In case of “single point of time” administrations, the <low> element and <high> element SHALL equally be set to the date/time of the administration.

In case of “interval” administrations (simple or complex), the <low> and <high> element indicate the start and stop date/time of the administration interval documented.

Note: In case of „Complex interval administrations“, this element contains the start and stop date/time of the current “partial interval” of the overall “Complex interval administration”.

Note: In case of „Complex interval administrations“, this element contains the dose quantity of the current “partial interval” of the overall “Complex interval administration”.

The constraints defined for this element in PCC TF2, Medication Entry Module (1.3.6.1.4.1.19376.1.5.3.1.4.7) specification apply to this element.

In the case that the Medication Administration Item is used within a Community Medication Administration document according to the “Community Medication Administration” (CMA) Profile this element SHALL NOT be present.

In all other cases (e.g., when used in a “Community Medication List” document according to the PML Profile or in medication sections of other documents as for example Discharge Summaries, etc.) this element SHOULD be present and represent the author and timestamp of the Medication Administration Item.

This first author element SHALL be present in case that the “Community Medication Administration document author” is present (see Section 6.3.4.E1.3.16).

The table below shows the meaning of the data elements of this <author> element. It SHOULD be corresponding to the <author> element of the Community Medication Administration document or, if given, the <author> element of the Medication Administration section within the Community Medication Administration document.
...

If the author of the Community Medication Administration document is already present in the “Medication Administration Author” element (see section above) this element SHALL NOT be present.

In all other cases (e.g., when used in a “Community Medication List” document according to the PML Profile or in medication sections of other documents as for example Discharge Summaries, etc.) this element MAY be present and represent the author and timestamp of the Community Medication Administration document.

The table below shows the meaning of the data elements of this <author> element. It SHALL be corresponding to the <author> element of the Community Medication Administration document header.

At most one fulfillment note MAY be provided for each <substanceAdministration> entry. When present, this entry relationship SHALL contain a Medication Fulfillment Instructions (1.3.6.1.4.1.19376.1.5.3.1.4.3.1) entry.

Fulfillment Notes (used in a Medication Administration Item) are comments from the administering person regarding issues happened during the administration act or up until the creation of the CMA report. Due to the nature of the Medication Fulfillment Instructions (1.3.6.1.4.1.19376.1.5.3.1.4.3.1) Content Module, these comments are limited to narrative text  only.

Examples:

• The patient reacted on the administration by fainting

• The infusion device had a minor malfunction, but was repaired without influencing the administration 

Note: Comments regarding the administration act about issues happening after the creation of the CMA report (e.g., an allergy to the medication recognized after the administration act, etc.) should be documented by a Pharmaceutical Advice (PADV) related to this administration. PADV may also be used for comments regarding the administration act happened during the administration act or up until the creation of the CMA report, e.g., in case narrative description of the issue is not sufficient.

<templateId root='1.3.6.1.4.1.19376.1.9.1.3.11'/> <!-- PHARM -->

…

</substanceAdministration>

</entryRelationship>

Example: a Pharmaceutical Advice to the underlying dispense of this administration, indicating that the dosage instructions have changed since the last administration of the dispensed medication.

The reference to a Pharmaceutical Advice Item this administration is related to SHOULD be present IF KNOWN and SHALL contain a reference to a Pharmaceutical Advice Item, conforming to the Reference to Pharmaceutical Advice Item Content Module (1.3.6.1.4.1.19376.1.9.1.3.13).

See PHARM-TF3, Reference to Pharmaceutical Advice Item Content Module (1.3.6.1.4.1.19376.1.9.1.3.13) specification.

In the case that the Medication Administration Item is used within a Community Medication Administration document according to the “Community Medication Administration” (CMA) Profile this element SHALL NOT be present.

In all other cases (e.g., when used in a “Community Medication List” document according to the PML Profile or in medication sections of other documents as for example Discharge Summaries, etc.) this element SHOULD be present and contain the identifier of the Community Medication Administration document, the Medication Administration Item initially has been created.