$TXT Created by THOMPSON,SETH at DAYT17.FO-BAYPINES.MED.VA.GOV (KIDS) on Wednesday, 07/30/08 at 07:52 ============================================================================= Run Date: AUG 28, 2008 Designation: PSJ*5*204 Package : PSJ - INPATIENT MEDICATIONS Priority: Mandatory Version : 5 SEQ #181 Status: Released Compliance Date: SEP 28, 2008 ============================================================================= Associated patches: (v)PSJ*5*108 <<= must be installed BEFORE `PSJ*5*204' Subject: HOLD STATUS NOT REINSTATED AFTER READMIT Category: - Routine Description: ============ With order placed on HOLD, patient was discharged then auto-reinstated without status of HOLD ASSOCIATED REMEDY TICKET: ========================= HD0000000228442 - HOLD med d/c'd then auto-reinstated without HOLD PATIENT SAFETY ISSUE: ===================== PSI-08-008 ASSOCIATED NSR: =============== N/A PARTICIPATING TEST SITES: ========================= DURHAM, NC PALO ALTO HCS UPSTATE NEW YORK HCS REMEDY TICKET OVERVIEW: ======================= HD0000000228442 - With order placed on HOLD, patient was discharged then auto-reinstated without status of HOLD Problem: -------- An order for Metformin was written on Friday for a certain patient. The patient had a CT scan on the same day and the Physician put the medication on HOLD. The intention was to have the order on HOLD for 48 hours, since the medication can cause problems with renal failure in conjunction with the CT procedure. The next day the patient was discharged from observation and then immediately admitted to a regular ward. This action reinstated the medication and from this time forward the medication was administered for the rest of the weekend. The medication was administered via BCMA GUI, as if there were no HOLD on it. After the weekend, when the Physician went to UNHOLD the medication, it was discovered that it was NOT in a HOLD status as expected. The medication had been administered over the weekend and had not been in a HOLD status because of the discharge and immediate auto-reinstatement. Resolution: ----------- The logic in ENR^PSJOERI was modified to check that the HOLD FLAG field (#56) on the UNIT DOSE subfile (#55.06) or the HOLD FLAG field (#149) of the IV subfile (#55.01) of the PHARMACY PATIENT file (#55) is set to "1" on the order. If the HOLD FLAG field for the order is set to "1", the status will be reset to "H" for Hold instead of "A" for Active as it currently does. INSTALL INSTRUCTIONS: ===================== ************************** 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 1 minute. Suggested time to install: non-peak requirement hours. 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*204): 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*204. 5. When prompted "Want KIDS to INHIBIT LOGONs during the install? YES//" respond NO. 6. When prompted "Want to DISABLE Scheduled Options, Menu Options, and Protocols? YES//" 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 3 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PSJOERI Before: B6703213 After: B8184698 **86,108,204** Routine list of preceding patches: 108 ============================================================================= User Information: Entered By : ZEMANSKI,GARY Date Entered : FEB 04, 2008 Completed By: GOLDSMITH,JAMES H Date Completed: AUG 28, 2008 Released By : LYTTLE,KIM M Date Released : AUG 28, 2008 ============================================================================= Packman Mail Message: ===================== $END TXT