When the chart and the screen disagree
A medication chart that does not match the administration screen is not a training issue until you have ruled out a mapping issue.
We keep a simple rule on ward audits: if paper and software disagree, we do not start with the nurse. We start with the last interface, the last pharmacy update, and the last time a drug name was mapped by someone who does not work on that ward.
In one Johor specialist centre the administration screen showed a dose as given. The paper chart, still in use for the controlled register, showed it as withheld. Both were 'source of truth' for different committees. The patient was unharmed that week. The next week would have been luck.
These disagreements hide in ordinary places: a synonym list that treats two preparations as the same drug, a time zone set to the vendor’s office, a cancelled order that still prints. None of that appears in a satisfaction survey.
Sampling helps. We take a day’s administrations and walk them backwards. Who acknowledged the result. Who changed the time. Whether the audit log names a person or a shared ward account. If the log names 'nurse', the application is not ready to be the legal record, whatever the policy says.
Clinicians will keep a paper chart if they have been blamed for the software once. That is rational. An audit that scolds them for dual records has missed the point. Fix the disagreement, then ask whether the paper can retire.