============================================================================= Run Date: SEP 08, 2011 Designation: PSJ*5*235 Package : PSJ - INPATIENT MEDICATIONS Priority: Mandatory Version : 5 SEQ #214 Status: Released Compliance Date: OCT 09, 2011 ============================================================================= Associated patches: (v)PSJ*5*113 <<= must be installed BEFORE `PSJ*5*235' Subject: EXPECTED FIRST DOSE IS INCORRECT Category: - Routine Description: ============ This patch will address the following 2 issues: 1. The Expected First Dose line in CPRS, as well as the REQUESTED START DATE line in Inpatient Order Entry [PSJ OE] are not displaying the correct date. 2. When a complex Unit Dose order is entered in CPRS, and the complex order uses a THEN conjunction, and the Administration time of the first section of the order is before the current time, the Administration time for the subsequent section(s) is incorrect. ASSOCIATED NSR(S): ================== N/A ASSOCIATED REMEDY: ================== 1. HD0000000349678 - QOD (every other day) schedule not working Duplicates: HD0000000350458 - Problem with start time of order HD0000000380843 - First dose of an edited order doesn't appear on anticipated date of next day for Q14day order HD0000000410587 - QOD schedule and BCMA HD0000000486532 - Fentanyl patches order issue 2. HD0000000282528 - Complex Order using conjunction of THEN skips the first dose of the second part when the first part has a duration of 1 day. Duplicates: HD0000000228645 - Complex delayed orders - copy and transfer problem HD0000000236194 - Complex Dates Overlap on StepUp dosing HD0000000391656 - Known Complex Order Issue HD0000000467939 - Start and stop dates for titration order PARTICIPATING TEST SITES: ========================= Lebanon VAMC Milwaukee VAMC San Diego VAMC REMEDY TICKET OVERVIEW: ======================= 1. HD0000000349678 - QOD (every other day) schedule not working Patient Safety Issue: --------------------- PSPO #1521 Problem: -------- When calculating the Expected First Dose, CPRS is ignoring the Inpatient Ward parameter DEFAULT START DATE CALCULATION and is defaulting the calculation for the first dose of the order to be based on USE NEXT ADMIN TIME AS DEFAULT. Depending on the Administration Schedule used and for Wards with this Parameter set to either USE NOW AS DEFAULT or USE CLOSEST AS DEFAULT, the Expected First Dose in CPRS and the Requested Start date in Inpatient Order Entry (PSJ OE) can be incorrect and not match the actual Due date shown in the BCMA Virtual Due List. Example: If it is currently 10 am and you are creating an order with an Administration time of 9 am on a schedule of EVERY OTHER MORNING, and since Today's dose has passed, the Expected Next Dose should show as the day-after-tomorrow at 9 am, where it is currently showing as Tomorrow at 9 am. Resolution: ----------- Routine PSJORPOE has been modified so that CPRS will calculate the Expected First Dose based on the actual selected Inpatient Ward parameter DEFAULT START DATE CALCULATION and not always base the calculation on USE NEXT ADMIN TIME AS DEFAULT. NOTE: ----- This is not a defect but is in fact the way the system was designed. Making this change therefore necessitates an update to the Inpatient Medications Nurse's User Manual and Pharmacist's Manual to reflect this change. 2. HD0000000282528 - Complex Order using conjunction of THEN skips the first dose of the second part when the first part has a duration of 1 day. Patient Safety Issue: --------------------- PSPO #1136 Problem: -------- The system currently calculates the start time of each section of a complex order independently and the calculations are erroneously based on NOW. This is causing the subsequent sections in a complex order to have an incorrect start time. Example: If it is 1000 and the second part of a complex order using the THEN conjunction has Administration times of 0900 and 1700, this order would start on that day at 1700 because 0900 today has already passed. This is incorrect. Resolution: ----------- Routine PSJORPOE has been modified so that tag STARTSTP now accepts another parameter and allows the start date calculation to be based on an initial date. Previously all calculations were based on NOW. After this correction, calculations will be based on the date/time passed in. **NOTE** This change modifies Integration Agreement #3167 DOCUMENTATION RETRIEVAL: ======================== The revised NURSE'S USER MANUAL and PHARMACIST'S USER MANUAL are available on the ANONYMOUS.SOFTWARE directory at one of the following Office of Information (OI) Field Offices. These files should be retrieved in binary format. Sites may retrieve documentation in one of the following ways: (1) The preferred method is to FTP the files from download.vista.med.va.gov, which will transmit the files from the first available FTP server. (2) Sites may also elect to retrieve documentation directly from a specific server as follows: Albany ftp.fo-albany.med.va.gov Hines ftp.fo-hines.med.va.gov Salt Lake City ftp.fo-slc.med.va.gov The documentation distribution includes: File Name Description Protocol --------- ----------- -------- psj_5_nurse_um_r0911.pdf Nurse's User Manual Binary psj_5_phar_um_r0911.pdf Pharmacist's User Manual Binary psj_5_p235_nurse_um_cp.pdf Nurse's UM change pages Binary psj_5_p235_phar_um_cp.pdf Pharmacist's UM change pages Binary Software Retrieval: =================== Patches for this installation are combined in host file PSJ_235_OR_333.KID. Installation of this host file should be coordinated among the packages affected since only one installation is necessary. The patches are: PSJ*5.0*235 OR*3.0*333 Sites may retrieve the KIDS build in one of the following ways: (1) The preferred method is to FTP the files from download.vista.med.va.gov which will transmit the files from the first available FTP server. (2) Sites may also elect to retrieve the patch directly from a specific server as follows: OIFO FTP ADDRESS DIRECTORY -------------- ------------------------ ------------------ Albany ftp.fo-albany.med.va.gov anonymous.software Hines ftp.fo-hines.med.va.gov anonymous.software Salt Lake City ftp.fo-slc.med.va.gov anonymous.software Installation Instructions: ========================== PSJ*5.0*235 is being released in conjunction with ORDER ENTRY/RESULTS REPORTING patch, OR*3.0*333. Installing PSJ*5.0*235 will also install OR*3.0*333. ************************ 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 or Outpatient Pharmacy users are on the system. ****************************************************** Installation will take less than 1 minute. Suggested time to install: non-peak requirement hours. 1. Obtain the file PSJ_235_OR_333.KID. 2. From the Kernel Installation & Distribution System menu, select the Installation menu. 3. Use Load a Distribution using PSJ_235_OR_333.KID when prompted to Enter a Host File name. You may need to append a directory name. 4. From this menu, you may select to use the following options (when prompted for INSTALL NAME, enter PSJ*5.0*235): 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. 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 checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PSJORPOE Before: B36843911 After: B37607736 **50,56,92,80,110,127,133,134, 113,235** Routine list of preceding patches: 113 ============================================================================= User Information: Entered By : THOMPSON,SETH Date Entered : NOV 16, 2009 Completed By: WERNER,GARY Date Completed: AUG 22, 2011 Released By : BLOCH,JACULYN Date Released : SEP 08, 2011 ============================================================================= Packman Mail Message: ===================== No routines included