MedicationAdministration2-v3.0(2024EN)

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General information

Name: nl.zorg.MedicationAdministration2 NL.png
Version: 3.0
HCIM Status:Final
Release: 2024
Release status: Prepublished
Release date: 15-04-2024


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Metadata

DCM::CoderList Projectgroep Medicatieproces
DCM::ContactInformation.Address
DCM::ContactInformation.Name *
DCM::ContactInformation.Telecom
DCM::ContentAuthorList Projectgroep Medicatieproces
DCM::CreationDate 1-2-2017
DCM::DeprecatedDate
DCM::DescriptionLanguage nl
DCM::EndorsingAuthority.Address
DCM::EndorsingAuthority.Name PM
DCM::EndorsingAuthority.Telecom
DCM::Id 2.16.840.1.113883.2.4.3.11.60.40.3.9.13
DCM::KeywordList Medicatie, Toediening
DCM::LifecycleStatus Final
DCM::ModelerList Architectuurgroep Registratie aan de Bron
DCM::Name nl.zorg.MedicatieToediening2
DCM::PublicationDate 15-04-2024
DCM::PublicationStatus Prepublished
DCM::ReviewerList Projectgroep Medicatieproces & Architectuurgroep Registratie aan de Bron
DCM::RevisionDate 20-03-2024
DCM::Supersedes nl.zorg.MedicatieToediening2-v2.0.1
DCM::Version 3.0
HCIM::PublicationLanguage EN

Revision History

Only available in Dutch

Publicatieversie 1.0 (04-09-2017)

Publicatieversie 1.0.1 (31-12-2017)

ZIB-618 Hernoemen Verstrekking naar Medicatieverstrekking

Publicatieversie 1.1 (31-01-2020)

ZIB-812 Cardinaliteit ToegediendeHoeveelheid wellicht te streng

Publicatieversie 1.1.1 (01-09-2020)

ZIB-911 Correction English "Farmaceutical"

Publicatieversie 2.0 (10-06-2022)

ZIB-1724 Verzameling errata bouwsteen Medicatietoediening
ZIB-1740 Element DubbelControleUitgevoerd verwijderd uit bouwsteen Medicatietoediening

Publicatieversie 2.0.1 (15-10-2023)

ZIB-1896 Replace provider by professional
ZIB-1974 Suggested typo and textual improvements

Publicatieversie 3.0 (15-04-2024)

ZIB-815 Toedieningssnelheid is geen 'bereik'
ZIB-2154 Waardenlijst prik en plaklocatie
ZIB-2206 Medicatietoediening Status
ZIB-2207 Medicatietoediening volgensAfspraak verwijderen
ZIB-2208 Medicatietoediening gerelateerdeAfspraak kardinaliteiten
ZIB-2209 Waardenlijst redenVanAfwijken uitbreiden met 'foutieve registratie'
ZIB-2132 2023-1 Verwijzingen naar FarmaceutischProduct gebruiken verkeerde NL-CM id
ZIB-2134 2023-1 Verwijzing naar Medicatieafspraak gebruikt verkeerde NL-CM id
ZIB-2135 2023-1 Verwijzing naar Toedieningsafspraak gebruikt verkeerde NL-CM id

Concept

Medication administration is the registration of the individual administrations of the medicine on the patient by the administrator (e.g. a nurse or patient themselves), in relation to the entered agreements. Only actually administered medication can be described with this HCIM.

Purpose

The goal of administering the medication is to provide insight into the actual administered products.

Information Model


#1645ContactPerson-v4.1(2024EN)Patient-v4.3(2024EN)#1655HealthProfessional-v4.0(2024EN)#1635#1649#1638#1647PharmaceuticalProduct-v2.2.1(2024EN)#1643#1637#MedicationAdministrationRouteOfAdministration#MedicationAdministrationReasonForDeviationCodeLisAnatomicalLocation-v1.0.3(2024EN)#InjectPatchLocationCodelist#4497MedicationAdministration2-v3.0Model(2024EN).png


Type Id Concept Card. Definition DefinitionCode Reference
Block.png NL-CM:9.13.20928 Arrowdown.pngMedicationAdministration Root concept of the MedicationAdministration information model. This root concept contains all data elements of the MedicationAdministration information model.
18629005 Administration of medication
Verwijzing.png NL-CM:9.13.20929 Arrowright.pngAdministrationProduct::PharmaceuticalProduct 1 The product taken or administered. This is usually medication. Food, blood products, aids and bandages do not strictly fall under the category of medication, but can be reported as well.

In principle, this will be the prescribed product, but the administrator may substitute it by replacing the product with an equivalent product. For example: two 50mg tablets can be administered instead of one 100mg tablet.

Block.png PharmaceuticalProduct
PQ.png NL-CM:9.13.23159 Arrowright.pngAdministeringSpeed 0..1 The administering speed is used in slow administration of liquid. In practice, the measuring unit is almost always ml/hour.

Entering an interval (such as 0-10 ml/hour) is also a commonly used option.

For example, with an administering speed of 10ml/hour: <ul> <li>amount = 10,</li> <li>dose unit = ml</li> </ul> <ul> <li>time unit = hour</li> </ul> Optionally a translation to NHG table Gebruiksvoorschriften(Table 25) is also allowed.

TS.png NL-CM:9.13.21193 Arrowright.pngAdministrationDateTime 1 The date and time at which the medication was administered.
PQ.png NL-CM:9.13.21194 Arrowright.pngAdministeredAmount 0..1 Amount of the administered product.
CD.png NL-CM:9.13.21195 Arrowright.pngRouteOfAdministration 1 The route through which the medication is administered (oral, nasal, intravenous,...).
410675002 Route of administration
List2.png MedicationAdministrationRouteOfAdministration
Verwijzing.png NL-CM:9.13.23381 Arrowright.pngAdministrationLocation::AnatomicalLocation 0..1 Location on or in the body where the medication was administered. Usually used to indicate the location at which a patient was administered an injection or patch was applied. The value list PrikPlakLocationCodelijst list can serve as a starting point for coding these concepts. If both the anatomical location and administration route are filled, they should be aligned.
Block.png AnatomicalLocation
CD.png NL-CM:20.7.4 Arrowright.pngLocation Location from AnatomicalLocation.
List2.png InjectPatchLocationCodelist
Folder.png NL-CM:9.13.21196 Arrowdown.pngAdministrator 0..1 Container of the Administrator concept. This container contains all data elements of the Administrator concept. The concept describes the person who administered the product. This is a professional authorised administrator, the patient themselves or the caregiver, for example.
Verwijzing.png NL-CM:9.13.23380 Arrowright.pngPatient (0..1) If the patient administered the medication themselves, indicate that here. If the medication is administered by a health professional or caregiver/family member/etc., the health professional is entered in the 'HealthProfessional' element or the caregiver/family member/etc. is entered in the 'Contact' element respectively.
Block.png Patient
Verwijzing.png NL-CM:9.13.23172 Arrowright.pngHealthProfessional (0..1) The concept describes the person who administered the product. This is a professional authorised administrator.
Block.png HealthProfessional
Verwijzing.png NL-CM:9.13.23355 Arrowright.pngCaregiver::Contact (0..1) Information on the patient’s personal relative or contact that administered the medication.
Block.png ContactPerson
CD.png NL-CM:9.13.23166 Arrowright.pngMedicationAdministrationReasonForDeviation 0..1 Reason why the medication was not taken or administered or was taken or administered differently. Here, you can choose to enter text or one of the codes.
153631000146105 Reason for deviation in administration of drug or medicament
List2.png MedicationAdministrationReasonForDeviationCodeLis
ST.png NL-CM:9.13.21337 Arrowright.pngComment 0..1 Comments on administering the medication.
48767-8 Annotation comment [Interpretation] Narrative

Columns Concept and DefinitionCode: hover over the values for more information
For explanation of the symbols, please see the legend page List2.png

Example Instances

Only available in Dutch

MedicatieToedieningDatumTijd Toedieningsproduct AfwijkendeToediening MedicatieToedieningStatus Toedieningsweg Toegediende Hoeveelheid AfgesprokenDatumTijd MedicatieToedieningRedenVanAfwijken MedicatieAfspraak
ProductCode GebruiksInstructie
Doseerinstructie|Dosering|Keerdosis
3-6-2014 16:19:07
Pantoprazol mylan tablet msr 20mg Nee Gereed Oraal 1 stuk
Bumetanide pch tablet 2 mg Ja Afgebroken Oraal 1 stuk Patiënt heeft geweigerd
2 stuks
19-9-2014 14:12:11 Novorapid Flexpen Injvlst 100e/Ml Pen 3ml Ja Uitgesteld Subcutaan 22 eenheden 19-9-2014 9:00:00
Vergeten toe te dienen 22 elementen

Valuesets

InjectPatchLocationCodelist

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.9.13.4 Binding: Extensible
Conceptname Conceptcode Codesystem name Codesystem OID Description
Structure of upper part of lumbar region of abdominal wall 160531000146108 SNOMED CT 2.16.840.1.113883.6.96 structuur van bovenste gedeelte van lumbale regio van wand van abdomen
Structure of lower part of lumbar region of abdominal wall 160481000146106 SNOMED CT 2.16.840.1.113883.6.96 structuur van onderste gedeelte van lumbale regio van wand van abdomen
Structure of right part of supraumbilical region 160501000146103 SNOMED CT 2.16.840.1.113883.6.96 structuur van rechter gedeelte van supra-umbilicale regio
Structure of left part of infra-umbilical region 160441000146104 SNOMED CT 2.16.840.1.113883.6.96 structuur van linker gedeelte van infra-umbilicale regio
Structure of left part of supraumbilical region 160451000146101 SNOMED CT 2.16.840.1.113883.6.96 structuur van linker gedeelte van supra-umbilicale regio
Structure of right part of infra-umbilical region 160491000146108 SNOMED CT 2.16.840.1.113883.6.96 structuur van rechter gedeelte van infra-umbilicale regio
Structure of soft tissue of upper outer quadrant of anterior surface of thigh 160521000146106 SNOMED CT 2.16.840.1.113883.6.96 structuur van weke delen van laterale bovenkwadrant van anterieur oppervlak van bovenbeen
Structure of soft tissue of upper inner quadrant of anterior surface of thigh 160511000146101 SNOMED CT 2.16.840.1.113883.6.96 structuur van weke delen van mediale bovenkwadrant van anterieur oppervlak van bovenbeen
Structure of soft tissue of lower outer quadrant of anterior surface of thigh 160471000146109 SNOMED CT 2.16.840.1.113883.6.96 structuur van weke delen van laterale onderkwadrant van anterieur oppervlak van bovenbeen
Structure of soft tissue of lower inner quadrant of anterior surface of thigh 160461000146103 SNOMED CT 2.16.840.1.113883.6.96 structuur van weke delen van mediale onderkwadrant van anterieur oppervlak van bovenbeen
Structure of upper outer quadrant of buttock 703712000 SNOMED CT 2.16.840.1.113883.6.96 structuur van laterale bovenkwadrant van regio glutealis
Structure of upper inner quadrant of buttock 160541000146100 SNOMED CT 2.16.840.1.113883.6.96 structuur van mediale bovenkwadrant van regio glutealis
Structure of lower outer quadrant of buttock 160431000146107 SNOMED CT 2.16.840.1.113883.6.96 structuur van laterale onderkwadrant van regio glutealis
Structure of lower inner quadrant of buttock 160421000146105 SNOMED CT 2.16.840.1.113883.6.96 structuur van mediale onderkwadrant van regio glutealis
Skin structure of clavicular region 91009005 SNOMED CT 2.16.840.1.113883.6.96 structuur van huid van regio clavicularis
Skin structure of left part of back of upper thoracic region 160371000146104 SNOMED CT 2.16.840.1.113883.6.96 structuur van huid van linker gedeelte van achterzijde van bovenste gedeelte van thoracale regio
Skin structure left part of back of upper thoracic region 160391000146100 SNOMED CT 2.16.840.1.113883.6.96 structuur van huid van rechter gedeelte van achterzijde van bovenste gedeelte van thoracale regio
Skin structure of left part of back of lower thoracic region 160361000146105 SNOMED CT 2.16.840.1.113883.6.96 structuur van huid van linker gedeelte van achterzijde van onderste gedeelte van thoracale regio
Skin structure of right part of back of lower thoracic region 160381000146102 SNOMED CT 2.16.840.1.113883.6.96 structuur van huid van rechter gedeelte van achterzijde van onderste gedeelte van thoracale regio
Skin structure of left part of lumbosacral region 160401000146102 SNOMED CT 2.16.840.1.113883.6.96 structuur van huid van linker gedeelte van lumbosacrale regio
Skin structure of right part of lumbosacral region 160411000146100 SNOMED CT 2.16.840.1.113883.6.96 structuur van huid van rechter gedeelte van lumbosacrale regio
Skin structure of anterior surface of upper arm 45981001 SNOMED CT 2.16.840.1.113883.6.96 structuur van huid van anterieur oppervlak van bovenarm
Structure of posterior surface of upper arm 15703000 SNOMED CT 2.16.840.1.113883.6.96 structuur van posterieur oppervlak van bovenarm
Structure of deltoid muscle 35259002 SNOMED CT 2.16.840.1.113883.6.96 structuur van musculus deltoideus
Skin structure of right upper quadrant of anterior surface of thorax 160561000146104 SNOMED CT 2.16.840.1.113883.6.96 structuur van huid van rechter bovenkwadrant van voorzijde van thorax
Skin structure of left upper quadrant of anterior surface of thorax 160551000146102 SNOMED CT 2.16.840.1.113883.6.96 structuur van huid van linker bovenkwadrant van voorzijde van thorax
Skin structure of right lower quadrant of anterior surface of thorax 160581000146107 SNOMED CT 2.16.840.1.113883.6.96 structuur van huid van rechter onderkwadrant van voorzijde van thorax
Skin structure of left lower quadrant of anterior surface of thorax 160571000146105 SNOMED CT 2.16.840.1.113883.6.96 structuur van huid van linker onderkwadrant van voorzijde van thorax
Skin structure of scapular region of back 45980000 SNOMED CT 2.16.840.1.113883.6.96 structuur van huid van regio scapularis
Skin structure of postauricular region 24483006 SNOMED CT 2.16.840.1.113883.6.96 structuur van huid van postauriculaire regio

MedicationAdministrationReasonForDeviationCodeLis

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.9.13.3 Binding: Extensible
Conceptname Conceptcode Codesystem name Codesystem OID Description
Product discontinued DISCONT ActReason 2.16.840.1.113883.5.8 Product niet meer leverbaar [DEPRECATED]
Patient not available NON-AVAIL ActReason 2.16.840.1.113883.5.8 Patiënt niet beschikbaar [DEPRECATED]
Patient refuse PREFUS ActReason 2.16.840.1.113883.5.8 Patiënt heeft geweigerd [DEPRECATED]
Unable to use UNABLE ActReason 2.16.840.1.113883.5.8 Toediening volgens voorschrift niet mogelijk [DEPRECATED]
Order aborted FOABORT ActReason 2.16.840.1.113883.5.8 Medicatieafspraak is gestopt [DEPRECATED]
Forgotten to administer FORGOT NL-CM-CS 2.16.840.1.113883.2.4.3.11.60.40.4 Vergeten toe te dienen [DEPRECATED]
Administration performer not available APNA NL-CM-CS 2.16.840.1.113883.2.4.3.11.60.40.4 Toediener niet aanwezig [DEPRECATED]
Deficit of medication supply 705046008 SNOMED CT 2.16.840.1.113883.6.96 Product niet meer leverbaar
Medication discontinued 274512008 SNOMED CT 2.16.840.1.113883.6.96 Medicatieafspraak is gestopt
Medication spat out by patient 152741000146103 SNOMED CT 2.16.840.1.113883.6.96 Uiitgespuugd door patiënt
Healthcare professional not available to administer medication 153221000146105 SNOMED CT 2.16.840.1.113883.6.96 Toediener niet aanwezig
Healthcare professional forgot to administer medication 153211000146100 SNOMED CT 2.16.840.1.113883.6.96 Vergeten toe te dienen
Unable to use medication 408366001 SNOMED CT 2.16.840.1.113883.6.96 Toediening volgens voorschrift niet mogelijk
Medication declined 406149000 SNOMED CT 2.16.840.1.113883.6.96 Patiënt heeft geweigerd
Patient not available to receive medication 153241000146104 SNOMED CT 2.16.840.1.113883.6.96 Patiënt niet beschikbaar
Incorrect registration of medication 159691000146109 SNOMED CT 2.16.840.1.113883.6.96 Foutieve registratie van medicatie

MedicationAdministrationRouteOfAdministration

Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.9.13.2 Binding: Extensible
Conceptname Codesystem name Codesystem OID
All values G-Standaard Toedieningswegen 2.16.840.1.113883.2.4.4.9

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Technical specifications in HL7v3 CDA and HL7 FHIR

To exchange information based on health and care information models, additional, more technical specifications are required.<BR> Not every environment can handle the same technical specifications. For this reason, there are several types of technical specifications:

  • HL7® version 3 CDA compatible specifications, available through the Nictiz ART-DECOR® environment Artdecor.jpg
  • HL7® FHIR® compatible specifications, available through the Nictiz environment on the Simplifier FHIR Fhir.png

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This information model is also available as pdf file PDF.png or as spreadsheet Xlsx.png

About this information

The information in this wikipage is based on Prerelease 2024-1
SNOMED CT and LOINC codes are based on:

  • SNOMED Clinical Terms versie: 20240331 [R] (maart 2024-editie)
  • LOINC version 2.77

Conditions for use are located on the mainpage List2.png
This page is generated on 25/04/2024 12:41:41 with ZibExtraction v. 9.3.8880.19756


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