Medication safety
DEMO-14 — Conflicting Repositories: Medication Discontinuation vs. Administration
Authored demonstration. Not a live employer result.
01 · Situation
An authoritative order-history record shows a medication discontinued and never reactivated. The nursing administration record shows the same medication administered afterward, in conflict with the governing requirement that administration occur only against an active order.
Illustrative medication-administration protocol (E0), stating nursing may administer only against an active order.
02 · Evidence
What the record holds.
- E0Illustrative medication-administration protocol: administration requires an active order
Verified · on file
- E1Authoritative medication-order history reviewed through Day 7: order changed to discontinued effective Day 5, with no subsequent reactivation or replacement order recorded before the Day 7 administration
Verified · Day 7
- E2Nursing administration record: same medication administered, Day 7
Verified · Day 7
03 · Obligations / Owners
The chain of responsibility.
- 01
Nursing (administer only against an active order, per E0).
04 · Event Type
The classification of the event.
order-status change reviewed via authoritative history (E1); administration event recorded (E2) — these are represented as distinct stored events, not as two ExecutionClaimed events.
05 · Verification Result
What verification established.
CONTRADICTED — the Day 7 administration conflicts with the Day 5 discontinuation order's effective status, verified against E0's requirement that administration occur only against an active order. The authoritative order history confirms no intervening reactivation or replacement order, so the discontinuation remained effective at the time of administration.
06 · Projection
What the evidence implies ahead.
Administration event conflicts with discontinuation status.
07 · Next Action
The corrective obligation.
Reconcile the administration against the order history; determine whether an unrecorded reactivation exists outside this repository.
08 · Economic Boundary
Where the evidence stops.
Not established.
09 · Engine Answer
What the Engine can and cannot establish.
E0 establishes that administration requires an active order. The authoritative order history, reviewed through Day 7, confirms the discontinuation remained effective — no reactivation or replacement order intervened before the Day 7 administration. Verified against E0's requirement, this is CONTRADICTED — an administration event inconsistent with the order's own recorded status at the time it occurred.
The order was discontinued, and stayed discontinued. The medication was given anyway.
10 · What Remains Unknown
Outside the Engine's reach.
Why administration occurred against a discontinued order; whether a verbal or unrecorded reactivation existed outside this repository.