maintenance: title: FORM_SET_INTRA_ABDOMINAL_ANTIBIOTICS;; mlmname: FORM_SET_INTRA_ABDOMINAL_ANTIBIOTICS;; arden: version 2.5;; version: 15.10;; institution: St Clair Hospital;; author: Juliet M. Law, Allscripts ;; specialist: Peggy Leschak, Allscripts;; date: 2016-05-09;; validation: testing;; library: purpose: Used for Intra-Abdominal Antibiotics order set ;; explanation: This MLM is called from Intra-Abdominal Antibiotics Order Set Change history 05.09.2016 JML CSR 34091: Created for Intra-Abdominal Antibiotic Order Set 04.12.2017 JML CSR 35566: Change default Zosyn selection to lower dose. 02.13.2018 JML CSR 26163: Replaced cefepime / ceftriaxone with mini-syringes due to drug shortage 03.09.2018 TMS CSR 34822: Update Zosyn selections to use extended infusion logic ;; keywords: Called MLMs, Antibiotic Intra-Abdominal, Weight Based Dosing ;; knowledge: type: data-driven;; data: standard_libs := mlm {{{SINGLE-QUOTE}}}std_include_libs{{{SINGLE-QUOTE}}}; include standard_libs; using "ObjectsPlusXA.SCM.Forms"; using namespace "ObjectsPlusXA.SunriseClinicalManager.Forms"; DiscontinueOrder := MLM {{{SINGLE-QUOTE}}}SCH_FUNC_DISCONTINUE_BY_ORDERGUID{{{SINGLE-QUOTE}}}; crcl_mlm := mlm {{{SINGLE-QUOTE}}}FORM_MLM_Creatinine_Clearance_OS{{{SINGLE-QUOTE}}}; // This MLM is passed three arguments, of types // communication_type, form_type and client info object respectively. (this_communication, // Communication object this_form, // Form object client_info_obj //Arden ClientInfo object ) := argument; ClientGuid := this_communication.ClientGUID; ChartGuid := this_communication.ChartGUID; ClientVisitGuid := this_communication.ClientVisitGUID; PrimaryObjdetail:=this_communication.PrimaryObj; OrderSetName := PrimaryObjdetail.OrderSetName; /*******************Make Changes To Spelling And Flags In This Section*******************/ /* Set to True if a decision.log is needed.*/ log_execution_info := False; /***************************************************************************************/ // Initialize error message error_message:=""; enable_chkbx_mlm := mlm {{{SINGLE-QUOTE}}}FORM_Func_Disable_OS_Checkboxes{{{SINGLE-QUOTE}}}; antibiotic_guideline_mlm := mlm {{{SINGLE-QUOTE}}}FORM_FUNC_DISPLAY_ANTIBIOTIC_GUIDELINES{{{SINGLE-QUOTE}}}; AutoMedScheduling := MLM {{{SINGLE-QUOTE}}}FORM_Antibiotic_Scheduling{{{SINGLE-QUOTE}}}; exceptFld := (); cefazolin_logic_run := false; // Assigns fields passed in the Form object to the Field object field_list:= this_form.fields; CallingEvent := this_communication.CallingEvent; CallingField := this_communication.CallingFieldName; //Define fields Augmentin_Chk := first of ( field_list WHERE field_list.DataItemName = "PRX_Checkbox1" AND field_list.Control_MultiFieldOccNum = 1 ); Levaquin_Flagyl_Chk := first of ( field_list WHERE field_list.DataItemName = "PRX_Checkbox1" AND field_list.Control_MultiFieldOccNum = 2 ); Zosyn_Chk := first of ( field_list WHERE field_list.DataItemName = "PRX_Checkbox1" AND field_list.Control_MultiFieldOccNum = 3 ); Cefepime_Flagyl_Chk := first of ( field_list WHERE field_list.DataItemName = "PRX_Checkbox1" AND field_list.Control_MultiFieldOccNum = 5 ); Zosyn2_Chk := first of ( field_list WHERE field_list.DataItemName = "PRX_Checkbox1" AND field_list.Control_MultiFieldOccNum = 4 ); Cipro_Flagyl_Chk := first of ( field_list WHERE field_list.DataItemName = "PRX_Checkbox1" AND field_list.Control_MultiFieldOccNum = 7 ); Ancef_Chk := first of ( field_list WHERE field_list.DataItemName = "PRX_Checkbox1" AND field_list.Control_MultiFieldOccNum = 8 ); Zosyn3_Chk := first of ( field_list WHERE field_list.DataItemName = "PRX_Checkbox1" AND field_list.Control_MultiFieldOccNum = 9 ); Cipro_Flagyl2_Chk := first of ( field_list WHERE field_list.DataItemName = "PRX_Checkbox1" AND field_list.Control_MultiFieldOccNum = 11 ); Fluconazole_Chk := first of ( field_list WHERE field_list.DataItemName = "PRX_Checkbox1" AND field_list.Control_MultiFieldOccNum = 16 ); CrCl_MgDl := first of ( field_list WHERE field_list.DataItemName = "PRX_CrCl_mg_dl" AND field_list.Control_MultiFieldOccNum = 1 ); CrCl_Estd := first of (field_list where field_list.DataItemName = "PRX_CrCl_Estimated" and field_List.Control_MultiFieldOccNum = 1); CrCl_Calc := first of ( field_list WHERE field_list.DataItemName = "PRX_Generic_CB" AND field_list.Control_MultiFieldOccNum = 1 ); Antibiotics_Grid := first of ( field_list WHERE field_list.DataItemName = "MultiOrderGrid" AND field_list.Control_MultiFieldOccNum = 1 ); Antibiotics_Grid_Value := Antibiotics_Grid.Value; Augmentin := first of ( Antibiotics_Grid_Value WHERE Antibiotics_Grid_Value.Name = "Amoxicillin/Clavulanic Acid 875mg Tab" ); Levaquin := first of ( Antibiotics_Grid_Value WHERE Antibiotics_Grid_Value.Name = "Levofloxacin 750mg Tab" ); Flagyl_Oral := first of ( Antibiotics_Grid_Value WHERE Antibiotics_Grid_Value.Name = "Metronidazole 500mg Tab" ); Flagyl_IV := first of ( Antibiotics_Grid_Value WHERE Antibiotics_Grid_Value.Name = "Metronidazole:" ); Zosyn := last of ( Antibiotics_Grid_Value WHERE Antibiotics_Grid_Value.Name = "Piperacillin/Tazobactam:" ); Zosyn_Low := first of ( Antibiotics_Grid_Value WHERE Antibiotics_Grid_Value.Name = "Piperacillin/Tazobactam:" ); Cefepime := first of ( Antibiotics_Grid_Value WHERE Antibiotics_Grid_Value.Name = "Cefepime:" OR Antibiotics_Grid_Value.Name = "Cefepime Mini-Syringe" ); Ciprofloxacin := first of ( Antibiotics_Grid_Value WHERE Antibiotics_Grid_Value.Name = "Ciprofloxacin;" ); Ancef := first of ( Antibiotics_Grid_Value WHERE Antibiotics_Grid_Value.Name = "Cefazolin:" ); Fluconazole_Now := first of ( Antibiotics_Grid_Value WHERE Antibiotics_Grid_Value.Name = "Fluconazole:" ); Fluconazole := last of ( Antibiotics_Grid_Value WHERE Antibiotics_Grid_Value.Name = "Fluconazole:" ); Ancef_Dose := first of ( field_list WHERE field_list.DataItemName = "DosageLow" AND field_list.Control_MultiFieldOccNum = 1 ); Override_ABX_Schedule := first of ( field_list WHERE field_list.DataItemname = "PRX_Override_Abx_Scheduling" AND field_list.Control_MultiFieldOccNum = 1 ); Load_ReqDate := last of ( field_list WHERE field_list.DataItemName = "RequestedDate" and field_list.Control_MultiFieldOccNum = 12); Load_ReqTime := last of ( field_list WHERE field_list.DataItemName = "RequestedTime" and field_list.Control_MultiFieldOccNum = 12); Load_ReqDate_Val := Load_ReqDate.Value; Load_ReqTime_Val := Load_ReqTime.Value; Zosyn_Freq := last of ( field_list WHERE field_list.DataItemName = "FrequencyCode" and field_list.Control_MultiFieldOccNum = 1); FreqValue := Zosyn_Freq.Value; Zosyn_Freq_Dictionary := last of ( field_list WHERE field_list.DataItemName = "PRX_Zosyn_Ext_Inf_Freq" and field_list.Control_MultiFieldOccNum = 1); Maint_ReqDate := last of ( field_list WHERE field_list.DataItemName = "RequestedDate" and field_list.Control_MultiFieldOccNum = 13); Maint_ReqTime := last of ( field_list WHERE field_list.DataItemName = "RequestedTime" and field_list.Control_MultiFieldOccNum = 13); Maint_ReqDate_Val := Maint_ReqDate.Value; Maint_ReqTime_Val := Maint_ReqTime.Value; Override:= last of ( field_list WHERE field_list.DataItemName = "PRX_Generic_CB" and field_list.Control_MultiFieldOccNum = 2); ZosynMsg := last of ( field_list WHERE field_list.DataItemName = "NUR_GenAdditiionalLabel" and field_list.Control_MultiFieldOccNum = 9); NoLoad := false; ZOSYNGuid := read last { "select guid from cv3ordercatalogmasteritem where Name = {{{SINGLE-QUOTE}}}Piperacillin/Tazobactam:{{{SINGLE-QUOTE}}}" }; StdZOSYNGuid := read last { "select guid from cv3ordercatalogmasteritem where Name = {{{SINGLE-QUOTE}}}Piperacillin/Tazobactam;{{{SINGLE-QUOTE}}}" }; CRRTGuid := read last { "select guid from cv3ordercatalogmasteritem where Name = {{{SINGLE-QUOTE}}}Renal Replacement Treatment Type{{{SINGLE-QUOTE}}}"}; CRRT := read last {" select summaryline from cv3order where name = {{{SINGLE-QUOTE}}}Renal Replacement Treatment Type{{{SINGLE-QUOTE}}} and ClientGUID = " || SQL(clientguid) || " and ClientVisitGUID = " || SQL(clientvisitguid) || " and orderstatuscode = {{{SINGLE-QUOTE}}}AUA1{{{SINGLE-QUOTE}}} "}; If override.value = true then Zosyn_Freq_Dictionary.Control_Read_Only := false; else Zosyn_Freq_Dictionary.Control_Read_Only := true; endif; // Get patient weight comb_ht_wt_field := first of (field_list where field_list.DataItemName = "CombinedMeasurements"); if exists comb_ht_wt_field then comb_ht_wt_val := comb_ht_wt_field.value; wt := comb_ht_wt_val.weight; ht := comb_ht_wt_val.height; weightvalue := (wt as number); endif; // Get patient age (birthDate) := read last {ClientInfo: BirthDate REFERENCING client_info_obj}; patientAge := (NOW - birthDate) / (1 year); If patientage < 11.99 and CallingEvent = "FormOpen" then; dialogResult := call {{{SINGLE-QUOTE}}}MessageBox{{{SINGLE-QUOTE}}}.Show with "Patient under 12 years of age." ||"\n Please call physician for dosing. " ,"Alert","OK" as {{{SINGLE-QUOTE}}}MessageBoxButtons{{{SINGLE-QUOTE}}}; endif; if ( CallingEvent = "FormOpen" ) then //Retrieve CrCl values (this_communication, this_form) := call crcl_mlm WITH this_communication, this_form, client_info_obj; //Populate Guidelines ( this_communication, this_form ) := call antibiotic_guideline_mlm WITH this_communication, this_form, client_info_obj; for item IN Antibiotics_Grid_Value do // if ( item.Name NOT IN ("Piperacillin/Tazobactam:", "Fluconazole:") ) then if ( item.Name NOT IN ("Fluconazole:") ) then item.IsReadonly := true; endif; enddo; If OrderSetName = "IntraAbdominal Antibiotic ED" then Zosyn_Freq_Dictionary.control_visible := FALSE; Override.control_visible := FALSE; ZosynMsg.control_visible := FALSE; endif; endif; if ( CallingEvent = "FieldChange" ) then //********* Height / Weight Measurements ******* if ( CallingField = "CombinedMeasurements|1" ) then if ( Ancef_Chk.Value = true ) then cefazolin_logic_run := true; endif; endif; //********* Creatinine Calculate ******** if ( CallingField = "PRX_CrCl_mg_dl|1" OR CallingField = "PRX_Generic_CB|1" ) then (this_communication, this_form) := call crcl_mlm WITH this_communication, this_form, client_info_obj; CrCl_Calc.Value := false; endif; //*********** AUGMENTIN ******************** if ( CallingField = "PRX_Checkbox1|1" ) then fieldValue := Augmentin_Chk.Value; if ( fieldValue = true ) then Augmentin.IsSelected := true; rtnValue := call enable_chkbx_mlm WITH this_communication, this_form, client_info_obj, CallingField, true, ""; elseif ( fieldValue = false ) then Augmentin.IsSelected := false; rtnValue := call enable_chkbx_mlm WITH this_communication, this_form, client_info_obj, CallingField, false, ""; endif; endif; //********** LEVAQUIN + FLAGYL ************** if ( CallingField = "PRX_Checkbox1|2" ) then fieldValue := Levaquin_Flagyl_Chk.Value; if ( fieldValue = true ) then Levaquin.IsSelected := true; Flagyl_Oral.IsSelected := true; rtnValue := call enable_chkbx_mlm WITH this_communication, this_form, client_info_obj, CallingField, true, ""; elseif ( fieldValue = false ) then Levaquin.IsSelected := false; Flagyl_Oral.IsSelected := false; rtnValue := call enable_chkbx_mlm WITH this_communication, this_form, client_info_obj, CallingField, false, ""; endif; endif; //************ ZOSYN ***************** if ( OrderSetName = "IntraAbdominal Antibiotic ED" and ( CallingField = "PRX_Checkbox1|3" OR CallingField = "PRX_Checkbox1|4" OR CallingField = "PRX_Checkbox1|9" ) ) then if ( CallingField = "PRX_Checkbox1|3" ) then fieldValue := Zosyn_Chk.Value; exceptFld := exceptFld, Fluconazole_Chk.DataItemName || "|" || Fluconazole_Chk.Control_MultiFieldOccNum; elseif ( CallingField = "PRX_Checkbox1|4" ) then fieldValue := Zosyn2_Chk.Value; elseif ( CallingField = "PRX_Checkbox1|9" ) then fieldValue := Zosyn3_Chk.Value; endif; if ( fieldValue = true ) then Zosyn_Low.IsSelected := true; rtnValue := call enable_chkbx_mlm WITH this_communication, this_form, client_info_obj, CallingField, true, exceptFld; elseif ( fieldValue = false ) then Zosyn.IsSelected := false; Zosyn_Low.IsSelected := false; rtnValue := call enable_chkbx_mlm WITH this_communication, this_form, client_info_obj, CallingField, false, ""; endif; endif; //*********** ZOSYN EXTENDED INFUSION *************************** if ( CallingField = "PRX_Zosyn_Ext_Inf_Freq|1" ) then override.value := true; if Zosyn_Freq_Dictionary.value = "Q12H" then FreqValue.FrequencySummary := "Q12H"; elseif Zosyn_Freq_Dictionary.value = "Q8H" then FreqValue.FrequencySummary := "Q8H"; endif; endif; if OrderSetName = "IntraAbdominal Antibiotic" and ( CallingField = "PRX_Checkbox1|3" OR CallingField = "PRX_Checkbox1|4" OR CallingField = "PRX_Checkbox1|9" ) or ( CallingField = "PRX_Zosyn_Ext_Inf_Freq|1" and (Zosyn_Chk.Value= true or Zosyn2_Chk.Value= true or Zosyn3_Chk.Value= true) ) or (CallingField = "PRX_Generic_CB|1" and (Zosyn_Chk.Value= true or Zosyn2_Chk.Value= true or Zosyn3_Chk.Value= true) ) or (CallingField = "PRX_Generic_CB|2" and (Zosyn_Chk.Value= true or Zosyn2_Chk.Value= true or Zosyn3_Chk.Value= true) ) then if ( CallingField = "PRX_Checkbox1|3" or Zosyn_Chk.Value= true ) then fieldValue := Zosyn_Chk.Value; exceptFld := exceptFld, Fluconazole_Chk.DataItemName || "|" || Fluconazole_Chk.Control_MultiFieldOccNum; elseif ( CallingField = "PRX_Checkbox1|4" or Zosyn2_Chk.Value= true) then fieldValue := Zosyn2_Chk.Value; elseif ( CallingField = "PRX_Checkbox1|9" or Zosyn3_Chk.Value= true ) then fieldValue := Zosyn3_Chk.Value; endif; if ( fieldValue = true ) then rtnValue := call enable_chkbx_mlm WITH this_communication, this_form, client_info_obj, CallingField, true, exceptFld; //Retrieve possible load orders LoadOrderDose, LoadOrderGuid, LoadSigDtm, LoadStopDtm, LoadOrderStatus:= read { " select me.dosagelow, o.guid, o.SignificantDtm, o.stopdtm, o.orderstatuscode from cv3order o join cv3clientvisit cv on cv.guid = o.ClientVisitGUID and cv.ClientGUID = o.ClientGUID join CV3MedicationExtension me on me.guid = o.guid where o.ClientVisitGUID = " || SQL(clientvisitguid) || " and o.ClientGuid = " || SQL(clientguid) || " and o.TypeCode = {{{SINGLE-QUOTE}}}Medication{{{SINGLE-QUOTE}}} and o.orderstatuscode in ({{{SINGLE-QUOTE}}}COMP{{{SINGLE-QUOTE}}},{{{SINGLE-QUOTE}}}AUA1{{{SINGLE-QUOTE}}}) and (me.dosagelow = {{{SINGLE-QUOTE}}}4.5{{{SINGLE-QUOTE}}} or me.dosagelow = {{{SINGLE-QUOTE}}}3.375{{{SINGLE-QUOTE}}}) and ( (o.OrderCatalogMasterItemGUID = " || zosynguid || " and o.frequencycode in ({{{SINGLE-QUOTE}}}Now{{{SINGLE-QUOTE}}}, {{{SINGLE-QUOTE}}}STAT{{{SINGLE-QUOTE}}}, {{{SINGLE-QUOTE}}}Once{{{SINGLE-QUOTE}}}, {{{SINGLE-QUOTE}}}PRE OP{{{SINGLE-QUOTE}}}, {{{SINGLE-QUOTE}}}POST OP{{{SINGLE-QUOTE}}}, {{{SINGLE-QUOTE}}}Pre-Procedure{{{SINGLE-QUOTE}}}, {{{SINGLE-QUOTE}}}Post-Procedure{{{SINGLE-QUOTE}}}, {{{SINGLE-QUOTE}}}Today{{{SINGLE-QUOTE}}})) or (o.OrderCatalogMasterItemGUID = " || stdzosynguid || " and o.frequencycode in ({{{SINGLE-QUOTE}}}Now{{{SINGLE-QUOTE}}}, {{{SINGLE-QUOTE}}}STAT{{{SINGLE-QUOTE}}}, {{{SINGLE-QUOTE}}}Once{{{SINGLE-QUOTE}}}, {{{SINGLE-QUOTE}}}PRE OP{{{SINGLE-QUOTE}}}, {{{SINGLE-QUOTE}}}POST OP{{{SINGLE-QUOTE}}}, {{{SINGLE-QUOTE}}}Pre-Procedure{{{SINGLE-QUOTE}}}, {{{SINGLE-QUOTE}}}Post-Procedure{{{SINGLE-QUOTE}}}, {{{SINGLE-QUOTE}}}Today{{{SINGLE-QUOTE}}}, {{{SINGLE-QUOTE}}}Q6H{{{SINGLE-QUOTE}}},{{{SINGLE-QUOTE}}}Q8H{{{SINGLE-QUOTE}}}, {{{SINGLE-QUOTE}}}Q12H{{{SINGLE-QUOTE}}})) ) order by o.orderstatuscode, o.SignificantDtm asc"}; //Retrieve possible maintenance orders MaintOrderDose, MaintOrderGuid := read { " select me.dosagelow, o.guid from cv3order o join CV3MedicationExtension me on me.guid = o.guid where ClientVisitGUID = " || SQL(clientvisitguid) || " and o.ClientGuid = " || SQL(clientguid) || " and o.TypeCode = {{{SINGLE-QUOTE}}}Medication{{{SINGLE-QUOTE}}} and o.OrderCatalogMasterItemGUID = " || ZosynGuid || " and o.frequencycode not in ({{{SINGLE-QUOTE}}}Now{{{SINGLE-QUOTE}}}, {{{SINGLE-QUOTE}}}STAT{{{SINGLE-QUOTE}}}, {{{SINGLE-QUOTE}}}Once{{{SINGLE-QUOTE}}}, {{{SINGLE-QUOTE}}}PRE OP{{{SINGLE-QUOTE}}}, {{{SINGLE-QUOTE}}}POST OP{{{SINGLE-QUOTE}}}, {{{SINGLE-QUOTE}}}Pre-Procedure{{{SINGLE-QUOTE}}}, {{{SINGLE-QUOTE}}}Post-Procedure{{{SINGLE-QUOTE}}}, {{{SINGLE-QUOTE}}}Today{{{SINGLE-QUOTE}}}) and o.orderstatuscode in ({{{SINGLE-QUOTE}}}AUA1{{{SINGLE-QUOTE}}},{{{SINGLE-QUOTE}}}DISC{{{SINGLE-QUOTE}}}) order by o.CreatedWhen asc"}; numorders := count LoadOrderDose; LoadOrderList := 1 seqto numorders; NumberMaintOrders := count MaintOrderDose; MaintOrderList := 1 seqto NumberMaintOrders; if NumberMaintOrders = 1 then MaintOrderGuid := MaintOrderGuid [1]; endif; // Check task status of maintenance orders if NumberMaintOrders > 0 then (MaintOrderLastGiven, MaintOrderHoursSinceGiven, MaintNextScheduled, MaintTaskStatus) := read {" select oto.performedfromdtm, DATEDIFF (HH, oto.performedfromdtm, getdate()), DATEDIFF (HH, oto.ScheduledDtm, getdate()), oto.TaskStatusCode from cv3ordercatalogmasteritem ocmi with (nolock) join cv3order o with (nolock)on o.ordercatalogmasteritemguid = ocmi.guid and o.ClientGUID = " || SQL(clientguid) || " and ClientVisitGuid = " || SQL(clientvisitguid) || " and o.TypeCode = {{{SINGLE-QUOTE}}}Medication{{{SINGLE-QUOTE}}} and ocmi.guid = " || ZosynGuid || " join cv3ordertask ot with (nolock) on ot.clientguid = o.clientguid and ot.orderguid = o.guid join cv3ordertaskoccurrence as oto with (nolock) on oto.clientguid = ot.clientguid and oto.orderguid = ot.orderguid and oto.ordertaskguid = ot.guid and o.guid in (" ||MaintOrderGuid || ") and oto.ScheduledDtm > DATEadd (HH, -14, getdate()) and oto.TaskStatusCode <> {{{SINGLE-QUOTE}}}Canceled{{{SINGLE-QUOTE}}} order by oto.taskstatuscode, oto.performedfromdtm, oto.ScheduledDtm desc" }; endif; for i in 1 seqto (count MaintTaskStatus)do if MaintTaskStatus [i] = "Overdue" then Overduetime := MaintNextScheduled [i]; elseif MaintTaskStatus [i] = "Pending" then Nextduetime := MaintNextScheduled [i]; elseif MaintTaskStatus [i] = "Performed" then HoursSinceGiven := MaintOrderHoursSinceGiven [i]; LastGivenTime := MaintOrderlastGiven [i]; endif; enddo; if numorders = 1 then LoadOrderGuid := LoadOrderGuid [1]; endif; // Check task status of load orders if numorders > 0 then (LoadOrderLastGiven, LoadOrderHoursSinceGiven, ExistingSchedule, LoadTaskStatus, LoadFrequency) := read last { " select top 1 oto.performedfromdtm, DATEDIFF (HH, oto.performedfromdtm, getdate()), oto.ScheduledDtm, oto.TaskStatusCode,o.FrequencyCode from cv3ordercatalogmasteritem ocmi join cv3order o with (nolock)on o.ordercatalogmasteritemguid = ocmi.guid and o.ClientGUID = " || SQL(clientguid) || " and o.clientvisitguid = " || SQL(clientvisitguid) || " join cv3ordertask ot with (nolock) on ot.clientguid = o.clientguid and ot.orderguid = o.guid join cv3ordertaskoccurrence as oto with (nolock) on oto.clientguid = ot.clientguid and oto.orderguid = ot.orderguid where o.TypeCode = {{{SINGLE-QUOTE}}}Medication{{{SINGLE-QUOTE}}} and (ocmi.guid = " ||ZosynGuid || " or ocmi.guid = " || StdZosynGuid || ") and oto.ordertaskguid = ot.guid and o.guid in (" || LoadOrderGuid || ") and oto.SignificantDtm > DATEadd (HH, -8, getdate()) and oto.TaskStatusCode = {{{SINGLE-QUOTE}}}Performed{{{SINGLE-QUOTE}}} order by oto.performedfromdtm desc" }; (LoadOrderHoursSinceScheduled, ExistingSchedule, LoadTaskStatus, LoadGuid) := read last { " select top 1 DATEDIFF (HH, oto.ScheduledDtm, getdate()) Timespan, oto.ScheduledDtm, oto.TaskStatusCode, o.guid from cv3ordercatalogmasteritem ocmi with (nolock) join cv3order o with (nolock)on o.ordercatalogmasteritemguid = ocmi.guid and o.ClientGUID = " || SQL(clientguid) || " and o.ClientVisitGUID = " || SQL(clientvisitguid) || " join cv3ordertask ot with (nolock) on ot.clientguid = o.clientguid and ot.orderguid = o.guid join cv3ordertaskoccurrence as oto with (nolock) on oto.clientguid = ot.clientguid and oto.orderguid = ot.orderguid where o.TypeCode = {{{SINGLE-QUOTE}}}Medication{{{SINGLE-QUOTE}}} and ocmi.guid = " || ZosynGuid || " and oto.ordertaskguid = ot.guid and o.guid in (" ||LoadOrderGuid || ") and oto.SignificantDtm > DATEadd (HH, -12, getdate()) and oto.SignificantDtm < DATEadd (HH, 1, getdate()) and oto.TaskStatusCode in ({{{SINGLE-QUOTE}}}Pending{{{SINGLE-QUOTE}}}, {{{SINGLE-QUOTE}}}Overdue{{{SINGLE-QUOTE}}}) order by oto.ScheduledDtm desc" }; endif; if LoadOrderLastGiven is not null then Zosyn.IsSelected := False; Zosyn_Low.IsSelected := True; // Determine if patient needs loaded or reloaded if (LoadOrderHoursSinceGiven >= 6 and (CrCl_Estd.value is null or CrCl_Estd.value >=20) and override.value = false) or (LoadOrderHoursSinceGiven >= 8 and CrCl_Estd.value < 20 and override.value = false) or (LoadOrderHoursSinceGiven >= 6 and Override.value = true and Zosyn_Freq_Dictionary.value = "Q8H" ) or (LoadOrderHoursSinceGiven >= 8 and Override.value = true and Zosyn_Freq_Dictionary.value = "Q12H" ) then StartDTM := now ; StartMin := extract minute now; Zosyn.IsSelected := True; If (StartMin as number) >= 45 then LoadDoseDTM := StartDTM + 2 hour; else LoadDoseDTM := StartDTM + 1 hour; endif; else startdtm := LoadOrderLastGiven ; startmin := extract minute LoadOrderLastGiven; If (StartMin as number) >= 45 then LoadDoseDTM := StartDTM + 1 hour; Else LoadDoseDTM := StartDTM ; Endif; endif; elseif ExistingSchedule is not null then // If load not given but ordered within past 2 hours then don{{{SINGLE-QUOTE}}}t reorder // If greater than 2 hours and not given discontinue and reorder If LoadOrderHoursSinceScheduled < 2 then Zosyn.IsSelected := False; Zosyn_Low.IsSelected := True; StartDTM := ExistingSchedule; StartMin := extract minute ExistingSchedule; If (StartMin as number) >= 45 then LoadDoseDTM := StartDTM + 1 hour; else LoadDoseDTM := StartDTM; endif; else MLMMessage := "This is where we discontinue old order"; Reason := "Change Administration Times"; Source := "CPOE Clarification"; dc_call := call DiscontinueOrder with LoadOrderGuid, this_communication.CareProviderGUID, ClientVisitGUID, Reason, Source; StartDTM := now ; StartMin := extract minute now; Zosyn.IsSelected := True; Zosyn_Low.IsSelected := True; If (StartMin as number) >= 45 then LoadDoseDTM := StartDTM + 2 hour; else LoadDoseDTM := StartDTM + 1 hour; endif; endif; elseif // If patient has loading dose or is transitioning from standard therapy scheduled maint dose ((HoursSinceGiven as number) > 9 and override.value = false and (CrCl_Estd.value >= 20 or CrCl_Estd.value is null)) or ((HoursSinceGiven as number) > 13 and override.value = false and CrCl_Estd.value < 20) or // ((Overduetime as number) >= 2 and HoursSinceGiven is null) or ((HoursSinceGiven as number) > 9 and Override.value = true and Zosyn_Freq_Dictionary.value = "Q8H" ) or ((HoursSinceGiven as number) > 13 and Override.value = true and Zosyn_Freq_Dictionary.value = "Q12H" ) then Zosyn.IsSelected := True; Zosyn_Low.IsSelected := True; NoLoad := False; FmtLoadDate := null; FmtLoadTime := null; StartDTM := now ; StartMin := extract minute now; If (StartMin as number) >= 45 then LoadDoseDTM := StartDTM + 2 hour; else LoadDoseDTM := StartDTM + 1 hour; endif; elseif // If patient needs reloaded order load and schedule maint dose ((HoursSinceGiven as number) <= 9 and override.value = false and (CrCl_Estd.value >= 20 or CrCl_Estd.value is null)) or ((HoursSinceGiven as number) <= 13 and override.value = false and CrCl_Estd.value < 20) or // ((Overduetime as number) < 2 ) or ((HoursSinceGiven as number) <= 9 and override.value = true and Zosyn_Freq_Dictionary.value = "Q8H") or ((HoursSinceGiven as number) <= 13 and override.value = true and Zosyn_Freq_Dictionary.value = "Q12H") then Zosyn.IsSelected := False; NoLoad := True; Zosyn_Low.IsSelected := True; Override_ABX_Sched.value := False; StartDTM := LastGivenTime ; StartMin := extract minute LastGivenTime; If (StartMin as number) >= 45 then MaintDoseDTM := StartDTM + 1 hour; else MaintDoseDTM := StartDTM ; endif; else // No prior zosyn orders schedule load and maint dose Zosyn.IsSelected := True; Zosyn_Low.IsSelected := True; StartDTM := now ; StartMin := extract minute now; If (StartMin as number) >= 45 then LoadDoseDTM := StartDTM + 2 hour; else LoadDoseDTM := StartDTM + 1 hour; endif; endif; // format all date and times MaintDose6HR := LoadDoseDTM + 6 hour; MaintDose8HR := LoadDoseDTM + 8 hour; MaintDoseQ8HR := MaintDoseDTM + 8 hour; MaintDoseQ12HR := MaintDoseDTM + 12 hour; loadhour := extract hour LoadDoseDTM; loadmon := extract month LoadDoseDTM; loadday := extract day LoadDoseDTM; loadyear := extract year LoadDoseDTM; due6hour := extract hour MaintDose6HR; due6mon := extract month MaintDose6HR; due6day := extract day MaintDose6HR; due6year := extract year MaintDose6HR; due8hour := extract hour MaintDose8HR; due8mon := extract month MaintDose8HR; due8day := extract day MaintDose8HR; due8year := extract year MaintDose8HR; maint8hour := extract hour MaintDoseQ8HR; maint8mon := extract month MaintDoseQ8HR; maint8day := extract day MaintDoseQ8HR; maint8year := extract year MaintDoseQ8HR; maint12hour := extract hour MaintDoseQ12HR; maint12mon := extract month MaintDoseQ12HR; maint12day := extract day MaintDoseQ12HR; maint12year := extract year MaintDoseQ12HR; FmtLoadTime := loadhour formatted with "%2.2d" || ":00"; FmtLoadDate := loadmon formatted with "%2.2d"||"-" ||loadday formatted with "%2.2d" ||"-" ||loadyear ; Fmt6HRTime := due6hour formatted with "%2.2d" || ":00"; Fmt6HRDate := due6mon formatted with "%2.2d"||"-" ||due6day formatted with "%2.2d" ||"-" ||due6year ; Fmt8HRTime := due8hour formatted with "%2.2d" || ":00"; Fmt8HRDate := due8mon formatted with "%2.2d"||"-" ||due8day formatted with "%2.2d" ||"-" ||due8year ; FmtQ8HRTime := maint8hour formatted with "%2.2d" || ":00"; FmtQ8HRDate := maint8mon formatted with "%2.2d"||"-" ||maint8day formatted with "%2.2d" ||"-" ||maint8year ; FmtQ12HRTime := maint12hour formatted with "%2.2d" || ":00"; FmtQ12HRDate := maint12mon formatted with "%2.2d"||"-" ||maint12day formatted with "%2.2d" ||"-" ||maint12year ; if NoLoad = false or noload is null then Load_ReqTime_Val.ReqTimeCode := "Scheduled/Start Time"; Load_ReqTime_Val.ReqTimeValue := FMTLoadTime; Load_ReqDate.value := FmtLoadDate; endif; // Select correct formatted time and frequency based upon CrCl, Load or No Load and if override the selected frequency If ((CrCl_Estd.value >= 20 or CrCl_Estd.value is null or CRRT is not null ) and override.value = false and NoLoad = False) or (override.value = true and Zosyn_Freq_Dictionary.value = "Q8H" and NoLoad = False ) then Maint_ReqDate.value := Fmt6HRDate; Maint_ReqTime_Val.ReqTimeCode := "Scheduled/Start Time"; Maint_ReqTime_Val.ReqTimeValue := Fmt6HRTime; FreqValue.FrequencySummary := "Q8H"; Zosyn_Freq_Dictionary.value := "Q8H"; elseif (CrCl_Estd.Value < 20 and CRRT is null and override.value = false and NoLoad = false) or (override.value = true and Zosyn_Freq_Dictionary.value = "Q12H" and noLoad = false) then Maint_ReqDate.value := Fmt8HRDate; Maint_ReqTime_Val.ReqTimeCode := "Scheduled/Start Time"; Maint_ReqTime_Val.ReqTimeValue := Fmt8HRTime; FreqValue.FrequencySummary := "Q12H"; Zosyn_Freq_Dictionary.value := "Q12H"; elseIf ((CrCl_Estd.value >= 20 or CrCl_Estd.value is null or CRRT is not null) and override.value = false and NoLoad = true) or (override.value = true and Zosyn_Freq_Dictionary.value = "Q8H" and NoLoad = true) then Maint_ReqDate.value := FmtQ8HRDate; Maint_ReqTime_Val.ReqTimeCode := "Scheduled/Start Time"; Maint_ReqTime_Val.ReqTimeValue := FmtQ8HRTime; FreqValue.FrequencySummary := "Q8H"; Zosyn_Freq_Dictionary.value := "Q8H"; elseif (CrCl_Estd.value < 20 and CRRT is null and override.value = false and NoLoad = true) or (override.value = true and Zosyn_Freq_Dictionary.value = "Q12H" and noLoad = true ) then Load_ReqDate.value := null; Load_ReqTime_Val.ReqTimeCode := null; Load_ReqTime_Val.ReqTimeValue := null; Maint_ReqDate.value := FmtQ12HRDate; Maint_ReqTime_Val.ReqTimeCode := "Scheduled/Start Time"; Maint_ReqTime_Val.ReqTimeValue := FmtQ12HRTime; FreqValue.FrequencySummary := "Q12H"; Zosyn_Freq_Dictionary.value := "Q12H"; endif; // **** end extended Zosyn infusion *********** elseif ( fieldValue = false ) then Zosyn.IsSelected := false; Zosyn_Low.IsSelected := false; rtnValue := call enable_chkbx_mlm with this_communication, this_form, client_info_obj, CallingField, false, ""; endif; endif; //*********** CEFEPIME + FLAGYL **************** if ( CallingField = "PRX_Checkbox1|5" ) then fieldValue := Cefepime_Flagyl_Chk.Value; if ( fieldValue = true ) then Cefepime.IsSelected := true; Flagyl_IV.IsSelected := true; exceptFld := exceptFld, Fluconazole_Chk.DataItemName || "|" || Fluconazole_Chk.Control_MultiFieldOccNum; rtnValue := call enable_chkbx_mlm WITH this_communication, this_form, client_info_obj, CallingField, true, exceptFld; elseif ( fieldValue = false ) then Cefepime.IsSelected := false; Flagyl_IV.IsSelected := false; rtnValue := call enable_chkbx_mlm WITH this_communication, this_form, client_info_obj, CallingField, false, ""; endif; endif; //************ CIPROFLOXACIN + FLAGYL ******************** if ( CallingField = "PRX_Checkbox1|7" OR CallingField = "PRX_Checkbox1|11" ) then if ( CallingField = "PRX_Checkbox1|7" ) then fieldValue := Cipro_Flagyl_Chk.Value; elseif ( CallingField = "PRX_Checkbox1|11" ) then fieldValue := Cipro_Flagyl2_Chk.Value; endif; if ( fieldValue = true ) then Ciprofloxacin.IsSelected := true; Flagyl_IV.IsSelected := true; rtnValue := call enable_chkbx_mlm WITH this_communication, this_form, client_info_obj, CallingField, true, ""; elseif ( fieldValue = false ) then Ciprofloxacin.IsSelected := false; Flagyl_IV.IsSelected := false; rtnValue := call enable_chkbx_mlm WITH this_communication, this_form, client_info_obj, CallingField, false, ""; endif; endif; //************ CEFAZOLIN (ANCEF) ****************** if ( CallingField = "PRX_Checkbox1|8" ) then fieldValue := Ancef_Chk.Value; if ( fieldValue = true ) then Ancef.IsSelected := true; cefazolin_logic_run := true; rtnValue := call enable_chkbx_mlm WITH this_communication, this_form, client_info_obj, CallingField, true, ""; elseif ( fieldValue = false ) then cefazolin_logic_run := false; Ancef.IsSelected := false; rtnValue := call enable_chkbx_mlm WITH this_communication, this_form, client_info_obj, CallingField, false, ""; endif; endif; //******** FLUCONAZOLE ******** if ( CallingField = "PRX_Checkbox1|16" ) then fieldValue := Fluconazole_Chk.Value; if ( fieldValue = true ) then //Determine if loading dose should be given //Check if fluconazole has been given in last 24 hours fluconazole_exists := READ LAST {"SELECT 1" || " FROM CV3ClientVisit cv WITH (NOLOCK) JOIN CV3Order o WITH (NOLOCK)" || " ON cv.ClientGUID = o.ClientGUID" || " AND cv.GUID = o.ClientVisitGUID" || " AND cv.ChartGUID = o.ChartGUID" || " WHERE o.NAME LIKE {{{SINGLE-QUOTE}}}FLUCONAZOLE%{{{SINGLE-QUOTE}}}" || " AND o.FrequencyCode IN ({{{SINGLE-QUOTE}}}Once{{{SINGLE-QUOTE}}},{{{SINGLE-QUOTE}}}STAT{{{SINGLE-QUOTE}}},{{{SINGLE-QUOTE}}}Now{{{SINGLE-QUOTE}}})" || " AND cv.ClientGUID = " || SQL(ClientGUID) || " AND cv.GUID = " || SQL(ClientVisitGUID) || " AND cv.ChartGUID = " || SQL(ChartGUID) || " AND DateDiff(hh, o.Entered, GETDATE()) <= 24" || " order by o.Entered desc" }; if ( exists fluconazole_exists ) then Fluconazole_Now.IsSelected := false; Override_ABX_Schedule.Value := false; else Fluconazole_Now.IsSelected := true; Override_ABX_Schedule.Value := true; endif; Fluconazole.IsSelected := true; exceptFld := exceptFld, Zosyn_Chk.DataItemName || "|" || Zosyn_Chk.Control_MultiFieldOccNum; exceptFld := exceptFld, Cefepime_Flagyl_Chk.DataItemName || "|" || Cefepime_Flagyl_Chk.Control_MultiFieldOccNum; rtnValue := call enable_chkbx_mlm WITH this_communication, this_form, client_info_obj, CallingField, true, exceptFld; elseif ( fieldValue = false ) then Fluconazole_Now.IsSelected := false; Fluconazole.IsSelected := false; rtnValue := call enable_chkbx_mlm WITH this_communication, this_form, client_info_obj, CallingField, false, ""; endif; endif; //******* ANTIBIOTICS GRID *************** if ( CallingField = "MultiOrderGrid|1" ) then if ( ( Zosyn.IsSelected = true OR Zosyn_Low.IsSelected = true ) AND ( Zosyn_Chk.Value = false AND Zosyn2_Chk.Value = false AND Zosyn3_Chk.Value = false ) ) then Zosyn.IsSelected := false; Zosyn_Low.IsSelected := false; elseif ( ( Zosyn.IsSelected = false AND Zosyn_Low.IsSelected = false ) AND ( Zosyn_Chk.Value = true OR Zosyn2_Chk.Value = true OR Zosyn3_Chk.Value = true ) ) then Zosyn_Chk.Value := false; Zosyn2_Chk.Value := false; Zosyn3_Chk.Value := false; rtnValue := call enable_chkbx_mlm WITH this_communication, this_form, client_info_obj, CallingField, false, ""; endif; if ( Fluconazole.IsSelected = true OR Fluconazole_Now.IsSelected = true ) then if ( Fluconazole_Chk.Value = false ) then Fluconazole_Chk.Value := true; endif; elseif ( Fluconazole.IsSelected = false AND Fluconazole_Now.IsSelected = false ) then Fluconazole_Chk.Value := false; endif; if ( Fluconazole_Now.IsSelected = false AND Fluconazole.IsSelected = true ) then Override_ABX_Schedule.Value := false; endif; if ( Fluconazole_Now.IsSelected = true AND Fluconazole.IsSelected = true ) then Override_ABX_Schedule.Value := true; endif; endif; endif; //End FieldChange if ( cefazolin_logic_run = true ) then if ( weightvalue = 0 OR weightvalue IS NULL ) then //Display message that weight is missing dialogResult := call {{{SINGLE-QUOTE}}}MessageBox{{{SINGLE-QUOTE}}}.Show with "Weight Based Dosing Requires Weight To Be Entered." , "Alert","OK" as {{{SINGLE-QUOTE}}}MessageBoxButtons{{{SINGLE-QUOTE}}}; else if ( weightvalue < 80 ) then Ancef_Dose.Value := ( 1 as number ); elseif ( weightvalue >= 80 ) then Ancef_Dose.Value := ( 2 as number ); endif; endif; endif; ;; evoke: // No evoke statement ;; logic: conclude True; ;; action: // This MLM returns two parameters, of types communication_type and form_type respectively. return this_communication, this_form; ;; end: