Carerealm enforces a two-person witness model on every controlled drug administration where the medication has requires_witness = true. The recording is blocked if no witness is selected.
Recording with a witness
Click the dose on the timeline. The recorder opens.
Pick the outcome. For CDs that need witnessing, the recorder shows a Witness picker.
Pick a second staff member who is present and observed the administration.
Their PIN or sign-in is captured to confirm presence.
Submit.
Post-administration confirmation
After submission, Carerealm emails the witness asking them to confirm (or dispute) the administration. The witness response goes back into the audit trail.
Confirmed — the witness verifies the administration. Audit entry closed.
Disputed — the witness flags a problem. The recording is reviewed and may be reversed or escalated.
Pending — no response yet. The administration counts as in-flight until confirmed; a chase reminder fires after a configured delay.
Heads up — Don't use the witness field to "co-sign" remotely. The witness must be physically present at the moment of administration. A retrospective confirmation by email doesn't make a non-witnessed administration legal — it confirms a real witness was there.
Schedules and the law
Schedule 2 controlled drugs (strong opioids etc.) legally require a witness; Schedules 3-5 are governed by your local policy. Carerealm makes requires_witness a per-medication flag — set it according to your service's policy, not the schedule alone.