicationAdministration> <id value="843b54b7-1479-43a3-9931-99f10d621181" /> <meta> <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationAdministration" /> </meta> <status value="completed" /> <medicationReference> <reference value="11dc9519-b6e8-41bb-bce5-f6f724b743bc" /> <type value="Medication" /> </medicationReference> <subject> <reference value="Patient/UKCore-Patient-RichardSmith-Example" /> </subject> <effectiveDateTime value="2022-02-28T17:06:00+00:00" /> <request> <reference value="34eb3c92-76e6-48c2-9691-aa1f0b58369b" /> <type value="MedicationRequest" /> </request> <dosage> <route> <coding> <system value="https://dmd.nhs.uk" /> <code value="47625008" /> <display value="Intravenous" /> </coding> </route> <method> <coding> <system value="http://snomed.info/sct" /> <code value="261754007" /> <display value="Continuous infusion" /> </coding> </method> <dose> <value value="100" /> <unit value="millilitre" /> <system value="http://unitsofmeasure.org" /> <code value="ml" /> </dose> </dosage> </MedicationAdministration> </resource> </entry> </Bundle>
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Bundle.type[0] | message |
Bundle.entry[0].fullUrl[0] | urn:uuid:682858a9-3942-412d-9ae5-71a2f17f7c5b |
Bundle.entry[0].resource[0].id[0] | 682858a9-3942-412d-9ae5-71a2f17f7c5b |
Bundle.entry[0].resource[0].event[0].system[0] | http://snomed.info/sct |
Bundle.entry[0].resource[0].event[0].code[0] | 18629005 |
Bundle.entry[0].resource[0].event[0].display[0] | Administration of medication |
Bundle.entry[0].resource[0].source[0].endpoint[0] | https://myendpoint.nhs.uk/ |
Bundle.entry[0].resource[0].focus[0].reference[0] | 843b54b7-1479-43a3-9931-99f10d621181 |
Bundle.entry[0].resource[0].focus[0].type[0] | MedicationAdministration |
Bundle.entry[1].fullUrl[0] | urn:uuid:11dc9519-b6e8-41bb-bce5-f6f724b743bc |
Bundle.entry[1].resource[0].id[0] | 11dc9519-b6e8-41bb-bce5-f6f724b743bc |
Bundle.entry[1].resource[0].meta[0].profile[0] | https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication |
Bundle.entry[1].resource[0].code[0].text[0] | Ceftriaxone 1g in 50mL Sodium chloride 0.9% solution for infusion |
Bundle.entry[1].resource[0].form[0].coding[0].system[0] | https://dmd.nhs.uk |
Bundle.entry[1].resource[0].form[0].coding[0].code[0] | 385229008 |
Bundle.entry[1].resource[0].form[0].coding[0].display[0] | Solution for infusion |
Bundle.entry[1].resource[0].ingredient[0].item[0].coding[0].system[0] | https://dmd.nhs.uk |
Bundle.entry[1].resource[0].ingredient[0].item[0].coding[0].code[0] | 22824911000001102 |
Bundle.entry[1].resource[0].ingredient[0].item[0].coding[0].display[0] | Ceftriaxone 1g powder for solution for infusion vials (Kent Pharma (UK) Ltd) |
Bundle.entry[1].resource[0].ingredient[0].strength[0].numerator[0].value[0] | 1 |
Bundle.entry[1].resource[0].ingredient[0].strength[0].numerator[0].unit[0] | gram |
Bundle.entry[1].resource[0].ingredient[0].strength[0].numerator[0].system[0] | http://unitsofmeasure.org |
Bundle.entry[1].resource[0].ingredient[0].strength[0].numerator[0].code[0] | g |
Bundle.entry[1].resource[0].ingredient[0].strength[0].denominator[0].value[0] | 1 |
Bundle.entry[1].resource[0].ingredient[1].item[0].coding[0].system[0] | https://dmd.nhs.uk |
Bundle.entry[1].resource[0].ingredient[1].item[0].coding[0].code[0] | 4880711000001109 |
Bundle.entry[1].resource[0].ingredient[1].item[0].coding[0].display[0] | Sodium chloride 0.9% infusion 50ml Mini-Bag Viaflex bags (Baxter Healthcare Ltd) |
Bundle.entry[1].resource[0].ingredient[1].strength[0].numerator[0].value[0] | 50 |
Bundle.entry[1].resource[0].ingredient[1].strength[0].numerator[0].unit[0] | millilitre |
Bundle.entry[1].resource[0].ingredient[1].strength[0].numerator[0].system[0] | http://unitsofmeasure.org |
Bundle.entry[1].resource[0].ingredient[1].strength[0].numerator[0].code[0] | ml |
Bundle.entry[1].resource[0].ingredient[1].strength[0].denominator[0].value[0] | 1 |
Bundle.entry[2].fullUrl[0] | urn:uuid:7b36eb7b-ea3f-44fb-87c9-dfa51e4b6d5b |
Bundle.entry[2].resource[0].id[0] | 843b54b7-1479-43a3-9931-99f10d621181 |
Bundle.entry[2].resource[0].meta[0].profile[0] | https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationAdministration |
Bundle.entry[2].resource[0].status[0] | completed |
Bundle.entry[2].resource[0].medication[0].reference[0] | 11dc9519-b6e8-41bb-bce5-f6f724b743bc |
Bundle.entry[2].resource[0].medication[0].type[0] | Medication |
Bundle.entry[2].resource[0].subject[0].reference[0] | Patient/UKCore-Patient-RichardSmith-Example |
Bundle.entry[2].resource[0].effective[0] | 2022-02-28T17:06:00+00:00 |
Bundle.entry[2].resource[0].request[0].reference[0] | 34eb3c92-76e6-48c2-9691-aa1f0b58369b |
Bundle.entry[2].resource[0].request[0].type[0] | MedicationRequest |
Bundle.entry[2].resource[0].dosage[0].route[0].coding[0].system[0] | https://dmd.nhs.uk |
Bundle.entry[2].resource[0].dosage[0].route[0].coding[0].code[0] | 47625008 |
Bundle.entry[2].resource[0].dosage[0].route[0].coding[0].display[0] | Intravenous |
Bundle.entry[2].resource[0].dosage[0].method[0].coding[0].system[0] | http://snomed.info/sct |
Bundle.entry[2].resource[0].dosage[0].method[0].coding[0].code[0] | 261754007 |
Bundle.entry[2].resource[0].dosage[0].method[0].coding[0].display[0] | Continuous infusion |
Bundle.entry[2].resource[0].dosage[0].dose[0].value[0] | 100 |
Bundle.entry[2].resource[0].dosage[0].dose[0].unit[0] | millilitre |
Bundle.entry[2].resource[0].dosage[0].dose[0].system[0] | http://unitsofmeasure.org |
Bundle.entry[2].resource[0].dosage[0].dose[0].code[0] | ml |
Bundle |
type : message |
entry |
fullUrl : urn:uuid:682858a9-3942-412d-9ae5-71a2f17f7c5b |
resource |
id : 682858a9-3942-412d-9ae5-71a2f17f7c5b |
event |
system : http://snomed.info/sct |
code : 18629005 |
display : Administration of medication |
source |
endpoint : https://myendpoint.nhs.uk/ |
focus |
reference : 843b54b7-1479-43a3-9931-99f10d621181 |
type : MedicationAdministration |
entry |
fullUrl : urn:uuid:11dc9519-b6e8-41bb-bce5-f6f724b743bc |
resource |
id : 11dc9519-b6e8-41bb-bce5-f6f724b743bc |
meta |
profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication |
form |
coding |
system : https://dmd.nhs.uk |
code : 385229008 |
display : Solution for infusion |
code |
text : Ceftriaxone 1g in 50mL Sodium chloride 0.9% solution for infusion |
ingredient |
item |
coding |
system : https://dmd.nhs.uk |
code : 22824911000001102 |
display : Ceftriaxone 1g powder for solution for infusion vials (Kent Pharma (UK) Ltd) |
strength |
numerator |
value : 1 |
unit : gram |
system : http://unitsofmeasure.org |
code : g |
denominator |
value : 1 |
ingredient |
item |
coding |
system : https://dmd.nhs.uk |
code : 4880711000001109 |
display : Sodium chloride 0.9% infusion 50ml Mini-Bag Viaflex bags (Baxter Healthcare Ltd) |
strength |
numerator |
value : 50 |
unit : millilitre |
system : http://unitsofmeasure.org |
code : ml |
denominator |
value : 1 |
entry |
fullUrl : urn:uuid:7b36eb7b-ea3f-44fb-87c9-dfa51e4b6d5b |
resource |
id : 843b54b7-1479-43a3-9931-99f10d621181 |
meta |
profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationAdministration |
status : completed |
medication |
reference : 11dc9519-b6e8-41bb-bce5-f6f724b743bc |
type : Medication |
subject |
reference : Patient/UKCore-Patient-RichardSmith-Example |
effective : 2022-02-28T17:06:00+00:00 |
request |
reference : 34eb3c92-76e6-48c2-9691-aa1f0b58369b |
type : MedicationRequest |
dosage |
route |
coding |
system : https://dmd.nhs.uk |
code : 47625008 |
display : Intravenous |
method |
coding |
system : http://snomed.info/sct |
code : 261754007 |
display : Continuous infusion |
dose |
value : 100 |
unit : millilitre |
system : http://unitsofmeasure.org |
code : ml |
Administration Event: Using a pre-prepared infusion product
An administration record using a pre-prepared and dm+d coded Ceftriaxone 1g/50ml infusion bags
product. There would be five administration records, one for each infusion, on each day.
<MedicationAdministration xmlns="http://hl7.org/fhir"> <id value="cc191603-72c0-4e65-86ee-a149a2dc81d4" /> <meta> <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationAdministration" /> </meta> <status value="completed" /> <medicationCodeableConcept> <coding> <system value="https://dmd.nhs.uk" /> <code value="22102811000001100" /> <display value="Ceftriaxone 1g/50ml infusion bags (Special Order)" /> </coding> </medicationCodeableConcept> <subject> <reference value="Patient/UKCore-Patient-RichardSmith-Example" /> </subject> <effectiveDateTime value="2022-02-28T16:52:00+00:00" /> <request> <reference value="34eb3c92-76e6-48c2-9691-aa1f0b58369b" /> <type value="MedicationRequest" /> </request> <dosage> <route> <coding> <system value="https://dmd.nhs.uk" /> <code value="47625008" /> <display value="Intravenous" /> </coding> </route> <method> <coding> <system value="http://snomed.info/sct" /> <code value="261754007" /> <display value="Continuous infusion" /> </coding> </method> <dose> <value value="1" /> <unit value="bag" /> <system value="http://snomed.info/sct" /> <code value="428672001" /> </dose> </dosage> </MedicationAdministration>
{ "resourceType": "MedicationAdministration", "id": "cc191603-72c0-4e65-86ee-a149a2dc81d4", "meta": { "profile": [ "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationAdministration" ] }, "status": "completed", "medicationCodeableConcept": { "coding": [ { "system": "https://dmd.nhs.uk", "code": "22102811000001100", "display": "Ceftriaxone 1g/50ml infusion bags (Special Order)" } ] }, "subject": { "reference": "Patient/UKCore-Patient-RichardSmith-Example" }, "effectiveDateTime": "2022-02-28T16:52:00+00:00", "request": { "reference": "34eb3c92-76e6-48c2-9691-aa1f0b58369b", "type": "MedicationRequest" }, "dosage": { "route": { "coding": [ { "system": "https://dmd.nhs.uk", "code": "47625008", "display": "Intravenous" } ] }, "method": { "coding": [ { "system": "http://snomed.info/sct", "code": "261754007", "display": "Continuous infusion" } ] }, "dose": { "value": 1, "unit": "bag", "system": "http://snomed.info/sct", "code": "428672001" } } }
MedicationAdministration.id[0] | cc191603-72c0-4e65-86ee-a149a2dc81d4 |
MedicationAdministration.meta[0].profile[0] | https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationAdministration |
MedicationAdministration.status[0] | completed |
MedicationAdministration.medication[0].coding[0].system[0] | https://dmd.nhs.uk |
MedicationAdministration.medication[0].coding[0].code[0] | 22102811000001100 |
MedicationAdministration.medication[0].coding[0].display[0] | Ceftriaxone 1g/50ml infusion bags (Special Order) |
MedicationAdministration.subject[0].reference[0] | Patient/UKCore-Patient-RichardSmith-Example |
MedicationAdministration.effective[0] | 2022-02-28T16:52:00+00:00 |
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MedicationAdministration.dosage[0].method[0].coding[0].display[0] | Continuous infusion |
MedicationAdministration.dosage[0].dose[0].value[0] | 1 |
MedicationAdministration.dosage[0].dose[0].unit[0] | bag |
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MedicationAdministration |
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meta |
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status : completed |
medication |
coding |
system : https://dmd.nhs.uk |
code : 22102811000001100 |
display : Ceftriaxone 1g/50ml infusion bags (Special Order) |
subject |
reference : Patient/UKCore-Patient-RichardSmith-Example |
effective : 2022-02-28T16:52:00+00:00 |
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reference : 34eb3c92-76e6-48c2-9691-aa1f0b58369b |
type : MedicationRequest |
dosage |
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coding |
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code : 47625008 |
display : Intravenous |
method |
coding |
system : http://snomed.info/sct |
code : 261754007 |
display : Continuous infusion |
dose |
value : 1 |
unit : bag |
system : http://snomed.info/sct |
code : 428672001 |
Chlorphenamine single bolus infusion
Clinical Scenario
TBC
Prescribing Event
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MedicationRequest.id[0] | 34eb3c92-76e6-48c2-9691-aa1f0b58369b |
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MedicationRequest.subject[0].reference[0] | Patient/UKCore-Patient-RichardSmith-Example |
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MedicationRequest.dosageInstruction[0].method[0].coding[0].display[0] | Single bolus |
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].value[0] | 10 |
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].unit[0] | milligram |
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].system[0] | http://unitsofmeasure.org |
MedicationRequest.dosageInstruction[0].doseAndRate[0].dose[0].code[0] | mg |
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].numerator[0].value[0] | 40 |
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].numerator[0].unit[0] | milligram |
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].numerator[0].system[0] | http://unitsofmeasure.org |
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].numerator[0].code[0] | mg |
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].denominator[0].value[0] | 24 |
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].denominator[0].unit[0] | hour |
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].denominator[0].system[0] | http://unitsofmeasure.org |
MedicationRequest.dosageInstruction[0].maxDosePerPeriod[0].denominator[0].code[0] | h |
MedicationRequest |
id : 34eb3c92-76e6-48c2-9691-aa1f0b58369b |
meta |
profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest |
subject |
reference : Patient/UKCore-Patient-RichardSmith-Example |
medication |
coding |
system : https://dmd.nhs.uk |
code : 9944001 |
display : Chlorphenamine |
reasonCode |
coding |
system : http://snomed.info/sct |
code : 39579001 |
display : Anaphylactic reaction |
dosageInstruction |
text : Single bolus 10 milligram over 1 minute - Intravenous - up to a maximum of 40 milligram in 24 hours |
timing |
repeat |
duration : 1 |
durationUnit : min |
method |
coding |
system : http://snomed.info/sct |
code : 397801003 |
display : Single bolus |
route |
coding |
system : http://snomed.info/sct |
code : 47625008 |
display : Intravenous |
doseAndRate |
dose |
value : 10 |
unit : milligram |
system : http://unitsofmeasure.org |
code : mg |
maxDosePerPeriod |
numerator |
value : 40 |
unit : milligram |
system : http://unitsofmeasure.org |
code : mg |
denominator |
value : 24 |
unit : hour |
system : http://unitsofmeasure.org |
code : h |
Calcium Gluconate continuous infusion
Clinical Scenario
The patient requires a loading dose of 20 ml Calcium Gluconate 10% in a diluent of 100 ml Glucose 5%.
Followed by a maintenance dose of Calcium gluconate 10% as a continuous infusion at a rate of 2 ml per hour via an intravenous central route.
Prescribing Event - Loading Dose
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Bundle.entry[3].resource[0].status[0] | active |
Bundle.entry[3].resource[0].intent[0] | order |
Bundle.entry[3].resource[0].medication[0].reference[0] | Medication/72c5dfc7-e865-436c-b67a-937c10ec14b9 |
Bundle.entry[3].resource[0].medication[0].display[0] | Calcium gluconate 10% 20mL Glucose 5% 100mL |
Bundle.entry[3].resource[0].subject[0].reference[0] | Patient/UKCore-Patient-RichardSmith-Example |
Bundle.entry[3].resource[0].reasonCode[0].coding[0].system[0] | http://snomed.info/sct |
Bundle.entry[3].resource[0].reasonCode[0].coding[0].code[0] | 5291005 |
Bundle.entry[3].resource[0].reasonCode[0].coding[0].display[0] | Hypocalcaemia |
Bundle.entry[3].resource[0].dosageInstruction[0].text[0] | Continuous infusion - 120mL |
Bundle.entry[3].resource[0].dosageInstruction[0].additionalInstruction[0].text[0] | May repeat until patient is asymptomatic |
Bundle.entry[3].resource[0].dosageInstruction[0].timing[0].repeat[0].duration[0] | 10 |
Bundle.entry[3].resource[0].dosageInstruction[0].timing[0].repeat[0].durationUnit[0] | min |
Bundle.entry[3].resource[0].dosageInstruction[0].route[0].coding[0].system[0] | http://snomed.info/sct |
Bundle.entry[3].resource[0].dosageInstruction[0].route[0].coding[0].code[0] | 47625008 |
Bundle.entry[3].resource[0].dosageInstruction[0].route[0].coding[0].display[0] | Intravenous |
Bundle.entry[3].resource[0].dosageInstruction[0].method[0].coding[0].system[0] | http://snomed.info/sct |
Bundle.entry[3].resource[0].dosageInstruction[0].method[0].coding[0].code[0] | 261754007 |
Bundle.entry[3].resource[0].dosageInstruction[0].method[0].coding[0].display[0] | Continuous infusion |
Bundle.entry[3].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].value[0] | 120 |
Bundle.entry[3].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].unit[0] | millilitre |
Bundle.entry[3].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].system[0] | http://unitsofmeasure.org |
Bundle.entry[3].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].code[0] | mL |
Bundle.entry[3].resource[0].substitution[0].allowed[0] | False |
Bundle |
id : ff813874-3e56-4176-a666-e55a4c4a37d6 |
type : collection |
entry |
fullUrl : Medication/0547f17f-7d46-4667-88a7-4c19a6d521d8 |
resource |
id : 0547f17f-7d46-4667-88a7-4c19a6d521d8 |
meta |
profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication |
text |
status : generated |
code |
text : Calcium gluconate 10% 20mL |
amount |
numerator |
value : 20 |
unit : mL |
system : http://unitsofmeasure.org |
code : mL |
denominator |
value : 1 |
ingredient |
item |
coding |
system : https://dmd.nhs.uk |
code : 53691001 |
display : Calcium gluconate |
strength |
numerator |
value : 10 |
unit : % |
system : http://unitsofmeasure.org |
code : % |
denominator |
value : 1 |
entry |
fullUrl : Medication/aa3d3b67-e390-4b67-98ea-f7a04533f727 |
resource |
id : aa3d3b67-e390-4b67-98ea-f7a04533f727 |
meta |
profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication |
text |
status : generated |
code |
text : Glucose 5% 100mL |
amount |
numerator |
value : 100 |
unit : mL |
system : http://unitsofmeasure.org |
code : mL |
denominator |
value : 1 |
ingredient |
item |
coding |
system : https://dmd.nhs.uk |
code : 111138002 |
display : Glucose |
strength |
numerator |
value : 5 |
unit : % |
system : http://unitsofmeasure.org |
code : % |
denominator |
value : 1 |
entry |
fullUrl : Medication/72c5dfc7-e865-436c-b67a-937c10ec14b9 |
resource |
id : 72c5dfc7-e865-436c-b67a-937c10ec14b9 |
meta |
profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication |
text |
status : generated |
code |
text : Calcium gluconate 10% 20mL Glucose 5% 100mL |
ingredient |
item |
reference : Medication/0547f17f-7d46-4667-88a7-4c19a6d521d8 |
display : Calcium gluconate 10% 20mL |
ingredient |
item |
reference : Medication/aa3d3b67-e390-4b67-98ea-f7a04533f727 |
display : Glucose 5% 100mL |
entry |
fullUrl : MedicationRequest/bd4cbd2e-99af-4deb-a2bc-e1b1fc804120 |
resource |
id : bd4cbd2e-99af-4deb-a2bc-e1b1fc804120 |
meta |
profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest |
status : active |
intent : order |
medication |
reference : Medication/72c5dfc7-e865-436c-b67a-937c10ec14b9 |
display : Calcium gluconate 10% 20mL Glucose 5% 100mL |
subject |
reference : Patient/UKCore-Patient-RichardSmith-Example |
reasonCode |
coding |
system : http://snomed.info/sct |
code : 5291005 |
display : Hypocalcaemia |
dosageInstruction |
text : Continuous infusion - 120mL |
additionalInstruction |
text : May repeat until patient is asymptomatic |
timing |
repeat |
duration : 10 |
durationUnit : min |
route |
coding |
system : http://snomed.info/sct |
code : 47625008 |
display : Intravenous |
method |
coding |
system : http://snomed.info/sct |
code : 261754007 |
display : Continuous infusion |
doseAndRate |
dose |
value : 120 |
unit : millilitre |
system : http://unitsofmeasure.org |
code : mL |
substitution |
allowed : False |
Prescribing Event - Maintenance Dose
<MedicationRequest xmlns="http://hl7.org/fhir"> <id value="34eb3c92-76e6-48c2-9691-aa1f0b58369b" /> <meta> <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" /> </meta> <medicationCodeableConcept> <coding> <system value="https://dmd.nhs.uk" /> <code value="33456711000001109" /> <display value="Calcium gluconate 10% solution for injection 50ml vials" /> </coding> </medicationCodeableConcept> <subject> <reference value="Patient/UKCore-Patient-RichardSmith-Example" /> </subject> <reasonCode> <coding> <system value="http://snomed.info/sct" /> <code value="5291005" /> <display value="Hypocalcemia" /> </coding> </reasonCode> <dosageInstruction> <text value="Continuous infusion 2 millilitre per hour - Intravenous central route" /> <route> <coding> <system value="http://snomed.info/sct" /> <code value="418114005" /> <display value="Intravenous central route" /> </coding> </route> <method> <coding> <system value="http://snomed.info/sct" /> <code value="261754007" /> <display value="Continuous infusion" /> </coding> </method> <doseAndRate> <rateQuantity> <value value="2" /> <unit value="millilitre per hour" /> <system value="http://unitsofmeasure.org" /> <code value="ml/h" /> </rateQuantity> </doseAndRate> </dosageInstruction> </MedicationRequest>
{ "resourceType": "MedicationRequest", "id": "34eb3c92-76e6-48c2-9691-aa1f0b58369b", "meta": { "profile": [ "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" ] }, "subject": { "reference": "Patient/UKCore-Patient-RichardSmith-Example" }, "medicationCodeableConcept": { "coding": [ { "system": "https://dmd.nhs.uk", "code": "33456711000001109", "display": "Calcium gluconate 10% solution for injection 50ml vials" } ] }, "reasonCode": [ { "coding": [ { "system": "http://snomed.info/sct", "code": "5291005", "display": "Hypocalcemia" } ] } ], "dosageInstruction": [ { "text": "Continuous infusion 2 millilitre per hour - Intravenous central route", "method": { "coding": [ { "system": "http://snomed.info/sct", "code": "261754007", "display": "Continuous infusion" } ] }, "route": { "coding": [ { "system": "http://snomed.info/sct", "code": "418114005", "display": "Intravenous central route" } ] }, "doseAndRate": [ { "rateQuantity": { "value": 2, "unit": "millilitre per hour", "system": "http://unitsofmeasure.org", "code": "ml/h" } } ] } ] }
MedicationRequest.id[0] | 34eb3c92-76e6-48c2-9691-aa1f0b58369b |
MedicationRequest.meta[0].profile[0] | https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest |
MedicationRequest.medication[0].coding[0].system[0] | https://dmd.nhs.uk |
MedicationRequest.medication[0].coding[0].code[0] | 33456711000001109 |
MedicationRequest.medication[0].coding[0].display[0] | Calcium gluconate 10% solution for injection 50ml vials |
MedicationRequest.subject[0].reference[0] | Patient/UKCore-Patient-RichardSmith-Example |
MedicationRequest.reasonCode[0].coding[0].system[0] | http://snomed.info/sct |
MedicationRequest.reasonCode[0].coding[0].code[0] | 5291005 |
MedicationRequest.reasonCode[0].coding[0].display[0] | Hypocalcemia |
MedicationRequest.dosageInstruction[0].text[0] | Continuous infusion 2 millilitre per hour - Intravenous central route |
MedicationRequest.dosageInstruction[0].route[0].coding[0].system[0] | http://snomed.info/sct |
MedicationRequest.dosageInstruction[0].route[0].coding[0].code[0] | 418114005 |
MedicationRequest.dosageInstruction[0].route[0].coding[0].display[0] | Intravenous central route |
MedicationRequest.dosageInstruction[0].method[0].coding[0].system[0] | http://snomed.info/sct |
MedicationRequest.dosageInstruction[0].method[0].coding[0].code[0] | 261754007 |
MedicationRequest.dosageInstruction[0].method[0].coding[0].display[0] | Continuous infusion |
MedicationRequest.dosageInstruction[0].doseAndRate[0].rate[0].value[0] | 2 |
MedicationRequest.dosageInstruction[0].doseAndRate[0].rate[0].unit[0] | millilitre per hour |
MedicationRequest.dosageInstruction[0].doseAndRate[0].rate[0].system[0] | http://unitsofmeasure.org |
MedicationRequest.dosageInstruction[0].doseAndRate[0].rate[0].code[0] | ml/h |
MedicationRequest |
id : 34eb3c92-76e6-48c2-9691-aa1f0b58369b |
meta |
profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest |
subject |
reference : Patient/UKCore-Patient-RichardSmith-Example |
medication |
coding |
system : https://dmd.nhs.uk |
code : 33456711000001109 |
display : Calcium gluconate 10% solution for injection 50ml vials |
reasonCode |
coding |
system : http://snomed.info/sct |
code : 5291005 |
display : Hypocalcemia |
dosageInstruction |
text : Continuous infusion 2 millilitre per hour - Intravenous central route |
method |
coding |
system : http://snomed.info/sct |
code : 261754007 |
display : Continuous infusion |
route |
coding |
system : http://snomed.info/sct |
code : 418114005 |
display : Intravenous central route |
doseAndRate |
rate |
value : 2 |
unit : millilitre per hour |
system : http://unitsofmeasure.org |
code : ml/h |
Co-amoxiclav continuous infusion
To highlight the difference in representing an infusion and an injection using the FHIR standard.
FHIR Data Item | Infusion | Injection |
---|---|---|
Medication.ingredient (for the diluent) |
Sodium chloride 0.9% infusion 100ml bags | Water for injections 20ml ampoules |
dosageInstruction.timing.duration |
over 30 minutes | over 3-4 minutes |
dosageInstruction.method |
Continous infusion | Inject |
dosageInstruction.doseAndRate |
100 ml | 20 ml |
Prescribing Event - by Infusion
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{ "resourceType": "Bundle", "id": "co-amoxiclav-infusion-request", "type": "message", "entry": [ { "fullUrl": "urn:uuid:682858a9-3942-412d-9ae5-71a2f17f7c5b", "resource": { "resourceType": "MessageHeader", "id": "682858a9-3942-412d-9ae5-71a2f17f7c5b", "eventCoding": { "system": "http://snomed.info/sct", "code": "33633005", "display": "Prescription of drug" }, "source": { "endpoint": "https://myendpoint.nhs.uk/" }, "focus": [ { "reference": "34eb3c92-76e6-48c2-9691-aa1f0b58369b", "type": "MedicationRequest" } ] } }, { "fullUrl": "urn:uuid:11dc9519-b6e8-41bb-bce5-f6f724b743bc", "resource": { "resourceType": "Medication", "id": "11dc9519-b6e8-41bb-bce5-f6f724b743bc", "meta": { "profile": [ "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication" ] }, "form": { "coding": [ { "system": "http://snomed.info/sct", "code": "385229008", "display": "Solution for infusion" } ] }, "code": { "text": "Co-amoxiclav 1.2 gram in Sodium chloride 0.9% infusion 100ml bags - Solution for infusion" }, "ingredient": [ { "itemCodeableConcept": { "coding": [ { "system": "https://dmd.nhs.uk", "code": "39463011000001107", "display": "Co-amoxiclav" } ] }, "strength": { "numerator": { "value": 1.2, "unit": "gram", "system": "http://unitsofmeasure.org", "code": "g" }, "denominator": { "value": 1 } } }, { "itemCodeableConcept": { "coding": [ { "system": "https://dmd.nhs.uk", "code": "4898311000001108", "display": "Sodium chloride 0.9% infusion 100ml bags" } ] } } ] } }, { "fullUrl": "urn:uuid:34eb3c92-76e6-48c2-9691-aa1f0b58369b", "resource": { "resourceType": "MedicationRequest", "id": "34eb3c92-76e6-48c2-9691-aa1f0b58369b", "meta": { "profile": [ "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" ] }, "subject": { "reference": "Patient/UKCore-Patient-RichardSmith-Example" }, "medicationReference": { "reference": "11dc9519-b6e8-41bb-bce5-f6f724b743bc", "type": "Medication" }, "reasonCode": [ { "coding": [ { "system": "http://snomed.info/sct", "code": "68566005", "display": "Urinary tract infection" } ] } ], "dosageInstruction": [ { "text": "Continuous infusion 100 millilitre - over 30 minutes - 3 times a day - Intravenous", "timing": { "repeat": { "duration": 30, "durationUnit": "min", "frequency": 3, "period": 1, "periodUnit": "d" } }, "method": { "coding": [ { "system": "http://snomed.info/sct", "code": "261754007", "display": "Continuous infusion" } ] }, "route": { "coding": [ { "system": "http://snomed.info/sct", "code": "47625008", "display": "Intravenous" } ] }, "doseAndRate": [ { "doseQuantity": { "value": 100, "unit": "millilitre", "system": "http://unitsofmeasure.org", "code": "ml" } } ] } ] } } ] }
Bundle.id[0] | co-amoxiclav-infusion-request |
Bundle.type[0] | message |
Bundle.entry[0].fullUrl[0] | urn:uuid:682858a9-3942-412d-9ae5-71a2f17f7c5b |
Bundle.entry[0].resource[0].id[0] | 682858a9-3942-412d-9ae5-71a2f17f7c5b |
Bundle.entry[0].resource[0].event[0].system[0] | http://snomed.info/sct |
Bundle.entry[0].resource[0].event[0].code[0] | 33633005 |
Bundle.entry[0].resource[0].event[0].display[0] | Prescription of drug |
Bundle.entry[0].resource[0].source[0].endpoint[0] | https://myendpoint.nhs.uk/ |
Bundle.entry[0].resource[0].focus[0].reference[0] | 34eb3c92-76e6-48c2-9691-aa1f0b58369b |
Bundle.entry[0].resource[0].focus[0].type[0] | MedicationRequest |
Bundle.entry[1].fullUrl[0] | urn:uuid:11dc9519-b6e8-41bb-bce5-f6f724b743bc |
Bundle.entry[1].resource[0].id[0] | 11dc9519-b6e8-41bb-bce5-f6f724b743bc |
Bundle.entry[1].resource[0].meta[0].profile[0] | https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication |
Bundle.entry[1].resource[0].code[0].text[0] | Co-amoxiclav 1.2 gram in Sodium chloride 0.9% infusion 100ml bags - Solution for infusion |
Bundle.entry[1].resource[0].form[0].coding[0].system[0] | http://snomed.info/sct |
Bundle.entry[1].resource[0].form[0].coding[0].code[0] | 385229008 |
Bundle.entry[1].resource[0].form[0].coding[0].display[0] | Solution for infusion |
Bundle.entry[1].resource[0].ingredient[0].item[0].coding[0].system[0] | https://dmd.nhs.uk |
Bundle.entry[1].resource[0].ingredient[0].item[0].coding[0].code[0] | 39463011000001107 |
Bundle.entry[1].resource[0].ingredient[0].item[0].coding[0].display[0] | Co-amoxiclav |
Bundle.entry[1].resource[0].ingredient[0].strength[0].numerator[0].value[0] | 1.2 |
Bundle.entry[1].resource[0].ingredient[0].strength[0].numerator[0].unit[0] | gram |
Bundle.entry[1].resource[0].ingredient[0].strength[0].numerator[0].system[0] | http://unitsofmeasure.org |
Bundle.entry[1].resource[0].ingredient[0].strength[0].numerator[0].code[0] | g |
Bundle.entry[1].resource[0].ingredient[0].strength[0].denominator[0].value[0] | 1 |
Bundle.entry[1].resource[0].ingredient[1].item[0].coding[0].system[0] | https://dmd.nhs.uk |
Bundle.entry[1].resource[0].ingredient[1].item[0].coding[0].code[0] | 4898311000001108 |
Bundle.entry[1].resource[0].ingredient[1].item[0].coding[0].display[0] | Sodium chloride 0.9% infusion 100ml bags |
Bundle.entry[2].fullUrl[0] | urn:uuid:34eb3c92-76e6-48c2-9691-aa1f0b58369b |
Bundle.entry[2].resource[0].id[0] | 34eb3c92-76e6-48c2-9691-aa1f0b58369b |
Bundle.entry[2].resource[0].meta[0].profile[0] | https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest |
Bundle.entry[2].resource[0].medication[0].reference[0] | 11dc9519-b6e8-41bb-bce5-f6f724b743bc |
Bundle.entry[2].resource[0].medication[0].type[0] | Medication |
Bundle.entry[2].resource[0].subject[0].reference[0] | Patient/UKCore-Patient-RichardSmith-Example |
Bundle.entry[2].resource[0].reasonCode[0].coding[0].system[0] | http://snomed.info/sct |
Bundle.entry[2].resource[0].reasonCode[0].coding[0].code[0] | 68566005 |
Bundle.entry[2].resource[0].reasonCode[0].coding[0].display[0] | Urinary tract infection |
Bundle.entry[2].resource[0].dosageInstruction[0].text[0] | Continuous infusion 100 millilitre - over 30 minutes - 3 times a day - Intravenous |
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].duration[0] | 30 |
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].durationUnit[0] | min |
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].frequency[0] | 3 |
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].period[0] | 1 |
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].periodUnit[0] | d |
Bundle.entry[2].resource[0].dosageInstruction[0].route[0].coding[0].system[0] | http://snomed.info/sct |
Bundle.entry[2].resource[0].dosageInstruction[0].route[0].coding[0].code[0] | 47625008 |
Bundle.entry[2].resource[0].dosageInstruction[0].route[0].coding[0].display[0] | Intravenous |
Bundle.entry[2].resource[0].dosageInstruction[0].method[0].coding[0].system[0] | http://snomed.info/sct |
Bundle.entry[2].resource[0].dosageInstruction[0].method[0].coding[0].code[0] | 261754007 |
Bundle.entry[2].resource[0].dosageInstruction[0].method[0].coding[0].display[0] | Continuous infusion |
Bundle.entry[2].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].value[0] | 100 |
Bundle.entry[2].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].unit[0] | millilitre |
Bundle.entry[2].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].system[0] | http://unitsofmeasure.org |
Bundle.entry[2].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].code[0] | ml |
Bundle |
id : co-amoxiclav-infusion-request |
type : message |
entry |
fullUrl : urn:uuid:682858a9-3942-412d-9ae5-71a2f17f7c5b |
resource |
id : 682858a9-3942-412d-9ae5-71a2f17f7c5b |
event |
system : http://snomed.info/sct |
code : 33633005 |
display : Prescription of drug |
source |
endpoint : https://myendpoint.nhs.uk/ |
focus |
reference : 34eb3c92-76e6-48c2-9691-aa1f0b58369b |
type : MedicationRequest |
entry |
fullUrl : urn:uuid:11dc9519-b6e8-41bb-bce5-f6f724b743bc |
resource |
id : 11dc9519-b6e8-41bb-bce5-f6f724b743bc |
meta |
profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication |
form |
coding |
system : http://snomed.info/sct |
code : 385229008 |
display : Solution for infusion |
code |
text : Co-amoxiclav 1.2 gram in Sodium chloride 0.9% infusion 100ml bags - Solution for infusion |
ingredient |
item |
coding |
system : https://dmd.nhs.uk |
code : 39463011000001107 |
display : Co-amoxiclav |
strength |
numerator |
value : 1.2 |
unit : gram |
system : http://unitsofmeasure.org |
code : g |
denominator |
value : 1 |
ingredient |
item |
coding |
system : https://dmd.nhs.uk |
code : 4898311000001108 |
display : Sodium chloride 0.9% infusion 100ml bags |
entry |
fullUrl : urn:uuid:34eb3c92-76e6-48c2-9691-aa1f0b58369b |
resource |
id : 34eb3c92-76e6-48c2-9691-aa1f0b58369b |
meta |
profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest |
subject |
reference : Patient/UKCore-Patient-RichardSmith-Example |
medication |
reference : 11dc9519-b6e8-41bb-bce5-f6f724b743bc |
type : Medication |
reasonCode |
coding |
system : http://snomed.info/sct |
code : 68566005 |
display : Urinary tract infection |
dosageInstruction |
text : Continuous infusion 100 millilitre - over 30 minutes - 3 times a day - Intravenous |
timing |
repeat |
duration : 30 |
durationUnit : min |
frequency : 3 |
period : 1 |
periodUnit : d |
method |
coding |
system : http://snomed.info/sct |
code : 261754007 |
display : Continuous infusion |
route |
coding |
system : http://snomed.info/sct |
code : 47625008 |
display : Intravenous |
doseAndRate |
dose |
value : 100 |
unit : millilitre |
system : http://unitsofmeasure.org |
code : ml |
Prescribing Event - by Injection
<Bundle xmlns="http://hl7.org/fhir"> <id value="co-amoxiclav-injection-request" /> <type value="message" /> <entry> <fullUrl value="urn:uuid:682858a9-3942-412d-9ae5-71a2f17f7c5b" /> <resource> <MessageHeader> <id value="682858a9-3942-412d-9ae5-71a2f17f7c5b" /> <focus> <reference value="34eb3c92-76e6-48c2-9691-aa1f0b58369b" /> <type value="MedicationRequest" /> </focus> </MessageHeader> </resource> </entry> <entry> <fullUrl value="urn:uuid:11dc9519-b6e8-41bb-bce5-f6f724b743bc" /> <resource> <Medication> <id value="11dc9519-b6e8-41bb-bce5-f6f724b743bc" /> <meta> <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication" /> </meta> <code> <text value="Co-amoxiclav 1.2 gram in Water for injections 20ml ampoules - Solution for injection" /> </code> <form> <coding> <system value="http://snomed.info/sct" /> <code value="385219001" /> <display value="Solution for injection" /> </coding> </form> <ingredient> <itemCodeableConcept> <coding> <system value="https://dmd.nhs.uk" /> <code value="39463011000001107" /> <display value="Co-amoxiclav" /> </coding> </itemCodeableConcept> <strength> <numerator> <value value="1.2" /> <unit value="gram" /> <system value="http://unitsofmeasure.org" /> <code value="g" /> </numerator> <denominator> <value value="1" /> </denominator> </strength> </ingredient> <ingredient> <itemCodeableConcept> <coding> <system value="https://dmd.nhs.uk" /> <code value="39720011000001104" /> <display value="Water for injections 20ml ampoules" /> </coding> </itemCodeableConcept> <strength> <numerator> <value value="1" /> <unit value="ampoule" /> <system value="http://snomed.info/sct" /> <code value="413516001" /> </numerator> <denominator> <value value="1" /> </denominator> </strength> </ingredient> </Medication> </resource> </entry> <entry> <fullUrl value="urn:uuid:34eb3c92-76e6-48c2-9691-aa1f0b58369b" /> <resource> <MedicationRequest> <id value="34eb3c92-76e6-48c2-9691-aa1f0b58369b" /> <meta> <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" /> </meta> <medicationReference> <reference value="11dc9519-b6e8-41bb-bce5-f6f724b743bc" /> <type value="Medication" /> </medicationReference> <subject> <reference value="Patient/UKCore-Patient-RichardSmith-Example" /> </subject> <reasonCode> <coding> <system value="http://snomed.info/sct" /> <code value="68566005" /> <display value="Urinary tract infection" /> </coding> </reasonCode> <dosageInstruction> <text value="Inject 20 millilitre - over 3-4 minutes - 3 times a day - Intravenous" /> <timing> <repeat> <duration value="3" /> <durationMax value="4" /> <durationUnit value="min" /> <frequency value="3" /> <period value="1" /> <periodUnit value="d" /> </repeat> </timing> <route> <coding> <system value="http://snomed.info/sct" /> <code value="47625008" /> <display value="Intravenous" /> </coding> </route> <method> <coding> <system value="http://snomed.info/sct" /> <code value="422145002" /> <display value="Inject" /> </coding> </method> <doseAndRate> <doseQuantity> <value value="20" /> <unit value="millilitre" /> <system value="http://unitsofmeasure.org" /> <code value="ml" /> </doseQuantity> </doseAndRate> </dosageInstruction> </MedicationRequest> </resource> </entry> </Bundle>
{ "resourceType": "Bundle", "id": "co-amoxiclav-injection-request", "type": "message", "entry": [ { "fullUrl": "urn:uuid:682858a9-3942-412d-9ae5-71a2f17f7c5b", "resource": { "resourceType": "MessageHeader", "id": "682858a9-3942-412d-9ae5-71a2f17f7c5b", "focus": [ { "reference": "34eb3c92-76e6-48c2-9691-aa1f0b58369b", "type": "MedicationRequest" } ] } }, { "fullUrl": "urn:uuid:11dc9519-b6e8-41bb-bce5-f6f724b743bc", "resource": { "resourceType": "Medication", "id": "11dc9519-b6e8-41bb-bce5-f6f724b743bc", "meta": { "profile": [ "https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication" ] }, "form": { "coding": [ { "system": "http://snomed.info/sct", "code": "385219001", "display": "Solution for injection" } ] }, "code": { "text": "Co-amoxiclav 1.2 gram in Water for injections 20ml ampoules - Solution for injection" }, "ingredient": [ { "itemCodeableConcept": { "coding": [ { "system": "https://dmd.nhs.uk", "code": "39463011000001107", "display": "Co-amoxiclav" } ] }, "strength": { "numerator": { "value": 1.2, "unit": "gram", "system": "http://unitsofmeasure.org", "code": "g" }, "denominator": { "value": 1 } } }, { "itemCodeableConcept": { "coding": [ { "system": "https://dmd.nhs.uk", "code": "39720011000001104", "display": "Water for injections 20ml ampoules" } ] }, "strength": { "numerator": { "value": 1, "unit": "ampoule", "system": "http://snomed.info/sct", "code": "413516001" }, "denominator": { "value": 1 } } } ] } }, { "fullUrl": "urn:uuid:34eb3c92-76e6-48c2-9691-aa1f0b58369b", "resource": { "resourceType": "MedicationRequest", "id": "34eb3c92-76e6-48c2-9691-aa1f0b58369b", "meta": { "profile": [ "https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" ] }, "subject": { "reference": "Patient/UKCore-Patient-RichardSmith-Example" }, "medicationReference": { "reference": "11dc9519-b6e8-41bb-bce5-f6f724b743bc", "type": "Medication" }, "reasonCode": [ { "coding": [ { "system": "http://snomed.info/sct", "code": "68566005", "display": "Urinary tract infection" } ] } ], "dosageInstruction": [ { "text": "Inject 20 millilitre - over 3-4 minutes - 3 times a day - Intravenous", "timing": { "repeat": { "duration": 3, "durationMax": 4, "durationUnit": "min", "frequency": 3, "period": 1, "periodUnit": "d" } }, "method": { "coding": [ { "system": "http://snomed.info/sct", "code": "422145002", "display": "Inject" } ] }, "route": { "coding": [ { "system": "http://snomed.info/sct", "code": "47625008", "display": "Intravenous" } ] }, "doseAndRate": [ { "doseQuantity": { "value": 20, "unit": "millilitre", "system": "http://unitsofmeasure.org", "code": "ml" } } ] } ] } } ] }
Bundle.id[0] | co-amoxiclav-injection-request |
Bundle.type[0] | message |
Bundle.entry[0].fullUrl[0] | urn:uuid:682858a9-3942-412d-9ae5-71a2f17f7c5b |
Bundle.entry[0].resource[0].id[0] | 682858a9-3942-412d-9ae5-71a2f17f7c5b |
Bundle.entry[0].resource[0].focus[0].reference[0] | 34eb3c92-76e6-48c2-9691-aa1f0b58369b |
Bundle.entry[0].resource[0].focus[0].type[0] | MedicationRequest |
Bundle.entry[1].fullUrl[0] | urn:uuid:11dc9519-b6e8-41bb-bce5-f6f724b743bc |
Bundle.entry[1].resource[0].id[0] | 11dc9519-b6e8-41bb-bce5-f6f724b743bc |
Bundle.entry[1].resource[0].meta[0].profile[0] | https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication |
Bundle.entry[1].resource[0].code[0].text[0] | Co-amoxiclav 1.2 gram in Water for injections 20ml ampoules - Solution for injection |
Bundle.entry[1].resource[0].form[0].coding[0].system[0] | http://snomed.info/sct |
Bundle.entry[1].resource[0].form[0].coding[0].code[0] | 385219001 |
Bundle.entry[1].resource[0].form[0].coding[0].display[0] | Solution for injection |
Bundle.entry[1].resource[0].ingredient[0].item[0].coding[0].system[0] | https://dmd.nhs.uk |
Bundle.entry[1].resource[0].ingredient[0].item[0].coding[0].code[0] | 39463011000001107 |
Bundle.entry[1].resource[0].ingredient[0].item[0].coding[0].display[0] | Co-amoxiclav |
Bundle.entry[1].resource[0].ingredient[0].strength[0].numerator[0].value[0] | 1.2 |
Bundle.entry[1].resource[0].ingredient[0].strength[0].numerator[0].unit[0] | gram |
Bundle.entry[1].resource[0].ingredient[0].strength[0].numerator[0].system[0] | http://unitsofmeasure.org |
Bundle.entry[1].resource[0].ingredient[0].strength[0].numerator[0].code[0] | g |
Bundle.entry[1].resource[0].ingredient[0].strength[0].denominator[0].value[0] | 1 |
Bundle.entry[1].resource[0].ingredient[1].item[0].coding[0].system[0] | https://dmd.nhs.uk |
Bundle.entry[1].resource[0].ingredient[1].item[0].coding[0].code[0] | 39720011000001104 |
Bundle.entry[1].resource[0].ingredient[1].item[0].coding[0].display[0] | Water for injections 20ml ampoules |
Bundle.entry[1].resource[0].ingredient[1].strength[0].numerator[0].value[0] | 1 |
Bundle.entry[1].resource[0].ingredient[1].strength[0].numerator[0].unit[0] | ampoule |
Bundle.entry[1].resource[0].ingredient[1].strength[0].numerator[0].system[0] | http://snomed.info/sct |
Bundle.entry[1].resource[0].ingredient[1].strength[0].numerator[0].code[0] | 413516001 |
Bundle.entry[1].resource[0].ingredient[1].strength[0].denominator[0].value[0] | 1 |
Bundle.entry[2].fullUrl[0] | urn:uuid:34eb3c92-76e6-48c2-9691-aa1f0b58369b |
Bundle.entry[2].resource[0].id[0] | 34eb3c92-76e6-48c2-9691-aa1f0b58369b |
Bundle.entry[2].resource[0].meta[0].profile[0] | https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest |
Bundle.entry[2].resource[0].medication[0].reference[0] | 11dc9519-b6e8-41bb-bce5-f6f724b743bc |
Bundle.entry[2].resource[0].medication[0].type[0] | Medication |
Bundle.entry[2].resource[0].subject[0].reference[0] | Patient/UKCore-Patient-RichardSmith-Example |
Bundle.entry[2].resource[0].reasonCode[0].coding[0].system[0] | http://snomed.info/sct |
Bundle.entry[2].resource[0].reasonCode[0].coding[0].code[0] | 68566005 |
Bundle.entry[2].resource[0].reasonCode[0].coding[0].display[0] | Urinary tract infection |
Bundle.entry[2].resource[0].dosageInstruction[0].text[0] | Inject 20 millilitre - over 3-4 minutes - 3 times a day - Intravenous |
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].duration[0] | 3 |
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].durationMax[0] | 4 |
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].durationUnit[0] | min |
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].frequency[0] | 3 |
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].period[0] | 1 |
Bundle.entry[2].resource[0].dosageInstruction[0].timing[0].repeat[0].periodUnit[0] | d |
Bundle.entry[2].resource[0].dosageInstruction[0].route[0].coding[0].system[0] | http://snomed.info/sct |
Bundle.entry[2].resource[0].dosageInstruction[0].route[0].coding[0].code[0] | 47625008 |
Bundle.entry[2].resource[0].dosageInstruction[0].route[0].coding[0].display[0] | Intravenous |
Bundle.entry[2].resource[0].dosageInstruction[0].method[0].coding[0].system[0] | http://snomed.info/sct |
Bundle.entry[2].resource[0].dosageInstruction[0].method[0].coding[0].code[0] | 422145002 |
Bundle.entry[2].resource[0].dosageInstruction[0].method[0].coding[0].display[0] | Inject |
Bundle.entry[2].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].value[0] | 20 |
Bundle.entry[2].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].unit[0] | millilitre |
Bundle.entry[2].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].system[0] | http://unitsofmeasure.org |
Bundle.entry[2].resource[0].dosageInstruction[0].doseAndRate[0].dose[0].code[0] | ml |
Bundle |
id : co-amoxiclav-injection-request |
type : message |
entry |
fullUrl : urn:uuid:682858a9-3942-412d-9ae5-71a2f17f7c5b |
resource |
id : 682858a9-3942-412d-9ae5-71a2f17f7c5b |
focus |
reference : 34eb3c92-76e6-48c2-9691-aa1f0b58369b |
type : MedicationRequest |
entry |
fullUrl : urn:uuid:11dc9519-b6e8-41bb-bce5-f6f724b743bc |
resource |
id : 11dc9519-b6e8-41bb-bce5-f6f724b743bc |
meta |
profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-Medication |
form |
coding |
system : http://snomed.info/sct |
code : 385219001 |
display : Solution for injection |
code |
text : Co-amoxiclav 1.2 gram in Water for injections 20ml ampoules - Solution for injection |
ingredient |
item |
coding |
system : https://dmd.nhs.uk |
code : 39463011000001107 |
display : Co-amoxiclav |
strength |
numerator |
value : 1.2 |
unit : gram |
system : http://unitsofmeasure.org |
code : g |
denominator |
value : 1 |
ingredient |
item |
coding |
system : https://dmd.nhs.uk |
code : 39720011000001104 |
display : Water for injections 20ml ampoules |
strength |
numerator |
value : 1 |
unit : ampoule |
system : http://snomed.info/sct |
code : 413516001 |
denominator |
value : 1 |
entry |
fullUrl : urn:uuid:34eb3c92-76e6-48c2-9691-aa1f0b58369b |
resource |
id : 34eb3c92-76e6-48c2-9691-aa1f0b58369b |
meta |
profile : https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest |
subject |
reference : Patient/UKCore-Patient-RichardSmith-Example |
medication |
reference : 11dc9519-b6e8-41bb-bce5-f6f724b743bc |
type : Medication |
reasonCode |
coding |
system : http://snomed.info/sct |
code : 68566005 |
display : Urinary tract infection |
dosageInstruction |
text : Inject 20 millilitre - over 3-4 minutes - 3 times a day - Intravenous |
timing |
repeat |
duration : 3 |
durationMax : 4 |
durationUnit : min |
frequency : 3 |
period : 1 |
periodUnit : d |
method |
coding |
system : http://snomed.info/sct |
code : 422145002 |
display : Inject |
route |
coding |
system : http://snomed.info/sct |
code : 47625008 |
display : Intravenous |
doseAndRate |
dose |
value : 20 |
unit : millilitre |
system : http://unitsofmeasure.org |
code : ml |
Heparin infusion
Heparin medication is a good example of a complex infusion. A typical treatment starts with a single loading dose based on the patient's body weight, followed by a continuous maintenance dose, again based on body weight. The dose, expressed as a number of units per kilogram, would be defined by the Heparin protocol implementation by the Trust.
Two sets of loading dose and maintenance are shown below. The first is where the Trust pharmacy team calculate the actual volume of medication to be infused, based on the units per kilogram calculations.
The second set of examples is where the ward clinicians have performed the calulations and these are recorded on the ePMA system. The FHIR standard allows multiple dosing instructions so the examples include the calculated dose as a volume and as a number of 'units'..
In all cases, the patient's body weight is shared within a referenced Observation
resource.
Prescribing Events
Prescribing Event - Loading Dose
<Bundle xmlns="http://hl7.org/fhir"> <id value="heparin-infusion-request-loading" /> <type value="message" /> <entry> <fullUrl value="urn:uuid:03791226-ed5d-469c-abb0-0a1c25c74839" /> <resource> <MessageHeader> <id value="03791226-ed5d-469c-abb0-0a1c25c74839" /> <eventCoding> <system value="http://snomed.info/sct" /> <code value="33633005" /> <display value="Prescription of drug" /> </eventCoding> <source> <endpoint value="https://myendpoint.nhs.uk/" /> </source> <focus> <reference value="2f09481c-a0bb-48aa-b52c-53211984b1bb" /> <type value="MedicationRequest" /> </focus> </MessageHeader> </resource> </entry> <entry> <fullUrl value="urn:uuid:4a0d9bdc-a583-4390-8983-92e287028b06" /> <resource> <Observation> <id value="4a0d9bdc-a583-4390-8983-92e287028b06" /> <meta> <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-Observation" /> </meta> <code> <coding> <system value="http://loinc.org" /> <code value="29463-7" /> <display value="Body weight" /> </coding> </code> <valueQuantity> <value value="50" /> <unit value="kilogram" /> <system value="http://unitsofmeasure.org" /> <code value="kg" /> </valueQuantity> </Observation> </resource> </entry> <entry> <fullUrl value="urn:uuid:2f09481c-a0bb-48aa-b52c-53211984b1bb" /> <resource> <MedicationRequest> <id value="2f09481c-a0bb-48aa-b52c-53211984b1bb" /> <meta> <profile value="https://fhir.hl7.org.uk/StructureDefinition/UKCore-MedicationRequest" /> </meta> <medicationCodeableConcept> <coding> <system value="https://dmd.nhs.uk" /> <code value="36054511000001107" /> <display value="Heparin sodium 20,000units/20ml solution for injection ampoules" /> </coding> </medicationCodeableConcept> <subject> <reference value="Patient/UKCore-Patient-RachelSmith-Example" /> </subject> <supportingInformation> <reference value="Observation/4a0d9bdc-a583-4390-8983-92e287028b06" /> <type value="Observation" /> </supportingInformation> <reasonCode> <coding> <system value="http://snomed.info/sct" /> <code value="49956009" /> <display value="Antenatal deep vein thrombosis" /> </coding> </reasonCode> <dosageInstruction> <text value="Continuous infusion 75 international unit per kilogram - Intravenous - over 5 minutes" /> <timing> <repeat> <count value="1" /> <duration value="5" /> <durationUnit value="min" /> </repeat> </timing> <route> <coding> <system value="https://dmd.nhs.uk" /> <code value="47625008" /> <display value="Intravenous" /> </coding> </route> <method> <coding> <system value="http://snomed.info/sct" /> <code value="261754007" /> <display value="Continuous infusion" /> </coding> </method> <doseAndRate> <rateQuantity> <value value="75" /> <unit value="international unit per kilogram" /> <system value="http://unitsofmeasure.org" /> <code value="[iU]/kg" /> </rateQuantity> </doseAndRate> </dosageInstruction> </MedicationRequest> </resource> </entry> </Bundle>
{ "resourceType": "Bundle", "type": "message", "id": "heparin-infusion-request-loading", "entry": [ { "fullUrl": "urn:uuid:03791226-ed5d-469c-abb0-0a1c25c74839", "resource": { "resourceType": "MessageHeader", "id": "03791226-ed5d-469c-abb0-0a1c25c74839", "eventCoding": { "system": "http://snomed.info/sct", "code": "33633005", "display": "Prescription of drug" }, "source": { "endpoint": "https://myendpoint.nhs.uk/" }, "focus": [ { "reference": "2f09481c-a0bb-48aa-b52c-53211984b1bb", "type": "MedicationRequest" } ] } }, { "fullUrl": "urn:uuid:4a0d9bdc-a583-4390-8983-92e287028b06", "reso