$TXT Created by at DEV.DEV.DOMAIN.EXT (KIDS) on Friday, 06/27/14 at 10:23 ============================================================================= Run Date: NOV 05, 2014 Designation: MD*1*35 Package : MD - CLINICAL PROCEDURES Priority: Mandatory Version : 1 SEQ #26 Status: Released Compliance Date: DEC 06, 2014 ============================================================================= Associated patches: (v)MD*1*32 <<= must be installed BEFORE `MD*1*35' Subject: AIS APPROVED CLINICAL PROCEDURES TERMINOLOGY ADDITIONS/UPDATES Category: - Other - Routine Description: ============ This patch will correct the following 3 issues: 1) The Clinical Procedures (CP) Terminology TERM file (#704.101) contains terms used during data entry/display in CP Flowsheet. The Office of Informatics and Analytics - Applied Informatics (AI) Terminology Review Group submitted a spreadsheet requesting additions or updates of 77 Terms. 2) Numeric Terms in Clinical Flowsheets have the ability to be Totaled and/or Sub-Totaled. Some should NOT be totaled because they may cause confusion and lead to incorrect clinical decisions. 3) A record in CP Terminology TERM_QUALIFIER_PAIR File (#704.103) was identified by a Salt Lake City Development group as a circular reference (or a record with an invalid pairing of Parent/Child records). They requested the record be removed from the file. The record does not cause any errors. ASSOCIATED REMEDY TICKETS: ========================== 1) INC0000000859796 Clinical Procedures - Flowsheets: Group #1 INC0000000862176 Clinical Procedures - Flowsheets: Group #2 INC0000000862205 Clinical Procedures - Flowsheets: Group #3 INC0000000862214 Clinical Procedures - Flowsheets: Group #4 INC0000000862219 Clinical Procedures - Flowsheets: Group #5 INC0000000862221 Clinical Procedures - Flowsheets: Group #6 INC0000000862225 Clinical Procedures - Flowsheets: Group #7 INC0000000862230 Clinical Procedures - Flowsheets: Group #8 2) INC0000000882351 Clinical Procedures - Flowsheets: Amend select numeric terms with "Do not check Total or Subtotals" 3) INC0000000971808 Clinical Procedures - Flowsheets: ASSOCIATED NSR(S): ================== N/A PARTICIPATING TEST SITES: ========================= Central Texas Veterans HCS Huntington VAMC, WV VA Heartland - East VA Pittsburgh HCS, PA REMEDY OVERVIEW: ================ 1) INC0000000859796 Clinical Procedures - Flowsheets: Group #1 INC0000000862176 Clinical Procedures - Flowsheets: Group #2 INC0000000862205 Clinical Procedures - Flowsheets: Group #3 INC0000000862214 Clinical Procedures - Flowsheets: Group #4 INC0000000862219 Clinical Procedures - Flowsheets: Group #5 INC0000000862221 Clinical Procedures - Flowsheets: Group #6 INC0000000862225 Clinical Procedures - Flowsheets: Group #7 INC0000000862230 Clinical Procedures - Flowsheets: Group #8 Problem: 1 ---------- The Clinical Procedures (CP) Terminology TERM file (#704.101) contains terms used during data entry/display in CP Flowsheet. The Office of Informatics and Analytics - Applied Informatics (AI) Terminology Review Group submitted a spreadsheet requesting additions or updates of 77 Terms. The following list documents the approved changes for group #1 (Add) - PROCEDURE PERSONNEL (Add) - ACTIVITIES OF DAILY LIVING: WANDERING PREVENTION MEASURES (Mod) - ARTERIAL LINE SITE CONDITION (Add) - CAUTI: ALTERNATIVES ATTEMPTED PRIOR TO CATH (Add) - CAUTI: CATHETER IN PLACE (Add) - CAUTI: INDICATIONS (Add) - CAUTI: INSERTION REQUIREMENTS (Mod) - DEGREES C (Mod) - CENTRAL LINE SITE CONDITION (Mod) - CENTRAL LINE TYPE The following list documents the approved changes for group #2 (Add) - DIAGNOSIS (Mod) - DIALYSIS CATHETER CONDITION (Add) - DIALYSIS: ARTERIAL PRESSURE (Add) - DIALYSIS: UFR (ULTRAFILTRATION RATE) (Add) - DIALYSIS: VENOUS PRESSURE (Add) - DISTANCE VISION (Mod) - EDUCATION TOPIC (Mod) - ENTERAL TUBE ASPIRATE COLOR (Add) - ENTERAL TUBE ASPIRATE PH (Add) - ENTERAL TUBE RESIDUAL VOLUME The following list documents the approved changes for group #3 (Add) - EPIDURAL: MEDICATION (Add) - EPIDURAL: RESERVOIR VOLUME REMAINING (Add) - EPIDURAL: TOTAL VOLUME GIVEN (Add) - FALL PREVENTION (Add) - GAIT (Mod) - IABP SITE CONDITION (Mod) - INTAKE- PO FLUIDS (Mod) - IV LINE CARE (Mod) - IV SITE CONDITION (Add) - MDS: BATHING-SELF PERFORMANCE The following list documents the approved changes for group #4 (Add) - MDS: BATHING-SUPPORT (Add) - MDS: BED MOBILITY-SELF PERFORMANCE (Add) - MDS: BED MOBILITY-SUPPORT (Add) - MDS: DRESSING-SELF PERFORMANCE (Add) - MDS: DRESSING-SUPPORT (Add) - MDS: EATING-SELF PERFORMANCE (Add) - MDS: EATING-SUPPORT (Add) - MDS: LOCOMOTION OFF UNIT-SELF PERFORMANCE (Add) - MDS: LOCOMOTION OFF UNIT-SUPPORT (Add) - MDS: LOCOMOTION ON UNIT-SELF PERFORMANCE The following list documents the approved changes for group #5 (Add) - MDS: LOCOMOTION ON UNIT-SUPPORT (Add) - MDS: PERSONAL HYGIENE-SELF PERFORMANCE (Add) - MDS: PERSONAL HYGIENE-SUPPORT (Add) - MDS: TOILET USE-SELF PERFORMANCE (Add) - MDS: TOILET USE-SUPPORT (Add) - MDS: TRANSFER-SELF PERFORMANCE (Add) - MDS: TRANSFER-SUPPORT (Add) - MDS: WALK IN CORRIDOR-SELF PERFORMANCE (Add) - MDS: WALK IN CORRIDOR-SUPPORT (Add) - MDS: WALK IN ROOM-SELF PERFORMANCE The following list documents the approved changes for group #6 (Add) - MDS: WALK IN ROOM-SUPPORT (Add) - MEDICATION LAST DOSE: HYPOGLYCEMIC AGENT (Add) - MEDICATION LAST DOSE: ESA ERYTHROPOETIN (Add) - MEWS-RESPIRATORY (Add) - MEWS-CONSCIOUS LEVEL (Add) - MEWS-HEART RATE (Add) - MEWS-HOURLY URINE (Add) - MEWS-SCORE (Add) - MEWS-SYSTOLIC BLOOD PRESSURE (Add) - MEWS-TEMPERATURE The following list documents the approved changes for group #7 (Add) - NUMBER OF DAYS (Add) - OSTOMY CARE (Mod) - OSTOMY TYPE (Mod) - PA CATHETER CONDITION (Add) - PCA - TOTAL DOSE 24 HR (Mod) - PRESSURE ULCER COLOR (Mod) - PRESSURE ULCER PREVENTION DEVICE TYPE (Mod) - PRESSURE ULCER RISK FACTORS (Add) - RESTRAINT- ACTIVE ORDER The following list documents the approved changes for group #8 (Add) - RESTRAINTS: BEHAVIOR CRITERIA FOR DISCONTINUE (Add) - SECLUSION: BEHAVIOR CRITERIA FOR DISCONTINUATION (Add) - SECOND VERIFIER (Add) - SEE CPRS PROGRESS NOTE FOR (Add) - ST/T WAVE MEASUREMENT (Mod) - ADL - AMBULATION DISTANCE (Mod) - TONOMETRY (Mod) - VENTILATOR MINUTE VOLUME Resolution: 1 ------------- Post-Init routine MDTERMX will make the above Additions/Modifications to the CP Terminology TERM File (#704.101) and TERM_TYPE file (#704.102) as described in the Problem Section above. The details of each of these terms is in the Clinical Observation (CliO) Terminology Dictionary And Clinical Data Model Documentation that is listed below. 2) INC0000000882351 Clinical Procedures - Flowsheets: Amend select numeric terms with "Do not check Total or Subtotals". PSPO: ----- PSPO #2448 Problem: 2 ---------- Any numeric term in CP Flowsheets has the potential to be totaled or subtotaled at the discretion of the CP Flowsheet Coordinator. This is done by placing a check mark in the Display Totals Row or Display Subtotals by Time Interval boxes within the Term Display Properties when building a Flowsheet View. This was a part of the original design of the software. HOWEVER, some terms should NOT be totaled because they may cause confusion and lead to incorrect clinical decisions. Resolution: 2 ------------- Post-Init routine MDTERMX will make the changes to the CP Terminology TERM File (#704.101) for the following terms that, if totaled, are considered "high risk" by Informatics Patient Safety and the Applied Informatics Service (AIS) CP Flowsheets Terminology Team. Each term will be changed to include the phrase "Do not check Total or Subtotals" in the actual term name. BIPAP-EXPIRATORY BIPAP-INSPIRATORY CEREBRAL PERFUSION PRESSURE INTRACRANIAL PRESSURE IV DOSE RATE - g/TIME IV DOSE RATE - mcg/kg/HOUR IV DOSE RATE - mcg/TIME IV DOSE RATE - mg/kg/HOUR IV DOSE RATE - mg/TIME IV DOSE RATE - UNITS/HOUR IV DOSE RATE - UNITS/kg/HOUR IV FLOW RATE - ml/kg/TIME IV FLOW RATE - ml/TIME **OUTPUT - BLADDER SCAN - (The Term Name will be changed to BLADDER SCAN) PACEMAKER RATE PCA - DEMAND DOSE PCA - LIMIT DOSE PCA - LOCK OUT PCA - VOLUME REMAINING PCA - VOLUME START PEAK INSPIRATORY PRESSURE PULSE RESPIRATORY RATE TRACTION WEIGHT VENTILATOR AUTO PEEP VENTILATOR PATIENT EXHALE VOLUME VENTILATOR PATIENT MINUTE VOLUME VENTILATOR PATIENT RATE VENTILATOR PATIENT RATE TOTAL VENTILATOR PEAK PRESSURE VENTILATOR TIDAL VOLUME ACTUAL VT/VC 3) INC0000000971808 Clinical Procedures - Flowsheets: Problem: 3 ---------- While testing Terminology Patch MD*1*32, a development group in Salt Lake City found a circular record reference in the CP Terminology TERM_QUALIFIER_PAIR File (#704.103) at record IEN 2381. While this record is not causing any problems, they felt that it should be removed from the file. Resolution: 3 ------------- Post-Init routine MDTERMX will remove the circular file reference from the CP Terminology TERM_QUALIFIER_PAIR File (#704.103). DOCUMENTATION: ============== Documentation is available for the Clinical Observation (CliO) Terminology Dictionary And Clinical Data Model Documentation on the ANONYMOUS.SOFTWARE directory at one of the following Office of Information (OI) Field Offices. Sites will be able to download the documentation in the ".PDF" format. The preferred method is to FTP the files from: Download.vista.domain.ext This transmits files from the first available FTP server. Sites may also elect to retrieve documentation directly from a specific server as follows: Albany ftp.domain.ext Hines ftp.domain.ext Salt Lake City ftp.domain.ext File Name: Description: Protocol: ========== ============ ========= MD1_0P35TERM.PDF CliO Terminology Dictionary Binary And Clinical Data Model Documentation may be found on the System Design and Development Web page at: http://www.domain.ext/vd INSTALLATION INSTRUCTIONS: ========================== If installed during the normal workday, it is recommended that the Clinical Procedures users be off the system. Other VISTA users will not be affected. Install Time - less than 5 minutes. 1. Load Transport Global --------------------- Choose the PackMan message containing this patch and invoke the INSTALL/CHECK MESSAGE PackMan option. 2. Start Up KIDS ------------- Start up the Kernel Installation and Distribution System Menu [XPD MAIN]: Edits and Distribution ... Utilities ... Installation ... Select Kernel Installation & Distribution System Option: INStallation --- Load a Distribution Print Transport Global Compare Transport Global to Current System Verify Checksums in Transport Global Install Package(s) Restart Install of Package(s) Unload a Distribution Backup a Transport Global 3. Select Installation Option: --------------------------- NOTE: The following are OPTIONAL - (When prompted for the INSTALL NAME, enter MD*1.0*35): a. Backup a Transport Global - This option will create a backup message of any routines exported with this patch. It will not backup any other changes such as DD's or templates. b. Compare Transport Global to Current System - This option will allow you to view all changes that will be made when this patch is installed. It compares all components of this patch (routines, DD's, templates, etc.). c. Verify Checksums in Transport Global - This option will allow you to ensure the integrity of the routines that are in the transport global. 4. Select Installation Option: Install Package(s) ---------------------------------------------- **This is the step to start the installation of this KIDS patch: a. Choose the Install Package(s) option to start the patch install. b. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//' answer NO c. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//' answer NO NOTE: Post-Init routine MDTERMX will be automatically deleted after it has made the file modifications. Routine Information: ==================== The second line of each of these routines now looks like: ;;1.0;CLINICAL PROCEDURES;**[Patch List]**;Aug 2, 2012;Build 7 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: MDTERMX Before: B4314808 After: B4314808 **35** ============================================================================= User Information: Entered By : Date Entered : MAY 31, 2013 Completed By: Date Completed: OCT 31, 2014 Released By : Date Released : NOV 05, 2014 ============================================================================= Packman Mail Message: ===================== $END TXT