$TXT Created by THOMPSON,SETH at CHEY19.FO-BAYPINES.MED.VA.GOV (KIDS) on Monday, 12/13/10 at 14:53 ============================================================================= Run Date: MAR 02, 2011 Designation: PSJ*5*179 Package : PSJ - INPATIENT MEDICATIONS Priority: Mandatory Version : 5 SEQ #207 Status: Released Compliance Date: APR 02, 2011 ============================================================================= Associated patches: (v)PSJ*5*95 <<= must be installed BEFORE `PSJ*5*179' (v)PSJ*5*113 <<= must be installed BEFORE `PSJ*5*179' (v)PSJ*5*142 <<= must be installed BEFORE `PSJ*5*179' (v)PSJ*5*193 <<= must be installed BEFORE `PSJ*5*179' Subject: POTENTIAL DOUBLE DOSING OF MEDS AND CLINIC STOP DATE Category: - Routine Description: ============ ************************** WARNING *************************** ************************************************************** If your facility has the Pyxis/Omnicell/McKesson interface from ILC, this patch will overwrite any "local" modifications in routine PSGOEE. This could affect certain orders being sent across this interface. The modifications will have to be reintroduced following installation of this patch. ************************************************************** ************************************************************** This patch addresses the following issues: 1. After a unit dose is given in Bar Code Medication Administration for an Inpatient Order and the pharmacist edits a field with a star(*), the new order may overwrite the administration that was given in BCMA. This presents the possibility of giving a patient a double dose. 2. Inpatient Medications for Outpatients (IMO): Outpatient Orders do not always display the correct default stop date on the patient profile when executing the backdoor Pharmacy Order Entry screen. 3. Orders with a continuous schedule type may default to the wrong stop date/time. 4. When a user edits the Admin time field, then the Comments field is also edited, the Admin time changes are not accepted by the system. The Admin time goes back to the original time before the edits took place. ASSOCIATED NSR: =============== N/A ASSOCIATED REMEDY TICKETS: ========================== 1. HD0000000099382 - PSI-05-053 Drug dose can be administered twice. - PSPO #188 Duplicates: HD0000000068419 HD0000000094196 HD0000000116779 HD0000000185459 HD0000000188822 HD0000000145909 HD0000000195861 HD0000000180202 HD0000000186152 HD0000000317097 HD0000000325406 2. HD0000000195783 - IMO Location not getting default stop date. Duplicates: HD0000000198025 HD0000000299750 HD0000000226674 HD0000000252574 3. HD0000000210901 - PSI-07-172 Reads of File 51.1 not checking Package Prefix. - PSPO #812 Duplicate: HD0000000177654 4. HD0000000237637 - Editing Admit time, then comments renders no change. Duplicate: HD0000000355465 PARTICIPATING TEST SITES: ========================= Maryland HCS Oklahoma City, OK REMEDY OVERVIEW: ================ 1. HD0000000099382 - PSI-05-053 Drug dose can be administered twice. - PSPO #188 PROBLEM ------- When a dose is given in Bar Code Medication Administration for an Inpatient Order, the order is marked in BCMA as GIVEN. If a Pharmacist edit's a field with a star (*), the new order may overwrite the administration that was given in BCMA. The possibility of giving the patient a "double" dose exists. RESOLUTION ---------- To resolve this issue, the calculation used to determine the "Start Date" of edited Active orders was changed. The new calculation will use the last given administration time to determine when the next dose is due. i.e. - With the exception of the (*)Start field, when the pharmacist edit's a field with (*), the calculation of the new orders' Start Date/Time will use the last given administration time to determine when the next administration time and that will also be the new Start Date/Time for the order. 2. HD0000000195783 - IMO Location not getting default stop date PROBLEM ------- When using inpatient medications for Outpatient Orders, the correct stop date is not displayed on the patient profile of the Backdoor Pharmacy Order Entry screen. If there is a value defined in Clinic Definition File for the "NUMBER OF DAYS UNTIL STOP field, the order should use the default stop date. Currently this default stop date is not used when the order is finished as a unit dose. RESOLUTION ---------- Routine, PSGNE3,will be modified to allow use of the NUMBER OF DAYS UNTIL STOP field in the Clinic Definition file when setting the Stop Date. 3. HD0000000210901 - PSI-07-172 Reads of File 51.1 not checking package prefix. - PSPO #812 PROBLEM ------- This Remedy ticket is also related to HD207510 (PSI-07-172). When calculating the default Stop Date/Time for a Unit Dose order, Inpatient Medications uses the schedule type field from the Administration Schedule File (#51.1) to determine which Inpatient Ward Parameter should be used. The Days Until Stop Date/Time or Days Until Stop for One-time will be used. However, the package prefix is not used when retrieving the schedule type from the Schedule File and as result, the wrong schedule and schedule type could be used. This will result in an incorrect default Stop Date/Time being calculated. RESOLUTION -------- Change the reference to the Administration Schedule File (#51.1) that occurs when calculating the default Stop Date/Time to use the package prefix. Once this is done, other packages' schedules will no longer have an effect on the calculation of a Unit Dose order's default stop date/time. 4. HD0000000237637 - Editing Admin time, then comments renders no change. PROBLEM ------- Updates to the admin time field are not accepted when editing the admin time on an existing Unit Dose order, then editing the comment field. The original admin time will remain. This also happens when the user edits the comment field first. RESOLUTION ---------- When the comment field is among the fields that get edited, the DR variable is reset with "*" before calling fileman routine DIE to file the edits. Routine PSGOEE0 is modified to concatenate the existing value of DR with "*" instead of reset it with "*". TECHNICAL INFORMATION ===================== Remedy Ticket HD0000000099382: To determine when the next dose is due, the following calculation will be performed: If a "Starred Field is Edited" and "A dose was given in BCMA" If the Administration was for a Scheduled Administration, Are there "Administration Times" defined for this order? If Yes: Determine Next Dose due by finding the "Next Administration" after the last administration that was Given. Set this Date/Time to the Start Date of the new order. If No: Determine Next Dose due by adding the "Frequency" to the last administration that was Given. Set this Date/Time to the Start Date of the new order If the Administration was NOT for a Scheduled Administration time Determine Next Dose due by adding the "Frequency" to the last administration that was Given. Set this Date/Time to the Start Date of the new order. The calculation above is an overview definition of the calculation. The actual calculation will attempt to take "Day of Week" Schedules, "Odd" schedules, "Every other Day" schedules, etc. into account. Since these and other schedules can span "days", the calculation will move forward to the appropriate day based on the last administration given, the time of the edit, the schedule, and the administration times that are defined. SPECIAL NOTE: 1. If the above calculation cannot calculate a Start Date/Time greater than "NOW", the existing Start Date/Time calculation will be used. 2. This logic will only be used when editing "ACTIVE" orders that have had BCMA Administrations that have been "Given" or "Refused" 3. This logic will be used for Unit Dose orders and orders with Day of Week schedules. 4. IV Piggyback orders will not allow acceptance without modification of the start date so that it is after the last given administration. Also, as part of this change, the Expected First Dose (EFD) logic was modified. The current logic did not take into account that the Start Date/Time could change based on an edit to a starred field. This logic was modified to calculate the Expected first dose using the newly re-calculated Start Date/Time. The Expected First Dose message has also been changed to Display "Next Dose Due" instead "Expected First Dose" for edited Active Unit dose Orders. The message "Expected First dose" has not been changed Installation Instructions: ========================== Suggested time to install: non-peak requirement hours. This patch should be installed when NO Inpatient Pharmacy users are on the system. If a user is on the system accessing this application, an error will occur. Install Time - less than 1 minute. 1. Use the INSTALL/CHECK MESSAGE option on the PackMan menu. 2. From the Kernel Installation & Distribution System menu, select the Installation menu. 3. From this menu, you may select to use the following options (when prompted for INSTALL NAME, enter PSJ*5.0*179): a. Verify Checksums in Transport Global - This option will allow you to ensure the integrity of the routines that are in the transport global. b. Print Transport Global - This option will allow you to view the components of the KIDS build. c. 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.). d. 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. 4. Use the Install Package(s) option and select the package PSJ*5.0*179. 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 45 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PSGNE3 Before: B30964253 After: B84337387 **4,26,47,50,63,69,105,80,111, 183,193,179** Routine Name: PSGOE6 Before: B24315055 After: B24406814 **3,7,39,45,65,58,81,156,134,179** Routine Name: PSGOE91 Before: B41628067 After: B41627571 **50,64,58,110,111,136,113,179** Routine Name: PSGOEE Before: B61292541 After: B63399742 **4,7,29,47,64,58,82,91,110, 111,112,142,179** Routine Name: PSGOEE0 Before: B26990604 After: B27327541 **58,95,179** Routine Name: PSIVCHK Before: B22884839 After: B24591078 **54,58,81,111,213,113,179** Routine Name: PSJOE1 Before: B23620921 After: B23435460 **2,7,25,30,47,56,64,179** Routine Name: PSJUTL Before: B65061820 After: B65890056 **9,47,58,80,110,136,157,177, 134,179** Routine list of preceding patches: 95, 113, 134, 142, 193 ============================================================================= User Information: Entered By : CASTLE,JOHN Date Entered : JUN 02, 2006 Completed By: CRICHLOW,SHERRY Date Completed: FEB 24, 2011 Released By : CAMPBELL,THOMAS Date Released : MAR 02, 2011 ============================================================================= Packman Mail Message: ===================== $END TXT