$TXT Created by THOMPSON,SETH at DAYT17.FO-BAYPINES.MED.VA.GOV (KIDS) on Monday, 04/27/09 at 14:41 ============================================================================= Run Date: JUL 08, 2009 Designation: PSJ*5*221 Package : PSJ - INPATIENT MEDICATIONS Priority: Mandatory Version : 5 SEQ #191 Status: Released Compliance Date: AUG 08, 2009 ============================================================================= Associated patches: (v)PSJ*5*133 <<= must be installed BEFORE `PSJ*5*221' Subject: SPEED FINISH/VERIFY RE-ENABLE AND CORRECTION Category: - Routine - Other Description: ============ The patch will re-enable the PSJU LM SPEED FINISH and PSJU LM SPEED VERIFY protocols which were previously disabled in emergency patch PSJ*5.0*220. The problem of the start date and frequency being copied from pending renewal orders into one or several pending orders is also corrected. Associated Remedy ticket(s): ============================ 1. HD0000000297810 - PSPO# 1221 - Orders did not show in BCMA. Duplicates: HD0000000289777 - Q14 coming up to be given every 2 days for one order 2. HD0000000302185 - PSPO# 1274 - 1 Possible patient safety issue with med order 3. HD0000000302727 - PSPO# 1278 - 1 Bar Code Med Admin issue - Admin Times Associated Patient Safety Issue(s): =================================== PSPO# 1221 PSPO# 1274 PSPO# 1278 Associated NSR(s): ================== N/A Participating Test Sites: ========================= BRONX, NY PALO ALTO HCS SPOKANE, WA TENNESSEE VALLEY HCS Overview of Remedy ticket(s): ============================= 1. HD0000000297810 - PSPO# 1221 - Orders did not show in BCMA. Problem: -------- If a patient has multiple pending renewals and pending orders, it was possible to use the SPEED FINISH (SF) and SPEED VERIFY (SV) options to finish the pending renewals, as well as finish the pending orders. When performing these functions, the frequency and start date from the pending renewal orders have been copied over into the pending orders. These orders would then be finished with a corrupt start date and frequency. These corrupt orders would display incorrect administration times on the virtual due list (VDL) in BCMA. In this case, doses did not appear on the VDL that should have. The patient then would receive medication at an unintended frequency causing an under dosing of the patient. 2. HD0000000302185 - PSPO# 1274 - 1 Possible patient safety issue with med order Problem: -------- A Patient had a standing order for a medication with a schedule of every 28 days. The medication was renewed and SPEED FINISH (SF) and SPEED VERIFY (SV) options were used to finish the pending renewal. At this point the frequency for the order changed from 40320 (28 days) to 1440 (24 hours). The resulting problem was that the order appeared on the BCMA VDL every day and the medication was administered 3 days in a row thus overdosing the patient. 3. HD0000000302727 - PSPO# 1278 - 1 Bar Code Med Admin issue - Admin Times Problem: -------- A patient had 3 medication orders for DAILY (once a day) medications. When viewing these orders in Inpatient Medications, the site discovered that they had no Administration time. When viewed in BCMA GUI they discovered that they were showing up to be given every 6 hours instead of once daily. Before this was discovered, the patient received 4 times the ordered dosage of these 3 medication orders, for a period of 10 days. The corrupt frequency was caused by using the SPEED FINISH (SF) and SPEED VERIFY (SV) options to finish pending renewals. Resolution: ----------- The protocols PSJU LM SPEED FINISH and PSJU LM SPEED VERIFY will be re-enabled. The resolution for this issue is to correct the selection criteria for the use of SPEED FINISH and SPEED VERIFY. Previously the selection criteria was not taking the PENDING orders into account and would let the user select pending orders when the option should only be used for pending renewals. Technical: ---------- The routine PSGOESF was modified to count the number of pending orders being displayed and account for those pending orders being below the pending renewals. This requires the user to select only pending renewals for Speed Finish. Speed Verify will only verify renewals at a Non-Verified status. During installation, a report can be queued in the background to send a summary of problem orders to the current user and users holding the "PSJ RPHARM" key. This report will only search for active, continuous, unit dose orders. The report can also be run again after the patch installation by running EN^PSJSFRQ from the programmer prompt. Medications with frequency mismatches should be discontinued immediately. Frequency Mismatch Report Example sent via MailMan: --------------------------------------------------- Subj: FREQUENCY MISMATCH :APR 16, 2009 [#534062] 04/16/09@12:54 11 lines From: INPT PHARMACY In 'IN' basket. Page 1 *New* ---------------------------------------------------------------------------- This excludes orders with no frequency and invalid schedules The orders on this list need to be reviewed! This report range is from:OCT 15, 2008@12:54:09 to APR 16, 2009@12:54:09 PATIENT:TEXZLT,CLZHT ALPUHYJH SSN:5956 DRUG:ACYCLOVIR 200MG CAP DFN:143379 ORDER#:12 SCHED:QD STATUS:A TYPE:UNIT DOSE FREQ:240 PATIENT:TEXZLT,CLZHT ALPUHYJH SSN:5956 DRUG:SERTRALINE HCL 100MG TAB DFN:143379 ORDER#:13 SCHED:QD STATUS:A TYPE:UNIT DOSE FREQ:240 INSTALLATION INSTRUCTIONS: ========================== *** This patch should NOT be queued for installation *** ************************ NOTE ************************** IF A USER IS ON THE SYSTEM AND USING THESE PROGRAMS AN EDITED ERROR WILL OCCUR. The patch should be installed when NO Inpatient Pharmacy users are on the system. ******************************************************** Installation will take less than 2 minutes. Suggested time to install: non-peak requirement hours. ************************************************************** * During installation, there will be a request for a time to * * start the frequency check routine PSJSFRQ, this request * * will be queued in the background and send a summary of * * problem orders to the current user and users holding the * * "PSJ RPHARM" key. This report will only search for active, * * continuous, unit dose orders. * ************************************************************** After installation the routine PSJSFRQ will remain and can be run interactively by calling EN^PSJSFRQ from the programmer prompt. This routine may also be deleted by the user after the queued job finishes. 1. Use the INSTALL/CHECK MESSAGE option on the PackMan menu. [Note: TEXT PRINT/DISPLAY option in the PackMan menu will display the patch text only]. 2. From the Kernel Installation and Distribution System (KIDS) menu, select the Installation menu. 3. From this menu, you may elect to use the following options: (when prompted for INSTALL NAME, enter PSJ*5.0*221) a. Backup a Transport Global - this option will create a backup message of any routines exported with the patch. It will NOT backup any other changes such as DDs or templates. b. Compare Transport Global to Current System - this option will allow you to view all changes that will be made when the patch is installed. It compares all components of the patch (routines, DDs, 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. d. Print Transport Global - this option will allow you to view the components of the KIDS build. 4. Use the Install Package(s) option and select the package PSJ*5.0*221 5. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', respond NO. 6. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//', respond NO. Routine Information: ==================== The second line of each of these routines now looks like: ;;5.0; INPATIENT MEDICATIONS ;**[Patch List]**;16 DEC 97;Build 11 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PSGOESF Before: B25954410 After: B27646476 **7,11,29,35,127,133,221** Routine Name: PSJSFRQ Before: n/a After: B60315510 **221** Routine list of preceding patches: 133 ============================================================================= User Information: Entered By : THOMPSON,SETH Date Entered : FEB 26, 2009 Completed By: GOLDSMITH,JAMES H Date Completed: JUL 07, 2009 Released By : CAMPBELL,THOMAS Date Released : JUL 08, 2009 ============================================================================= Packman Mail Message: ===================== $END TXT