$TXT Created by HARRIS,JAMES at DVBCACHE.FO-BIRM.DOMAIN.EXT (KIDS) on Tuesday, 10/01/13 at 21:55 ============================================================================= Run Date: DEC 12, 2013 Designation: PSJ*5*279 Package : PSJ - INPATIENT MEDICATIONS Priority: Mandatory Version : 5 SEQ #254 Status: Released Compliance Date: JAN 26, 2014 ============================================================================= Associated patches: (v)OR*3*266 <<= must be installed BEFORE `PSJ*5*279' (v)PSJ*5*228 <<= must be installed BEFORE `PSJ*5*279' (v)PSJ*5*229 <<= must be installed BEFORE `PSJ*5*279' (v)PSJ*5*247 <<= must be installed BEFORE `PSJ*5*279' (v)PSJ*5*258 <<= must be installed BEFORE `PSJ*5*279' (v)PSJ*5*275 <<= must be installed BEFORE `PSJ*5*279' (v)PSS*1*172 <<= must be installed BEFORE `PSJ*5*279' Subject: IMR6 - CLINIC ORDER Category: - Routine - Enhancement (Mandatory) - Data Dictionary - Other Description: ============ ******************************* ATTENTION ******************************** IMR6 CLINIC ORDERS, WITNESS FOR HIGH RISK/HIGH ALERT DRUGS, AND IV BAG LOGIC enhancement includes 4 patches which must be installed in the following order: 1. PSS*1*172 2. OR*3*266 3. PSJ*5*279 4. PSB*3*70 ATTENTION: This enhancement also includes a new Graphical User Interface (GUI) executable, BCMA GUI version 3.0.70.65. Installation of this GUI is required immediately after the KIDS install for the Patch to function. ************************************************************************** Clinic Orders ========================================= This patch contains changes to support clinic orders enhancements in patch PSB*3*70. Support is accomplished by modifying Inpatient Medications software to send active clinic orders with the clinic name to the Bar Code Medication Administration (BCMA) software. A new mail group PSJ CLINIC DEFINITION has been created to provide a means by which pharmacy personnel may be notified when clinic orders are created for clinics that have not been set up completely. If a clinic order, or Inpatient Medications for Outpatients (IMO) order, is created in CPRS for a clinic that is not defined in the CLINIC DEFINITION (#53.46) file, a message is sent to the PSJ CLINIC DEFINITION mail group indicating the order will not display in BCMA unless the clinic is defined in the CLINIC DEFINITION (#53.46) file, and the SEND TO BCMA? (#3) field is set to YES. IV Bag Logic ------------ This patch modifies Inpatient Order Entry so that when Inpatient orders are edited, BCMA IV parameters are now checked to determine if IV labels were invalidated as a result of the edit. If labels were invalidated, the pharmacy user making the edit is informed and a list of the invalidated IV labels are displayed. The pharmacy user is given an opportunity to print replacement labels, including when no new order is created as a result of the edit. T@0 Infusion Rate (Number of Labels per Day) -------------------------------------------- This patch creates a new field called Labels Per Day. The value in this field, if populated, will override the system-calculated number of IV labels. The Labels Per Day field will be accessible in Inpatient Order Entry, via the Infusion Rate field (the Labels Per Day prompt will display immediately after the prompt for Infusion Rate). Previous existing functionality allowing the entry of the number of labels directly into the Infusion Rate field via the "@" character (e.g. 125@1) will be retained, and the number of labels entered after the "@" character will automatically populate the Labels Per Day field. A new INFUSION INSTRUCTIONS (#53.47) file facilitates the entry of commonly used standard text, or 'canned' messages, in the INFUSION RATE (#.08) field in the IV (#100) sub-file of the PHARMACY PATIENT (#55) file. An abbreviation entered into the INFUSION RATE (#.08) field in the IV (#100) sub-file of the PHARMACY PATIENT (#55) sub-file (via Inpatient Order Entry) is replaced with expanded text, if the abbreviation has been defined in the INFUSION INSTRUCTIONS file (#53.47.) Pre-Exchange Report for Clinic Orders -------------------------------------- A new PRE-EXCHANGE REPORT DEVICE (#5) field is being added to the CLINIC DEFINITION (#53.46) file. The field, if populated, contains a device that will be the default print device at the prompt "Select DEVICE for PRE-EXCHANGE UNITS REPORT:" that displays after a clinic order is verified. PSJ CLINIC DEFINITION mail group --------------------------------- A new PSJ CLINIC DEFINITION mail group is being added to the MAIL GROUP (#3.8) file. A mail message is sent to this mail group when a valid Clinic Order is filed in the NON-VERIFIED ORDERS (#53.1) file that is associated with a location that is not defined in the CLINIC DEFINITION (#53.46) file. Patch Components ================ Files & Fields Associated: New/Modified File Name (Number) Field Name (Number) /Deleted ------------------ ------------------- ----------- Non-Verified Orders (53.1) Infusion Rate (#59) Modified Non-Verified Orders (53.1) Labels Per Day (#131) New Clinic Definition (53.46) Missing Dose Printer (#4) New Clinic Definition (53.46) Pre-Exchange Report Device (#5) New Forms Associated: ----------------- N/A Mail Groups Associated: ----------------------- PSJ CLINIC DEFINITION Options Associated: ------------------- N/A Protocols Associated: --------------------- PSJ LM FINISH PSJU LM COPY Security Keys Associated: ------------------------- N/A Templates Associated: --------------------- N/A Additional Information: New Service Requests (NSRs) ---------------------------- NSR 20010504 - Check for invalid bags, prompt to print new labels. NSR 20070506 - Clinic Orders. NSR 20090813 - Request separate area for IV label suppression information. Patient Safety Issues (PSIs) ----------------------------- PSPO 452 - Reported occurrence of patient receiving increased titration rate of morphine.(HD 173063) PSPO 1448 - Normal Saline is displaying on a Sodium Bicarbonate D5W order. (HD 322729, HD 278810, HD 615239) PSPO 1855 - Inpatient Medication Orders for Outpatient orders (IMO) start date/time is the date/time of the appointment, which may not be accurate. (HD 178352) Remedy Ticket(s) & Overview --------------------------- HD 178352 - Inpatient Medications for Outpatients (IMO) orders start date/time is the date/time of the appointment, which may not be accurate. ---------------------------------------------------------------------- Problem - When IMO orders are created in CPRS, the appointment date/time selected by the ordering provider is used as the default start date/time of the order when the order is finished in Inpatient Medications, even if the appointment date/time is in the past, prior to the actual creation of the order. This may cause confusion about the true start date/time of the order. Resolution - Use the appointment date/time selected by the ordering provider as the default start date/time for IMO orders if the appointment date/time is on or after the date/time the order is finished by the finishing pharmacist. If the appointment date/time is prior to the date/time the order is finished by the finishing pharmacist, the current date/time (i.e. NOW) is used as the order's default start date/time at the time the order is finished. HD 322729, HD 278810, HD 615239 - Normal Saline order displays on a Sodium Bicarbonate D5W order. ------------------------------------------------------------------------- Problem: When an infusing IV order changes significantly via an edit, previously printed IV labels may continue to display as available bags in BCMA with the 'old' order information (the order as it existed prior to the change), if the BCMA IV Parameters are not set up to invalidate the IV labels and bags based on the changed field(s). Alternatively, if the IV labels and bags are invalidated based on the BCMA IV parameters, the finishing pharmacist is not aware of the existence of the invalidated bags. Pharmacy users are not typically aware of the field settings of the BCMA IV parameters, making it difficult for pharmacy to know which edits will invalidate IV labels and bags, and when to retrieve invalidated bags to prevent them from being infused inadvertently. Resolution: At the time a changed IV order is finished, display to the finishing pharmacist a list of previously printed IV labels that were invalidated due to the change, and the changed field that triggered the invalidation based on the BCMA IV parameters. Alternatively, if the change did not invalidate the IV labels, display the list of IV labels that continue to be available for infusion. In addition, add a column titled "Available in BCMA" to the IV Label Log to indicate each label's current availability for infusion. HD 173063 - Request separate area for IV Label suppression. --------------------------------------------------------------------- Problem: VA facilities may enter text followed by "@" into the VistA field titled "Infusion Rate" that can lead to misunderstanding. This capability has been available in the VistA system since 1994. Resolution: Add a new field titled "NUMBER OF LABELS PER DAY" to the Inpatient Medications IV software package to allow the pharmacy flexibility to indicate the number of IV labels to print per day. INC801240 - Technician entered non-verified IV order hangs. ----------------------------------------------------------- Problem: When a pharmacy technician copied two IV orders the pharmacist is unable to verify the second order. When the second of the two copied IV orders is selected in Inpatient Order Entry, the order checking software causes the process to hang indefinitely. Resolution: When the second of two copied IV orders in the NON-VERIFIED ORDERS (#53.1) file is processed, verify that the previous order filed in the NON-VERIFIED ORDERS (#53.1) file is left blank if the order was created as a result of the COPY action. CQ BCMA00001657 - Long Profile problem with non-Active Unit Dose orders. --------------- Problem: The Long Profile view in the Inpatient Order Entry [PSJ OE] option and the Order Entry [PSJU NE] option are using the HOURS OF RECENTLY DC/EXPIRED (#7) field parameter in the INPATIENT WARD PARAMETERS (#59.6) file to determine the beginning of the range of dates within which to display non-active Unit Dose orders, rather than the patient's last Admission Date. The HOURS RECENTLY DC/EXPIRED parameter is (correctly) used by the Short Profile. Resolution: Change the Long Profile in the Inpatient Order Entry [PSJ OE] option and the Order Entry [PSJU NE] option to use the patient's last Admission Date to determine the beginning of the range of dates within which non-active Unit Dose orders display. The Short Profile will continue using the HOURS RECENTLY DC/EXPIRED parameter. Test Sites: ---------- Central Texas Loma Linda Pittsburgh St. Cloud Documentation Retrieval Instructions ------------------------------------ Updated documentation describing the new functionality introduced by this patch is available. The preferred method is to FTP the files from ftp://download.vista.domain.ext/. This transmits the files from the first available FTP server. Sites may also elect to retrieve software directly from a specific server as follows: Albany ftp.fo-albany.domain.ext Hines ftp.fo-hines.domain.ext Salt Lake City ftp.fo-slc.domain.ext Documentation can also be found on the VA Software Documentation Library at: http://www4.domain.ext/vdl/ Title File Name FTP Mode ----------------------------------------------------------------------- Inpatient Medications V. 5.0 PSJ_5_NURSE_UM_R1213.PDF BINARY Nurse's User Manual Inpatient Medications V. 5.0 PSJ_5_P279_NURSE_UM_CP.PDF BINARY Nurse's User Manual Change Pages Inpatient Medications V. 5.0 PSJ_5_PHAR_UM_R1213.PDF BINARY Pharmacist's User Manual Inpatient Medications V. 5.0 PSJ_5_P279_PHAR_UM_CP.PDF BINARY Pharmacist's User Manual Change Pages Inpatient Medications V. 5.0 PSJ_5_SUPR_UM_R1213.PDF BINARY Supervisor's User Manual Inpatient Medications V. 5.0 PSJ_5_P279_SUPR_UM_CP.PDF BINARY Supervisor's User Manual Change Pages Inpatient Medications V. 5.0 PSJ_5_TM_R1213.PDF BINARY Technical Manual/Security Guide Inpatient_Medications_V. 5.0 PSJ_5_P279_TM_CP.PDF BINARY Technical Manual/Security Guide Change Pages Inpatient Medications V. 5.0 PSJ_5_P279_RN.PDF BINARY IMR 6 Release Notes Patch Installation: Pre/Post Installation Overview ------------------------------ Pre-Installation Instructions ----------------------------- Installation Instructions ------------------------- REMINDER: Do NOT queue this patch to install at a later time. Verify users are logged of the Inpatient Medications V. 5.0 application. This patch should take less than 5 minutes to install. 1. Choose the PackMan message containing this patch. 2. Choose the INSTALL/CHECK MESSAGE PackMan option. 3. From the Kernel Installation and Distribution System Menu, select the Installation Menu. From this menu, you may elect to use the following option. When prompted for the INSTALL enter PSJ*5.0*279. 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. From the Installation Menu, select the Install Package(s) option and choose the patch to install. 5. When prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//', accept the default, 'NO'. 6. When prompted "Enter the Coordinator for Mail Group 'PSJ CLINIC DEFINITION':", enter the name of the person responsible for maintaining membership in pharmacy mail groups. 7. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', accept the default, 'NO'. 8. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//', enter 'NO'. 9. If prompted "Delay Install (Minutes): (0 - 60): 0// respond 0. Post-Installation Instructions ------------------------------ N/A Uninstall Instructions ---------------------- This procedure assumes that a backup copy of the routines was done during the installation process. Only routines are backed-up; other components such as DDs, templates, protocols, options or HL7 components are not backed up. To back out the patches, restore the backup copy saved in the MailMan message. This action will restore the routines to the state before installing the IMR 6 patches. Note: In order to completely back out all components, development will provide a patch for each package to restore non-routine components to their pre-IMR 6 state. Routine Information: ==================== The second line of each of these routines now looks like: ;;5.0;INPATIENT MEDICATIONS ;**[Patch List]**;16 DEC 97;Build 150 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PSGFILD3 Before: B23057587 After: B24920479 **279** Routine Name: PSGP Before: B11695903 After: B11793961 **10,53,111,181,267,275,279** Routine Name: PSGPER Before: B11838843 After: B18332674 **95,115,127,133,279** Routine Name: PSGPER0 Before: B26511977 After: B34370854 **58,82,95,115,279** Routine Name: PSGPER1 Before: B7625269 After: B18498632 **80,127,279** Routine Name: PSGPER2 Before: B24518370 After: B31489798 **80,115,279** Routine Name: PSIVCAL Before: B75101309 After: B76248321 **4,26,41,47,63,67,69,58,94, 80,110,111,177,120,134,229,279** Routine Name: PSIVEDT1 Before: B63913566 After:B111693180 **3,7,41,47,50,64,58,116,110, 111,113,267,279** Routine Name: PSIVHYPL Before: B42608112 After: B49378868 **58,96,128,178,184,279** Routine Name: PSIVHYPR Before: B39800593 After: B46405814 **58,88,96,178,184,279** Routine Name: PSIVLABL Before: B38277482 After: B43882246 **58,82,104,127,178,184,273,279** Routine Name: PSIVLABR Before: B34113753 After: B39932964 **58,82,178,184,279** Routine Name: PSIVLB Before: B7797321 After: B7955740 **58,81,279** Routine Name: PSIVLBL1 Before: B42715799 After: B42809676 **69,58,81,97,104,279** Routine Name: PSIVLTR1 Before: B9987089 After: B40668959 **58,279** Routine Name: PSIVOPT1 Before: B43461784 After: B46129724 **29,58,101,110,127,181,258,279** Routine Name: PSIVORAL Before: B19351743 After: B19483553 **58,135,267,279** Routine Name: PSIVORC1 Before: B54564779 After: B79901460 **1,37,69,110,157,134,181,263, 270,279** Routine Name: PSIVORE1 Before: B25223179 After: B25786480 **58,110,127,133,279** Routine Name: PSIVOREN Before: B27499279 After: B28253385 **3,18,69,110,127,133,140,134, 207,279** Routine Name: PSIVORFA Before: B28198833 After: B30883518 **4,7,18,28,50,71,58,91,80,110, 111,134,225,267,275,279** Routine Name: PSIVORLB Before: B13180848 After: B16554015 **58,184,279** Routine Name: PSIVRD Before: B24771031 After: B24864338 **38,58,88,279** Routine Name: PSIVSP Before: B41011288 After: B42203793 **30,37,41,50,56,74,83,111,133, 138,134,213,229,279** Routine Name: PSIVUTL Before: B30828184 After: B35163625 **69,58,81,85,110,133,181,263, 275,279** Routine Name: PSJAC Before: B14549203 After: B18623217 **8,10,50,127,181,275,279** Routine Name: PSJBCMA Before: B81219931 After:B104152395 **32,41,46,57,63,66,56,69,58, 81,91,104,111,112,186,159,173, 190,113,225,253,267,279** Routine Name: PSJBCMA1 Before: B94159665 After:B120598961 **32,41,46,57,63,66,56,58,81, 91,104,186,159,173,253,267,279** Routine Name: PSJBCMA6 Before: n/a After: B9827080 **279** Routine Name: PSJCLOR2 Before:B116137522 After:B116286849 **275,279** Routine Name: PSJHL2 Before: B36875797 After: B42288788 **1,18,16,23,28,42,50,70,58, 100,102,110,111,112,144,141, 134,279** Routine Name: PSJHL4 Before: B75570898 After: B76440545 **1,12,27,34,40,42,55,47,50, 56,58,98,85,105,107,110,111, 154,134,197,226,279** Routine Name: PSJHL7 Before: B54233730 After: B54843805 **42,47,50,70,82,110,127,133, 275,279** Routine Name: PSJHL9 Before: B61245429 After: B61985581 **1,18,31,42,47,50,63,72,75, 58,80,110,111,134,267,279** Routine Name: PSJIBAG Before: n/a After: B43933390 **279** Routine Name: PSJLIVFD Before: B54218075 After: B63427206 **7,50,63,64,58,81,91,80,116, 110,111,180,134,181,254,267, 228,279** Routine Name: PSJLIVMD Before: B96668523 After:B100202267 **37,50,63,58,81,91,80,116,110, 111,180,134,209,254,267,275, 279** Routine Name: PSJP Before: B26835871 After: B28361612 **10,53,60,181,273,267,275,279** ============================================================================= User Information: Entered By : HARRIS,JAMES C Date Entered : MAY 29, 2012 Completed By: BANGRAKULUR,KRISHNA Date Completed: NOV 27, 2013 Released By : MIAN,NAEEM Date Released : DEC 12, 2013 ============================================================================= Packman Mail Message: ===================== $END TXT