$TXT Created by at CLN2G2.AAC.DOMAIN.EXT (KIDS) on Tuesday, 07/20/21 at 15:31 ============================================================================= Run Date: AUG 18, 2021 Designation: PSJ*5*419 Package : PSJ - INPATIENT MEDICATIONS Priority: Mandatory Version : 5 SEQ #362 Status: Released Compliance Date: SEP 17, 2021 ============================================================================= Associated patches: (v)PSJ*5*279 <<= must be installed BEFORE `PSJ*5*419' (v)PSJ*5*319 <<= must be installed BEFORE `PSJ*5*419' (v)PSJ*5*397 <<= must be installed BEFORE `PSJ*5*419' Subject: NURSE VERIFICATION RESET AFTER DISPENSE DRUG EDIT Category: - Routine Description: ============ This patch will resolve the following issues: 1) INC11926924 - MAD: PSJ*#*### not resolve: order appeared verified by nurse HITPS-7361 in BCMA but CPRS it was found not to be. 2) INC12777528 - BCMA shows medication as not nurse verified, CPRS shows it as verified 3) INC17553085 - Error in MIN VistA: RPC+##^PSBCHKIV *PSBIVCHG BarCode Medication Administration (PSB) Duplicate: ----------- INC17559434 - IV bolus orders showing verified in CPRS but not BCMA Defect Tracking System Ticket(s) & Overview: -------------------------------------------- 1) INC11926924 - MAD: PSJ*#*### not resolve: order appeared verified by nurse in BCMA but CPRS it was found not to be. Problem: ------- The William S. Middleton Memorial Veterans Medical Center Affairs Hospital reported that the BCMA nurse verification information was not being properly reset (removed) after the field DISPENSE DRUG was edited by Inpatient Pharmacy users through the Inpatient Order Entry [PSJ OE] option. In CPRS the nurse verification is correctly being reset (removed) after any of the Dispense Drug field is modified. There was an expectation from the site that PSJ*5*397 would address this problem, however that patch addressed only edits to the SPECIAL INSTRUCTIONS field, not the DISPENSE DRUG field. This issue is also being considered a Patient Safety Issue (PSI) and the number assigned by the Patient Safety team is HITPS-7361. Resolution: ---------- Every time an order update is received from CPRS by Inpatient Pharmacy the Nurse Verification information (if any) will be invalidated/removed before updating the incoming data from CPRS. In case CPRS sends new Nurse Verification information with the order the information will be updated in Pharmacy order files, which will be reflected in the BCMA application. Depending on how the site BCMA parameters are set it will require a re-verification of the order in CPRS before it can be administered through the BCMA application. Technical Resolution: -------------------- Changed the routine PSJHL4 at line tag ORC+6 and included code to delete/remove the nurse verification information from the PHARMACY PATIENT file (#55) every time an update is received from CPRS. Also, the changes introduced in the routine PSJBCMA2 by PSJ*5*397 to address the incident INC6231181 (HITPS-6742) have been removed because this new change will better address that issue as well. A global hard-setting approach was used to avoid some updates from occurring through Mumps trigger cross-references. 2) INC12777528 - BCMA shows medication as not nurse verified, CPRS shows it as verified Problem: ------- The Minneapolis VA Health Care System reported that a medication order shows as requiring nurse verification in BCMA while CPRS shows the order have been nurse verified. After some research it was determined that the BCMA and CPRS were out of sync regarding the nurse verification due to a hard error that happened when the Special Instructions field is edited for a complex order and a semi-colon character (;) was included in the instructions. Resolution: ---------- The code was changed to prevent the hard error whenever the user includes a semi-colon (;) in the Special Instructions field for complex orders. Technical Resolution: -------------------- Changed the routine PSGOEE at line tag UPD+23 to perform a direct global set for the content of the SPECIAL INSTRUCTIONS file (#8) in the UNIT DOSE sub- file (#55.06) in the PHARMACY PATIENT file (#55) instead of using the FileMan DIE API. This code is used to copy the Special Instructions field content from one order to the other orders after edits in the case of complex orders. 3) INC17553085 - Error in MIN VistA: RPC+##^PSBCHKIV *PSBIVCHG BarCode Medication Administration (PSB) Problem: ------- Both test sites for PSJ*5*409 (Minneapolis and Madison) reported a hard error after the patch was released. It was confirmed the error was a direct side effect of the changes in PSJ*5*409 and that's the reason that patch was recalled (marked ENTERED IN ERROR on FORUM). It created some incomplete Activity Log records in the IV ORDER multiple (#55.01) of the PHARMACY PATINT file (#55) and that's what caused the error. Resolution: ---------- The code in the routine PSJHL4 added by PSJ*4*409 was changed from using FileMan ^DIE API call to doing a direct (hard setting) global setting which prevents some Mumps cross-references from setting the corrupt entries in the IV Activity Log. Technical Resolution: -------------------- The code in the line tag ORC+6 was changed from using a ^DIE call to performing direct sets to remove the nurse verification for the order. Patient Safety Issues (PSIs): ----------------------------- HITPS-7361 (INC11926924) Test Sites: ----------- Madison - William S. Middleton Memorial Veterans Hospital Minneapolis VAMC Miami VAMC Software and Documentation Retrieval Instructions: -------------------------------------------------- The software for this patch is being released in a PackMan message. Patch Installation: Pre/Post Installation Overview: ------------------------------- It is not necessary to disable any options. Pre-Installation Instructions: ------------------------------ This patch should be installed during non-peak hours to minimize potential disruption to users. This patch should take less than 2 minutes to install. Installation Instructions: -------------------------- 1. Choose the PackMan message containing this build. Then select the INSTALL/CHECK MESSAGE PackMan option to load the build. 2. From the Kernel Installation and Distribution System Menu, select the Installation Menu. From this menu, A. Select the Verify Checksums in Transport Global option to confirm the integrity of the routines that are in the transport global. When prompted for the INSTALL NAME enter the patch or build name. (ex. PSJ*5.0*419) NOTE: Using will not bring up a Multi-Package build even if it was loaded immediately before this step. It will only bring up the last patch in the build. B. Select the Backup a Transport Global option to create a backup message. You must use this option and specify what to backup; the entire Build or just Routines. The backup message can be used to restore the routines and components of the build to the pre-patch condition. i. At the Installation option menu, select Backup a Transport Global ii. At the Select INSTALL NAME prompt, enter your build PSJ*5.0*419 iii. When prompted for the following, enter "R" for Routines or "B" for Build. Select one of the following: B Build R Routines Enter response: Build iv. When prompted "Do you wish to secure your build? NO//", press and take the default response of "NO". v. When prompted with, "Send mail to: Last name, First Name", press to take default recipient. Add any additional recipients. vi. When prompted with "Select basket to send to: IN//", press and take the default IN mailbox or select a different mailbox. C. You may also elect to use the following options: i. Print Transport Global - This option will allow you to view the components of the KIDS build. ii. 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 of the components of this patch, such as routines, DDs, templates, etc. D. Select the Install Package(s) option and choose the patch to install. i. If prompted 'Want KIDS to Rebuild Menu Trees Upon Completion of Install? NO//', answer . ii. When prompted 'Want KIDS to INHIBIT LOGONs during the install? NO//', answer . iii. When prompted 'Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO//', answer . Post Installation Instructions: ------------------------------- None. Back-out Procedures: -------------------- Back-out will be done only with the concurrence and participation of development team and appropriate VA site/region personnel. The decision to back-out or rollback software will be a joint decision between development team, VA site/region personnel and other appropriate VA personnel. Prior to installing an updated KIDS package, the site/region should have saved a backup of the routines in a mail message using the Backup a Transport Global [XPD BACKUP] menu option (this is done at time of install). The message containing the backed-up routines can be loaded with the "Xtract PackMan" function at the Message Action prompt. The Packman function "INSTALL/CHECK MESSAGE" is then used to install the backed-up routines onto the VistA System. The back-out plan is to restore the routines from the backup created. No data was modified by this patch installation and, therefore, no rollback strategy is required. Validation of Back-out Procedure: --------------------------------- The Back-out Procedure can be verified by printing the first 2 lines of the routines contained in this patch using the option First Line Routine Print [XU FIRST LINE PRINT]. Once the routines contained in PSJ*5.0*419 patch have been backed out, the first two lines of the routines will no longer contain the designation of this patch in the patch list section on line 2. Routine Information: ==================== The second line of each of these routines now looks like: ;;5.0;INPATIENT MEDICATIONS;**[Patch List]**;16 DEC 97;Build 10 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PSGOEE Before:B148726801 After:B154027446 **4,7,29,47,64,58,82,91,110, 111,112,142,179,181,254,267, 268,281,315,338,373,366,327, 319,419** Routine Name: PSJBCMA2 Before: B62768742 After: B58323287 **32,41,54,56,81,267,370,397,419** Routine Name: PSJHL4 Before: B76440545 After: B83312601 **1,12,27,34,40,42,55,47,50, 56,58,98,85,105,107,110,111, 154,134,197,226,279,419** Routine list of preceding patches: 279, 319, 397 ============================================================================= User Information: Entered By : Date Entered : APR 16, 2021 Completed By: Date Completed: AUG 18, 2021 Released By : Date Released : AUG 18, 2021 ============================================================================= Packman Mail Message: ===================== $END TXT