Add ward MAR board plus nursing notes and SBAR handovers.
Deploy Ladill Care / deploy (push) Successful in 52s
Deploy Ladill Care / deploy (push) Successful in 52s
Nurses can chart given/held/refused doses from active prescriptions on placed patients, and document chronologic notes and unit shift handovers. Co-authored-by: Cursor <cursoragent@cursor.com>
This commit is contained in:
isaacclad
@@ -0,0 +1,112 @@
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<?php
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namespace App\Http\Controllers\Care;
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use App\Http\Controllers\Controller;
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use App\Http\Controllers\Care\Concerns\ScopesToAccount;
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use App\Models\CareUnit;
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use App\Models\MarOrder;
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use App\Models\Visit;
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use App\Services\Care\CarePermissions;
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use App\Services\Care\MarService;
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use Carbon\Carbon;
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use Illuminate\Http\RedirectResponse;
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use Illuminate\Http\Request;
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use Illuminate\Validation\Rule;
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use Illuminate\View\View;
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class MarController extends Controller
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{
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use ScopesToAccount;
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public function unitBoard(Request $request, CareUnit $careUnit, MarService $mar): View
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{
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$this->authorizeAbility($request, 'mar.view');
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$this->authorizeOwner($request, $careUnit);
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$organization = $this->organization($request);
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abort_unless((int) $careUnit->organization_id === (int) $organization->id, 404);
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$day = $request->filled('date')
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? Carbon::parse($request->input('date'))->startOfDay()
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: now()->startOfDay();
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$rows = $mar->unitRoundBoard($careUnit, $this->ownerRef($request), $day);
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$canAdminister = app(CarePermissions::class)->can($this->member($request), 'mar.administer');
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return view('care.nursing.mar-board', [
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'unit' => $careUnit->load('department.branch'),
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'day' => $day,
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'rows' => $rows,
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'canAdminister' => $canAdminister,
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'statuses' => config('care.mar_administration_statuses'),
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'stateLabels' => config('care.mar_slot_states'),
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]);
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}
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public function visitChart(Request $request, Visit $visit, MarService $mar): View
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{
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$this->authorizeAbility($request, 'mar.view');
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$this->authorizeOwner($request, $visit);
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$this->authorizeBranch($request, (int) $visit->branch_id);
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$day = $request->filled('date')
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? Carbon::parse($request->input('date'))->startOfDay()
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: now()->startOfDay();
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$orders = $mar->syncOrdersForVisit($visit, $this->ownerRef($request));
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$chart = [];
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foreach ($orders as $order) {
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$chart[] = [
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'order' => $order,
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'slots' => $mar->dueSlotsForOrder($order, $day),
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];
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}
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return view('care.nursing.mar-visit', [
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'visit' => $visit->load(['patient', 'careUnit', 'bed']),
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'day' => $day,
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'chart' => $chart,
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'canAdminister' => app(CarePermissions::class)->can($this->member($request), 'mar.administer'),
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'statuses' => config('care.mar_administration_statuses'),
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'stateLabels' => config('care.mar_slot_states'),
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'frequencies' => config('care.mar_frequency_codes'),
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]);
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}
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public function administer(Request $request, MarOrder $marOrder, MarService $mar): RedirectResponse
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{
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$this->authorizeAbility($request, 'mar.administer');
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$this->authorizeOwner($request, $marOrder);
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$validated = $request->validate([
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'status' => ['required', 'string', Rule::in(array_keys(config('care.mar_administration_statuses')))],
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'scheduled_for' => ['nullable', 'date'],
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'dose_given' => ['nullable', 'string', 'max:255'],
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'route' => ['nullable', 'string', 'max:100'],
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'witness_by' => ['nullable', 'string', 'max:255'],
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'reason' => ['nullable', 'string', 'max:500'],
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'notes' => ['nullable', 'string', 'max:2000'],
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'redirect_to' => ['nullable', 'string', 'max:500'],
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]);
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$mar->recordAdministration(
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$marOrder,
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$validated['status'],
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$this->ownerRef($request),
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$this->actorRef($request),
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isset($validated['scheduled_for']) ? Carbon::parse($validated['scheduled_for']) : null,
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$validated['dose_given'] ?? null,
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$validated['route'] ?? null,
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$validated['witness_by'] ?? null,
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$validated['reason'] ?? null,
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$validated['notes'] ?? null,
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);
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$redirect = $validated['redirect_to'] ?? null;
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if ($redirect && str_starts_with($redirect, url('/'))) {
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return redirect()->to($redirect)->with('success', 'MAR entry recorded.');
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}
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return back()->with('success', 'MAR entry recorded.');
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}
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}
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@@ -0,0 +1,189 @@
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<?php
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namespace App\Http\Controllers\Care;
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use App\Http\Controllers\Controller;
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use App\Http\Controllers\Care\Concerns\ScopesToAccount;
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use App\Models\CareUnit;
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use App\Models\Visit;
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use App\Models\WardHandover;
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use App\Services\Care\CarePermissions;
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use App\Services\Care\NursingDocumentationService;
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use Illuminate\Http\RedirectResponse;
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use Illuminate\Http\Request;
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use Illuminate\Validation\Rule;
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use Illuminate\View\View;
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class NursingDocumentationController extends Controller
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{
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use ScopesToAccount;
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public function unitNotes(Request $request, CareUnit $careUnit, NursingDocumentationService $docs): View
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{
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$this->authorizeAbility($request, 'nursing.notes.view');
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$this->authorizeOwner($request, $careUnit);
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abort_unless((int) $careUnit->organization_id === (int) $this->organization($request)->id, 404);
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$placedVisits = Visit::owned($this->ownerRef($request))
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->where('care_unit_id', $careUnit->id)
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->whereIn('status', [Visit::STATUS_OPEN, Visit::STATUS_IN_PROGRESS])
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->with(['patient', 'bed'])
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->orderBy('placed_at')
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->get();
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return view('care.nursing.notes', [
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'unit' => $careUnit->load('department.branch'),
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'notes' => $docs->notesForUnit($careUnit, $this->ownerRef($request)),
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'placedVisits' => $placedVisits,
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'canWrite' => app(CarePermissions::class)->can($this->member($request), 'nursing.notes.manage'),
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'noteTypes' => config('care.nursing_note_types'),
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'shiftCodes' => config('care.staff_shift_codes'),
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]);
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}
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public function storeNote(Request $request, CareUnit $careUnit, NursingDocumentationService $docs): RedirectResponse
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{
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$this->authorizeAbility($request, 'nursing.notes.manage');
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$this->authorizeOwner($request, $careUnit);
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$validated = $request->validate([
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'visit_id' => ['required', 'integer', 'exists:care_visits,id'],
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'note_type' => ['required', 'string', Rule::in(array_keys(config('care.nursing_note_types')))],
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'shift_code' => ['nullable', 'string', Rule::in(array_keys(config('care.staff_shift_codes')))],
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'body' => ['required', 'string', 'max:5000'],
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]);
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$visit = Visit::owned($this->ownerRef($request))
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->where('organization_id', $this->organization($request)->id)
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->findOrFail($validated['visit_id']);
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$this->authorizeBranch($request, (int) $visit->branch_id);
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$docs->addNote(
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$visit,
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$this->ownerRef($request),
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$this->actorRef($request),
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$validated['body'],
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$validated['note_type'],
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$validated['shift_code'] ?? null,
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$careUnit->id,
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);
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return redirect()
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->route('care.care-units.notes', $careUnit)
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->with('success', 'Nursing note saved.');
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}
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public function handovers(Request $request, CareUnit $careUnit): View
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{
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$this->authorizeAbility($request, 'nursing.handover.view');
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$this->authorizeOwner($request, $careUnit);
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abort_unless((int) $careUnit->organization_id === (int) $this->organization($request)->id, 404);
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$handovers = WardHandover::owned($this->ownerRef($request))
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->where('care_unit_id', $careUnit->id)
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->orderByDesc('created_at')
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->limit(30)
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->get();
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return view('care.nursing.handovers', [
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'unit' => $careUnit->load('department.branch'),
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'handovers' => $handovers,
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'canWrite' => app(CarePermissions::class)->can($this->member($request), 'nursing.handover.manage'),
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'shiftCodes' => config('care.staff_shift_codes'),
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'statuses' => config('care.ward_handover_statuses'),
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]);
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}
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public function createHandover(Request $request, CareUnit $careUnit, NursingDocumentationService $docs): View
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{
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$this->authorizeAbility($request, 'nursing.handover.manage');
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$this->authorizeOwner($request, $careUnit);
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return view('care.nursing.handover-form', [
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'unit' => $careUnit->load('department.branch'),
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'handover' => null,
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'patientSummaries' => $docs->defaultPatientSummaries($careUnit, $this->ownerRef($request)),
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'shiftCodes' => config('care.staff_shift_codes'),
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]);
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}
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public function storeHandover(Request $request, CareUnit $careUnit, NursingDocumentationService $docs): RedirectResponse
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{
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$this->authorizeAbility($request, 'nursing.handover.manage');
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$this->authorizeOwner($request, $careUnit);
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$validated = $this->validatedHandover($request);
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$complete = $request->boolean('complete');
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$handover = $docs->createHandover(
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$careUnit,
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$this->ownerRef($request),
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$this->actorRef($request),
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$validated,
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$complete,
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);
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return redirect()
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->route('care.care-units.handovers', $careUnit)
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->with('success', $complete ? 'Handover completed.' : 'Handover draft saved.');
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}
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public function showHandover(Request $request, CareUnit $careUnit, WardHandover $wardHandover): View
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{
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$this->authorizeAbility($request, 'nursing.handover.view');
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$this->authorizeOwner($request, $careUnit);
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$this->authorizeOwner($request, $wardHandover);
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abort_unless((int) $wardHandover->care_unit_id === (int) $careUnit->id, 404);
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return view('care.nursing.handover-show', [
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'unit' => $careUnit->load('department.branch'),
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'handover' => $wardHandover,
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'shiftCodes' => config('care.staff_shift_codes'),
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'statuses' => config('care.ward_handover_statuses'),
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'canWrite' => app(CarePermissions::class)->can($this->member($request), 'nursing.handover.manage')
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&& $wardHandover->status === WardHandover::STATUS_DRAFT,
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]);
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}
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public function completeHandover(
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Request $request,
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CareUnit $careUnit,
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WardHandover $wardHandover,
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NursingDocumentationService $docs,
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): RedirectResponse {
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$this->authorizeAbility($request, 'nursing.handover.manage');
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$this->authorizeOwner($request, $careUnit);
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$this->authorizeOwner($request, $wardHandover);
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abort_unless((int) $wardHandover->care_unit_id === (int) $careUnit->id, 404);
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$validated = $this->validatedHandover($request);
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$docs->completeHandover($wardHandover, $this->ownerRef($request), $this->actorRef($request), $validated);
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return redirect()
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->route('care.care-units.handovers', $careUnit)
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->with('success', 'Handover completed.');
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}
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/**
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* @return array<string, mixed>
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*/
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protected function validatedHandover(Request $request): array
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{
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$validated = $request->validate([
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'from_shift' => ['nullable', 'string', Rule::in(array_keys(config('care.staff_shift_codes')))],
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'to_shift' => ['nullable', 'string', Rule::in(array_keys(config('care.staff_shift_codes')))],
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'received_by' => ['nullable', 'string', 'max:255'],
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'situation' => ['nullable', 'string', 'max:5000'],
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'background' => ['nullable', 'string', 'max:5000'],
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'assessment' => ['nullable', 'string', 'max:5000'],
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'recommendation' => ['nullable', 'string', 'max:5000'],
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'patient_summaries' => ['nullable', 'array'],
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'patient_summaries.*.visit_id' => ['nullable', 'integer'],
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'patient_summaries.*.patient_name' => ['nullable', 'string', 'max:255'],
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'patient_summaries.*.bed' => ['nullable', 'string', 'max:100'],
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'patient_summaries.*.note' => ['nullable', 'string', 'max:2000'],
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]);
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return $validated;
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}
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}
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@@ -0,0 +1,68 @@
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<?php
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namespace App\Models;
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use App\Models\Concerns\BelongsToOwner;
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use Illuminate\Database\Eloquent\Model;
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use Illuminate\Database\Eloquent\Relations\BelongsTo;
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class MarAdministration extends Model
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{
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use BelongsToOwner;
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public const STATUS_GIVEN = 'given';
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public const STATUS_HELD = 'held';
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public const STATUS_REFUSED = 'refused';
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public const STATUS_MISSED = 'missed';
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protected $table = 'care_mar_administrations';
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protected $fillable = [
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'owner_ref',
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'organization_id',
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'mar_order_id',
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'visit_id',
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'patient_id',
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'care_unit_id',
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'scheduled_for',
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'recorded_at',
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'status',
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'dose_given',
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'route',
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'administered_by',
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'witness_by',
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'reason',
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'notes',
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];
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protected function casts(): array
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{
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return [
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'scheduled_for' => 'datetime',
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'recorded_at' => 'datetime',
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];
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}
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public function order(): BelongsTo
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{
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return $this->belongsTo(MarOrder::class, 'mar_order_id');
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}
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public function visit(): BelongsTo
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{
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return $this->belongsTo(Visit::class, 'visit_id');
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}
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public function patient(): BelongsTo
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{
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return $this->belongsTo(Patient::class, 'patient_id');
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}
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public function careUnit(): BelongsTo
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{
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return $this->belongsTo(CareUnit::class, 'care_unit_id');
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}
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}
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@@ -0,0 +1,76 @@
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<?php
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namespace App\Models;
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use App\Models\Concerns\BelongsToOwner;
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use Illuminate\Database\Eloquent\Model;
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use Illuminate\Database\Eloquent\Relations\BelongsTo;
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use Illuminate\Database\Eloquent\Relations\HasMany;
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use Illuminate\Database\Eloquent\SoftDeletes;
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class MarOrder extends Model
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{
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use BelongsToOwner, SoftDeletes;
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public const STATUS_ACTIVE = 'active';
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public const STATUS_PAUSED = 'paused';
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public const STATUS_STOPPED = 'stopped';
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protected $table = 'care_mar_orders';
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protected $fillable = [
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'owner_ref',
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'organization_id',
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'visit_id',
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'patient_id',
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'prescription_id',
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'prescription_item_id',
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'drug_name',
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'dosage',
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'route',
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'frequency_code',
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'times_of_day',
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'is_prn',
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'status',
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'starts_at',
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'ends_at',
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'instructions',
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];
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protected function casts(): array
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{
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return [
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'times_of_day' => 'array',
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'is_prn' => 'boolean',
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'starts_at' => 'datetime',
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'ends_at' => 'datetime',
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];
|
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}
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public function visit(): BelongsTo
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{
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return $this->belongsTo(Visit::class, 'visit_id');
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}
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public function patient(): BelongsTo
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{
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return $this->belongsTo(Patient::class, 'patient_id');
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}
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public function prescription(): BelongsTo
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{
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return $this->belongsTo(Prescription::class, 'prescription_id');
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}
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public function prescriptionItem(): BelongsTo
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{
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return $this->belongsTo(PrescriptionItem::class, 'prescription_item_id');
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}
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public function administrations(): HasMany
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{
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return $this->hasMany(MarAdministration::class, 'mar_order_id')->orderByDesc('recorded_at');
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}
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}
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@@ -0,0 +1,50 @@
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<?php
|
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|
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namespace App\Models;
|
||||
|
||||
use App\Models\Concerns\BelongsToOwner;
|
||||
use Illuminate\Database\Eloquent\Model;
|
||||
use Illuminate\Database\Eloquent\Relations\BelongsTo;
|
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use Illuminate\Database\Eloquent\SoftDeletes;
|
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|
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class NursingNote extends Model
|
||||
{
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use BelongsToOwner, SoftDeletes;
|
||||
|
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protected $table = 'care_nursing_notes';
|
||||
|
||||
protected $fillable = [
|
||||
'owner_ref',
|
||||
'organization_id',
|
||||
'visit_id',
|
||||
'patient_id',
|
||||
'care_unit_id',
|
||||
'note_type',
|
||||
'shift_code',
|
||||
'body',
|
||||
'recorded_by',
|
||||
'recorded_at',
|
||||
];
|
||||
|
||||
protected function casts(): array
|
||||
{
|
||||
return [
|
||||
'recorded_at' => 'datetime',
|
||||
];
|
||||
}
|
||||
|
||||
public function visit(): BelongsTo
|
||||
{
|
||||
return $this->belongsTo(Visit::class, 'visit_id');
|
||||
}
|
||||
|
||||
public function patient(): BelongsTo
|
||||
{
|
||||
return $this->belongsTo(Patient::class, 'patient_id');
|
||||
}
|
||||
|
||||
public function careUnit(): BelongsTo
|
||||
{
|
||||
return $this->belongsTo(CareUnit::class, 'care_unit_id');
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,54 @@
|
||||
<?php
|
||||
|
||||
namespace App\Models;
|
||||
|
||||
use App\Models\Concerns\BelongsToOwner;
|
||||
use Illuminate\Database\Eloquent\Model;
|
||||
use Illuminate\Database\Eloquent\Relations\BelongsTo;
|
||||
use Illuminate\Database\Eloquent\SoftDeletes;
|
||||
|
||||
class WardHandover extends Model
|
||||
{
|
||||
use BelongsToOwner, SoftDeletes;
|
||||
|
||||
public const STATUS_DRAFT = 'draft';
|
||||
|
||||
public const STATUS_COMPLETED = 'completed';
|
||||
|
||||
protected $table = 'care_ward_handovers';
|
||||
|
||||
protected $fillable = [
|
||||
'owner_ref',
|
||||
'organization_id',
|
||||
'care_unit_id',
|
||||
'from_shift',
|
||||
'to_shift',
|
||||
'handed_over_at',
|
||||
'handed_over_by',
|
||||
'received_by',
|
||||
'situation',
|
||||
'background',
|
||||
'assessment',
|
||||
'recommendation',
|
||||
'patient_summaries',
|
||||
'status',
|
||||
];
|
||||
|
||||
protected function casts(): array
|
||||
{
|
||||
return [
|
||||
'handed_over_at' => 'datetime',
|
||||
'patient_summaries' => 'array',
|
||||
];
|
||||
}
|
||||
|
||||
public function careUnit(): BelongsTo
|
||||
{
|
||||
return $this->belongsTo(CareUnit::class, 'care_unit_id');
|
||||
}
|
||||
|
||||
public function organization(): BelongsTo
|
||||
{
|
||||
return $this->belongsTo(Organization::class, 'organization_id');
|
||||
}
|
||||
}
|
||||
@@ -584,10 +584,19 @@ class CarePermissions
|
||||
if (in_array('vitals.manage', $abilities, true)) {
|
||||
$abilities[] = 'inpatient.placement.view';
|
||||
$abilities[] = 'inpatient.placement.manage';
|
||||
$abilities[] = 'mar.view';
|
||||
$abilities[] = 'mar.administer';
|
||||
$abilities[] = 'nursing.notes.view';
|
||||
$abilities[] = 'nursing.notes.manage';
|
||||
$abilities[] = 'nursing.handover.view';
|
||||
$abilities[] = 'nursing.handover.manage';
|
||||
}
|
||||
|
||||
if (in_array('analytics.department.view', $abilities, true)) {
|
||||
$abilities[] = 'inpatient.placement.view';
|
||||
$abilities[] = 'mar.view';
|
||||
$abilities[] = 'nursing.notes.view';
|
||||
$abilities[] = 'nursing.handover.view';
|
||||
}
|
||||
|
||||
return array_values(array_unique($abilities));
|
||||
|
||||
@@ -0,0 +1,339 @@
|
||||
<?php
|
||||
|
||||
namespace App\Services\Care;
|
||||
|
||||
use App\Models\CareUnit;
|
||||
use App\Models\MarAdministration;
|
||||
use App\Models\MarOrder;
|
||||
use App\Models\Prescription;
|
||||
use App\Models\PrescriptionItem;
|
||||
use App\Models\Visit;
|
||||
use Carbon\Carbon;
|
||||
use Carbon\CarbonInterface;
|
||||
use Illuminate\Support\Collection;
|
||||
use Illuminate\Validation\ValidationException;
|
||||
|
||||
class MarService
|
||||
{
|
||||
/**
|
||||
* Default clock times by frequency code.
|
||||
*
|
||||
* @var array<string, list<string>>
|
||||
*/
|
||||
protected array $defaultTimes = [
|
||||
'od' => ['08:00'],
|
||||
'bd' => ['08:00', '20:00'],
|
||||
'tds' => ['08:00', '14:00', '20:00'],
|
||||
'qds' => ['06:00', '12:00', '18:00', '22:00'],
|
||||
'q4h' => ['00:00', '04:00', '08:00', '12:00', '16:00', '20:00'],
|
||||
'q6h' => ['00:00', '06:00', '12:00', '18:00'],
|
||||
'q8h' => ['06:00', '14:00', '22:00'],
|
||||
'prn' => [],
|
||||
'stat' => [],
|
||||
'custom' => ['08:00'],
|
||||
];
|
||||
|
||||
/**
|
||||
* Sync MAR orders from active/dispensed prescriptions on a visit.
|
||||
*
|
||||
* @return Collection<int, MarOrder>
|
||||
*/
|
||||
public function syncOrdersForVisit(Visit $visit, string $ownerRef): Collection
|
||||
{
|
||||
$prescriptions = Prescription::owned($ownerRef)
|
||||
->where('visit_id', $visit->id)
|
||||
->whereIn('status', [Prescription::STATUS_ACTIVE, Prescription::STATUS_DISPENSED])
|
||||
->with('items')
|
||||
->get();
|
||||
|
||||
foreach ($prescriptions as $prescription) {
|
||||
foreach ($prescription->items as $item) {
|
||||
if ($item->is_procedure) {
|
||||
continue;
|
||||
}
|
||||
$this->upsertOrderFromItem($visit, $prescription, $item, $ownerRef);
|
||||
}
|
||||
}
|
||||
|
||||
return MarOrder::owned($ownerRef)
|
||||
->where('visit_id', $visit->id)
|
||||
->where('status', MarOrder::STATUS_ACTIVE)
|
||||
->orderBy('drug_name')
|
||||
->get();
|
||||
}
|
||||
|
||||
public function upsertOrderFromItem(
|
||||
Visit $visit,
|
||||
Prescription $prescription,
|
||||
PrescriptionItem $item,
|
||||
string $ownerRef,
|
||||
?string $frequencyCode = null,
|
||||
): MarOrder {
|
||||
$parsed = $this->parseFrequency((string) ($item->frequency ?? ''), $frequencyCode);
|
||||
|
||||
return MarOrder::query()->updateOrCreate(
|
||||
['prescription_item_id' => $item->id],
|
||||
[
|
||||
'owner_ref' => $ownerRef,
|
||||
'organization_id' => $visit->organization_id,
|
||||
'visit_id' => $visit->id,
|
||||
'patient_id' => $visit->patient_id,
|
||||
'prescription_id' => $prescription->id,
|
||||
'drug_name' => $item->name,
|
||||
'dosage' => $item->dosage,
|
||||
'route' => $item->route,
|
||||
'frequency_code' => $parsed['code'],
|
||||
'times_of_day' => $parsed['times'],
|
||||
'is_prn' => $parsed['is_prn'],
|
||||
'status' => MarOrder::STATUS_ACTIVE,
|
||||
'starts_at' => $visit->placed_at ?? $visit->checked_in_at ?? now(),
|
||||
'instructions' => $item->instructions,
|
||||
],
|
||||
);
|
||||
}
|
||||
|
||||
/**
|
||||
* Due / overdue / PRN slots for placed patients on a care unit for a calendar day.
|
||||
*
|
||||
* @return list<array<string, mixed>>
|
||||
*/
|
||||
public function unitRoundBoard(CareUnit $unit, string $ownerRef, ?CarbonInterface $day = null): array
|
||||
{
|
||||
$day = Carbon::parse($day ?? now())->startOfDay();
|
||||
|
||||
$visits = Visit::owned($ownerRef)
|
||||
->where('organization_id', $unit->organization_id)
|
||||
->where('care_unit_id', $unit->id)
|
||||
->whereIn('status', [Visit::STATUS_OPEN, Visit::STATUS_IN_PROGRESS])
|
||||
->with(['patient', 'bed'])
|
||||
->get();
|
||||
|
||||
$rows = [];
|
||||
foreach ($visits as $visit) {
|
||||
$orders = $this->syncOrdersForVisit($visit, $ownerRef);
|
||||
foreach ($orders as $order) {
|
||||
foreach ($this->dueSlotsForOrder($order, $day) as $slot) {
|
||||
$rows[] = $slot + [
|
||||
'visit' => $visit,
|
||||
'patient' => $visit->patient,
|
||||
'bed' => $visit->bed,
|
||||
'order' => $order,
|
||||
];
|
||||
}
|
||||
}
|
||||
}
|
||||
|
||||
usort($rows, function (array $a, array $b) {
|
||||
$aTime = $a['scheduled_for']?->timestamp ?? PHP_INT_MAX;
|
||||
$bTime = $b['scheduled_for']?->timestamp ?? PHP_INT_MAX;
|
||||
if ($aTime === $bTime) {
|
||||
return strcmp((string) ($a['patient']?->fullName() ?? ''), (string) ($b['patient']?->fullName() ?? ''));
|
||||
}
|
||||
|
||||
return $aTime <=> $bTime;
|
||||
});
|
||||
|
||||
return $rows;
|
||||
}
|
||||
|
||||
/**
|
||||
* @return list<array{scheduled_for: ?Carbon, state: string, administration: ?MarAdministration}>
|
||||
*/
|
||||
public function dueSlotsForOrder(MarOrder $order, CarbonInterface $day): array
|
||||
{
|
||||
$day = Carbon::parse($day)->startOfDay();
|
||||
$end = $day->copy()->endOfDay();
|
||||
|
||||
if ($order->status !== MarOrder::STATUS_ACTIVE) {
|
||||
return [];
|
||||
}
|
||||
|
||||
if ($order->starts_at && $order->starts_at->gt($end)) {
|
||||
return [];
|
||||
}
|
||||
if ($order->ends_at && $order->ends_at->lt($day)) {
|
||||
return [];
|
||||
}
|
||||
|
||||
$existing = MarAdministration::query()
|
||||
->where('mar_order_id', $order->id)
|
||||
->where(function ($q) use ($day, $end) {
|
||||
$q->whereBetween('scheduled_for', [$day, $end])
|
||||
->orWhere(function ($q2) use ($day, $end) {
|
||||
$q2->whereNull('scheduled_for')
|
||||
->whereBetween('recorded_at', [$day, $end]);
|
||||
});
|
||||
})
|
||||
->get();
|
||||
|
||||
if ($order->is_prn || $order->frequency_code === 'prn') {
|
||||
$givenToday = $existing->where('status', MarAdministration::STATUS_GIVEN);
|
||||
|
||||
return [[
|
||||
'scheduled_for' => null,
|
||||
'state' => $givenToday->isNotEmpty() ? 'prn_given' : 'prn_due',
|
||||
'administration' => $givenToday->sortByDesc('recorded_at')->first(),
|
||||
]];
|
||||
}
|
||||
|
||||
if ($order->frequency_code === 'stat') {
|
||||
$admin = $existing->first();
|
||||
|
||||
return [[
|
||||
'scheduled_for' => $order->starts_at ?? $day->copy()->setTime(8, 0),
|
||||
'state' => $admin ? $admin->status : 'due',
|
||||
'administration' => $admin,
|
||||
]];
|
||||
}
|
||||
|
||||
$times = $order->times_of_day ?: ($this->defaultTimes[$order->frequency_code] ?? ['08:00']);
|
||||
$slots = [];
|
||||
foreach ($times as $time) {
|
||||
[$h, $m] = array_map('intval', explode(':', $time) + [0, 0]);
|
||||
$scheduled = $day->copy()->setTime($h, $m);
|
||||
if ($order->starts_at && $scheduled->lt($order->starts_at)) {
|
||||
continue;
|
||||
}
|
||||
|
||||
$admin = $existing->first(function (MarAdministration $a) use ($scheduled) {
|
||||
return $a->scheduled_for && $a->scheduled_for->equalTo($scheduled);
|
||||
});
|
||||
|
||||
$state = 'due';
|
||||
if ($admin) {
|
||||
$state = $admin->status;
|
||||
} elseif ($scheduled->lt(now()->subMinutes(30))) {
|
||||
$state = 'overdue';
|
||||
}
|
||||
|
||||
$slots[] = [
|
||||
'scheduled_for' => $scheduled,
|
||||
'state' => $state,
|
||||
'administration' => $admin,
|
||||
];
|
||||
}
|
||||
|
||||
return $slots;
|
||||
}
|
||||
|
||||
public function recordAdministration(
|
||||
MarOrder $order,
|
||||
string $status,
|
||||
string $ownerRef,
|
||||
?string $actorRef,
|
||||
?CarbonInterface $scheduledFor = null,
|
||||
?string $doseGiven = null,
|
||||
?string $route = null,
|
||||
?string $witnessBy = null,
|
||||
?string $reason = null,
|
||||
?string $notes = null,
|
||||
?int $careUnitId = null,
|
||||
): MarAdministration {
|
||||
if (! in_array($status, [
|
||||
MarAdministration::STATUS_GIVEN,
|
||||
MarAdministration::STATUS_HELD,
|
||||
MarAdministration::STATUS_REFUSED,
|
||||
MarAdministration::STATUS_MISSED,
|
||||
], true)) {
|
||||
throw ValidationException::withMessages(['status' => 'Invalid MAR status.']);
|
||||
}
|
||||
|
||||
if ($order->status !== MarOrder::STATUS_ACTIVE) {
|
||||
throw ValidationException::withMessages(['mar_order_id' => 'This MAR order is not active.']);
|
||||
}
|
||||
|
||||
if (in_array($status, [MarAdministration::STATUS_HELD, MarAdministration::STATUS_REFUSED, MarAdministration::STATUS_MISSED], true)
|
||||
&& blank($reason) && blank($notes)) {
|
||||
throw ValidationException::withMessages([
|
||||
'reason' => 'Provide a reason when holding, refusing, or marking missed.',
|
||||
]);
|
||||
}
|
||||
|
||||
$visit = $order->visit ?? Visit::query()->findOrFail($order->visit_id);
|
||||
|
||||
if ($scheduledFor && ! $order->is_prn) {
|
||||
$duplicate = MarAdministration::query()
|
||||
->where('mar_order_id', $order->id)
|
||||
->where('scheduled_for', $scheduledFor)
|
||||
->exists();
|
||||
if ($duplicate) {
|
||||
throw ValidationException::withMessages([
|
||||
'scheduled_for' => 'This dose slot is already recorded.',
|
||||
]);
|
||||
}
|
||||
}
|
||||
|
||||
$admin = MarAdministration::create([
|
||||
'owner_ref' => $ownerRef,
|
||||
'organization_id' => $order->organization_id,
|
||||
'mar_order_id' => $order->id,
|
||||
'visit_id' => $order->visit_id,
|
||||
'patient_id' => $order->patient_id,
|
||||
'care_unit_id' => $careUnitId ?? $visit->care_unit_id,
|
||||
'scheduled_for' => $scheduledFor,
|
||||
'recorded_at' => now(),
|
||||
'status' => $status,
|
||||
'dose_given' => $doseGiven ?? $order->dosage,
|
||||
'route' => $route ?? $order->route,
|
||||
'administered_by' => $actorRef,
|
||||
'witness_by' => $witnessBy,
|
||||
'reason' => $reason,
|
||||
'notes' => $notes,
|
||||
]);
|
||||
|
||||
AuditLogger::record(
|
||||
$ownerRef,
|
||||
'mar.'.$status,
|
||||
$order->organization_id,
|
||||
$actorRef,
|
||||
MarAdministration::class,
|
||||
$admin->id,
|
||||
['mar_order_id' => $order->id, 'visit_id' => $order->visit_id],
|
||||
);
|
||||
|
||||
return $admin;
|
||||
}
|
||||
|
||||
/**
|
||||
* @return array{code: string, times: list<string>, is_prn: bool}
|
||||
*/
|
||||
public function parseFrequency(string $frequency, ?string $override = null): array
|
||||
{
|
||||
if ($override && isset($this->defaultTimes[$override])) {
|
||||
return [
|
||||
'code' => $override,
|
||||
'times' => $this->defaultTimes[$override],
|
||||
'is_prn' => $override === 'prn',
|
||||
];
|
||||
}
|
||||
|
||||
$raw = strtolower(trim($frequency));
|
||||
$map = [
|
||||
'od' => 'od', 'once daily' => 'od', 'daily' => 'od', 'once a day' => 'od', '1x' => 'od',
|
||||
'bd' => 'bd', 'bid' => 'bd', 'twice daily' => 'bd', 'twice a day' => 'bd', '2x' => 'bd',
|
||||
'tds' => 'tds', 'tid' => 'tds', 'three times' => 'tds', '3x' => 'tds',
|
||||
'qds' => 'qds', 'qid' => 'qds', 'four times' => 'qds', '4x' => 'qds',
|
||||
'q4h' => 'q4h', 'every 4' => 'q4h',
|
||||
'q6h' => 'q6h', 'every 6' => 'q6h',
|
||||
'q8h' => 'q8h', 'every 8' => 'q8h',
|
||||
'prn' => 'prn', 'as needed' => 'prn', 'when required' => 'prn',
|
||||
'stat' => 'stat', 'immediately' => 'stat', 'now' => 'stat',
|
||||
];
|
||||
|
||||
foreach ($map as $needle => $code) {
|
||||
if ($raw === $needle || str_contains($raw, $needle)) {
|
||||
return [
|
||||
'code' => $code,
|
||||
'times' => $this->defaultTimes[$code],
|
||||
'is_prn' => $code === 'prn',
|
||||
];
|
||||
}
|
||||
}
|
||||
|
||||
return [
|
||||
'code' => 'od',
|
||||
'times' => $this->defaultTimes['od'],
|
||||
'is_prn' => false,
|
||||
];
|
||||
}
|
||||
}
|
||||
@@ -0,0 +1,165 @@
|
||||
<?php
|
||||
|
||||
namespace App\Services\Care;
|
||||
|
||||
use App\Models\CareUnit;
|
||||
use App\Models\NursingNote;
|
||||
use App\Models\Visit;
|
||||
use App\Models\WardHandover;
|
||||
use Illuminate\Support\Collection;
|
||||
|
||||
class NursingDocumentationService
|
||||
{
|
||||
public function addNote(
|
||||
Visit $visit,
|
||||
string $ownerRef,
|
||||
?string $actorRef,
|
||||
string $body,
|
||||
string $noteType = 'progress',
|
||||
?string $shiftCode = null,
|
||||
?int $careUnitId = null,
|
||||
): NursingNote {
|
||||
$note = NursingNote::create([
|
||||
'owner_ref' => $ownerRef,
|
||||
'organization_id' => $visit->organization_id,
|
||||
'visit_id' => $visit->id,
|
||||
'patient_id' => $visit->patient_id,
|
||||
'care_unit_id' => $careUnitId ?? $visit->care_unit_id,
|
||||
'note_type' => $noteType,
|
||||
'shift_code' => $shiftCode,
|
||||
'body' => $body,
|
||||
'recorded_by' => $actorRef,
|
||||
'recorded_at' => now(),
|
||||
]);
|
||||
|
||||
AuditLogger::record(
|
||||
$ownerRef,
|
||||
'nursing_note.created',
|
||||
$visit->organization_id,
|
||||
$actorRef,
|
||||
NursingNote::class,
|
||||
$note->id,
|
||||
);
|
||||
|
||||
return $note;
|
||||
}
|
||||
|
||||
/**
|
||||
* @return Collection<int, NursingNote>
|
||||
*/
|
||||
public function notesForUnit(CareUnit $unit, string $ownerRef, int $limit = 50): Collection
|
||||
{
|
||||
return NursingNote::owned($ownerRef)
|
||||
->where('care_unit_id', $unit->id)
|
||||
->with(['patient', 'visit'])
|
||||
->orderByDesc('recorded_at')
|
||||
->limit($limit)
|
||||
->get();
|
||||
}
|
||||
|
||||
/**
|
||||
* @return Collection<int, NursingNote>
|
||||
*/
|
||||
public function notesForVisit(Visit $visit, string $ownerRef, int $limit = 50): Collection
|
||||
{
|
||||
return NursingNote::owned($ownerRef)
|
||||
->where('visit_id', $visit->id)
|
||||
->orderByDesc('recorded_at')
|
||||
->limit($limit)
|
||||
->get();
|
||||
}
|
||||
|
||||
/**
|
||||
* @param array<string, mixed> $data
|
||||
*/
|
||||
public function createHandover(
|
||||
CareUnit $unit,
|
||||
string $ownerRef,
|
||||
?string $actorRef,
|
||||
array $data,
|
||||
bool $complete = false,
|
||||
): WardHandover {
|
||||
$handover = WardHandover::create([
|
||||
'owner_ref' => $ownerRef,
|
||||
'organization_id' => $unit->organization_id,
|
||||
'care_unit_id' => $unit->id,
|
||||
'from_shift' => $data['from_shift'] ?? null,
|
||||
'to_shift' => $data['to_shift'] ?? null,
|
||||
'handed_over_at' => $complete ? now() : ($data['handed_over_at'] ?? null),
|
||||
'handed_over_by' => $actorRef,
|
||||
'received_by' => $data['received_by'] ?? null,
|
||||
'situation' => $data['situation'] ?? null,
|
||||
'background' => $data['background'] ?? null,
|
||||
'assessment' => $data['assessment'] ?? null,
|
||||
'recommendation' => $data['recommendation'] ?? null,
|
||||
'patient_summaries' => $data['patient_summaries'] ?? $this->defaultPatientSummaries($unit, $ownerRef),
|
||||
'status' => $complete ? WardHandover::STATUS_COMPLETED : WardHandover::STATUS_DRAFT,
|
||||
]);
|
||||
|
||||
AuditLogger::record(
|
||||
$ownerRef,
|
||||
$complete ? 'ward_handover.completed' : 'ward_handover.created',
|
||||
$unit->organization_id,
|
||||
$actorRef,
|
||||
WardHandover::class,
|
||||
$handover->id,
|
||||
);
|
||||
|
||||
return $handover;
|
||||
}
|
||||
|
||||
/**
|
||||
* @param array<string, mixed> $data
|
||||
*/
|
||||
public function completeHandover(
|
||||
WardHandover $handover,
|
||||
string $ownerRef,
|
||||
?string $actorRef,
|
||||
array $data = [],
|
||||
): WardHandover {
|
||||
$handover->update([
|
||||
'from_shift' => $data['from_shift'] ?? $handover->from_shift,
|
||||
'to_shift' => $data['to_shift'] ?? $handover->to_shift,
|
||||
'received_by' => $data['received_by'] ?? $handover->received_by,
|
||||
'situation' => $data['situation'] ?? $handover->situation,
|
||||
'background' => $data['background'] ?? $handover->background,
|
||||
'assessment' => $data['assessment'] ?? $handover->assessment,
|
||||
'recommendation' => $data['recommendation'] ?? $handover->recommendation,
|
||||
'patient_summaries' => $data['patient_summaries'] ?? $handover->patient_summaries,
|
||||
'handed_over_at' => now(),
|
||||
'handed_over_by' => $actorRef ?? $handover->handed_over_by,
|
||||
'status' => WardHandover::STATUS_COMPLETED,
|
||||
]);
|
||||
|
||||
AuditLogger::record(
|
||||
$ownerRef,
|
||||
'ward_handover.completed',
|
||||
$handover->organization_id,
|
||||
$actorRef,
|
||||
WardHandover::class,
|
||||
$handover->id,
|
||||
);
|
||||
|
||||
return $handover->fresh();
|
||||
}
|
||||
|
||||
/**
|
||||
* @return list<array{visit_id: int, patient_name: string, bed: ?string, note: string}>
|
||||
*/
|
||||
public function defaultPatientSummaries(CareUnit $unit, string $ownerRef): array
|
||||
{
|
||||
$visits = Visit::owned($ownerRef)
|
||||
->where('care_unit_id', $unit->id)
|
||||
->whereIn('status', [Visit::STATUS_OPEN, Visit::STATUS_IN_PROGRESS])
|
||||
->with(['patient', 'bed'])
|
||||
->orderBy('placed_at')
|
||||
->get();
|
||||
|
||||
return $visits->map(fn (Visit $visit) => [
|
||||
'visit_id' => $visit->id,
|
||||
'patient_name' => $visit->patient?->fullName() ?? 'Unknown',
|
||||
'bed' => $visit->bed?->label,
|
||||
'note' => '',
|
||||
])->all();
|
||||
}
|
||||
}
|
||||
@@ -143,6 +143,50 @@ return [
|
||||
'rotating' => 'Rotating',
|
||||
],
|
||||
|
||||
'mar_frequency_codes' => [
|
||||
'od' => 'Once daily (OD)',
|
||||
'bd' => 'Twice daily (BD)',
|
||||
'tds' => 'Three times daily (TDS)',
|
||||
'qds' => 'Four times daily (QDS)',
|
||||
'q4h' => 'Every 4 hours',
|
||||
'q6h' => 'Every 6 hours',
|
||||
'q8h' => 'Every 8 hours',
|
||||
'prn' => 'As needed (PRN)',
|
||||
'stat' => 'Immediate (STAT)',
|
||||
'custom' => 'Custom times',
|
||||
],
|
||||
|
||||
'mar_administration_statuses' => [
|
||||
'given' => 'Given',
|
||||
'held' => 'Held',
|
||||
'refused' => 'Refused',
|
||||
'missed' => 'Missed',
|
||||
],
|
||||
|
||||
'mar_slot_states' => [
|
||||
'due' => 'Due',
|
||||
'overdue' => 'Overdue',
|
||||
'given' => 'Given',
|
||||
'held' => 'Held',
|
||||
'refused' => 'Refused',
|
||||
'missed' => 'Missed',
|
||||
'prn_due' => 'PRN available',
|
||||
'prn_given' => 'PRN given today',
|
||||
],
|
||||
|
||||
'nursing_note_types' => [
|
||||
'progress' => 'Progress note',
|
||||
'assessment' => 'Nursing assessment',
|
||||
'intervention' => 'Intervention',
|
||||
'observation' => 'Observation',
|
||||
'other' => 'Other',
|
||||
],
|
||||
|
||||
'ward_handover_statuses' => [
|
||||
'draft' => 'Draft',
|
||||
'completed' => 'Completed',
|
||||
],
|
||||
|
||||
/*
|
||||
| Practitioner specialty options (Admin → Practitioners / Team invite).
|
||||
| Stored as free-text labels on care_practitioners.specialty.
|
||||
|
||||
@@ -0,0 +1,119 @@
|
||||
<?php
|
||||
|
||||
use Illuminate\Database\Migrations\Migration;
|
||||
use Illuminate\Database\Schema\Blueprint;
|
||||
use Illuminate\Support\Facades\Schema;
|
||||
|
||||
/**
|
||||
* Full MAR + nursing documentation on care units.
|
||||
*/
|
||||
return new class extends Migration
|
||||
{
|
||||
public function up(): void
|
||||
{
|
||||
Schema::create('care_mar_orders', function (Blueprint $table) {
|
||||
$table->id();
|
||||
$table->string('owner_ref')->index();
|
||||
$table->foreignId('organization_id')->constrained('care_organizations')->cascadeOnDelete();
|
||||
$table->foreignId('visit_id')->constrained('care_visits')->cascadeOnDelete();
|
||||
$table->foreignId('patient_id')->constrained('care_patients')->cascadeOnDelete();
|
||||
$table->foreignId('prescription_id')->constrained('care_prescriptions')->cascadeOnDelete();
|
||||
$table->foreignId('prescription_item_id')->constrained('care_prescription_items')->cascadeOnDelete();
|
||||
$table->string('drug_name');
|
||||
$table->string('dosage')->nullable();
|
||||
$table->string('route')->nullable();
|
||||
/** od|bd|tds|qds|q4h|q6h|q8h|prn|stat|custom */
|
||||
$table->string('frequency_code')->default('od');
|
||||
$table->json('times_of_day')->nullable();
|
||||
$table->boolean('is_prn')->default(false);
|
||||
/** active|paused|stopped */
|
||||
$table->string('status')->default('active');
|
||||
$table->timestamp('starts_at')->nullable();
|
||||
$table->timestamp('ends_at')->nullable();
|
||||
$table->text('instructions')->nullable();
|
||||
$table->timestamps();
|
||||
$table->softDeletes();
|
||||
|
||||
$table->unique(['prescription_item_id']);
|
||||
$table->index(['visit_id', 'status']);
|
||||
$table->index(['organization_id', 'status']);
|
||||
});
|
||||
|
||||
Schema::create('care_mar_administrations', function (Blueprint $table) {
|
||||
$table->id();
|
||||
$table->string('owner_ref')->index();
|
||||
$table->foreignId('organization_id')->constrained('care_organizations')->cascadeOnDelete();
|
||||
$table->foreignId('mar_order_id')->constrained('care_mar_orders')->cascadeOnDelete();
|
||||
$table->foreignId('visit_id')->constrained('care_visits')->cascadeOnDelete();
|
||||
$table->foreignId('patient_id')->constrained('care_patients')->cascadeOnDelete();
|
||||
$table->foreignId('care_unit_id')->nullable()->constrained('care_care_units')->nullOnDelete();
|
||||
$table->timestamp('scheduled_for')->nullable();
|
||||
$table->timestamp('recorded_at');
|
||||
/** given|held|refused|missed */
|
||||
$table->string('status');
|
||||
$table->string('dose_given')->nullable();
|
||||
$table->string('route')->nullable();
|
||||
$table->string('administered_by')->nullable();
|
||||
$table->string('witness_by')->nullable();
|
||||
$table->string('reason')->nullable();
|
||||
$table->text('notes')->nullable();
|
||||
$table->timestamps();
|
||||
|
||||
$table->index(['visit_id', 'recorded_at']);
|
||||
$table->index(['care_unit_id', 'scheduled_for']);
|
||||
$table->index(['mar_order_id', 'status']);
|
||||
});
|
||||
|
||||
Schema::create('care_nursing_notes', function (Blueprint $table) {
|
||||
$table->id();
|
||||
$table->string('owner_ref')->index();
|
||||
$table->foreignId('organization_id')->constrained('care_organizations')->cascadeOnDelete();
|
||||
$table->foreignId('visit_id')->constrained('care_visits')->cascadeOnDelete();
|
||||
$table->foreignId('patient_id')->constrained('care_patients')->cascadeOnDelete();
|
||||
$table->foreignId('care_unit_id')->nullable()->constrained('care_care_units')->nullOnDelete();
|
||||
/** progress|assessment|intervention|observation|other */
|
||||
$table->string('note_type')->default('progress');
|
||||
$table->string('shift_code')->nullable();
|
||||
$table->text('body');
|
||||
$table->string('recorded_by')->nullable();
|
||||
$table->timestamp('recorded_at');
|
||||
$table->timestamps();
|
||||
$table->softDeletes();
|
||||
|
||||
$table->index(['visit_id', 'recorded_at']);
|
||||
$table->index(['care_unit_id', 'recorded_at']);
|
||||
});
|
||||
|
||||
Schema::create('care_ward_handovers', function (Blueprint $table) {
|
||||
$table->id();
|
||||
$table->string('owner_ref')->index();
|
||||
$table->foreignId('organization_id')->constrained('care_organizations')->cascadeOnDelete();
|
||||
$table->foreignId('care_unit_id')->constrained('care_care_units')->cascadeOnDelete();
|
||||
$table->string('from_shift')->nullable();
|
||||
$table->string('to_shift')->nullable();
|
||||
$table->timestamp('handed_over_at')->nullable();
|
||||
$table->string('handed_over_by')->nullable();
|
||||
$table->string('received_by')->nullable();
|
||||
$table->text('situation')->nullable();
|
||||
$table->text('background')->nullable();
|
||||
$table->text('assessment')->nullable();
|
||||
$table->text('recommendation')->nullable();
|
||||
$table->json('patient_summaries')->nullable();
|
||||
/** draft|completed */
|
||||
$table->string('status')->default('draft');
|
||||
$table->timestamps();
|
||||
$table->softDeletes();
|
||||
|
||||
$table->index(['care_unit_id', 'status']);
|
||||
$table->index(['care_unit_id', 'handed_over_at']);
|
||||
});
|
||||
}
|
||||
|
||||
public function down(): void
|
||||
{
|
||||
Schema::dropIfExists('care_ward_handovers');
|
||||
Schema::dropIfExists('care_nursing_notes');
|
||||
Schema::dropIfExists('care_mar_administrations');
|
||||
Schema::dropIfExists('care_mar_orders');
|
||||
}
|
||||
};
|
||||
@@ -24,7 +24,19 @@
|
||||
: null;
|
||||
$permissions = app(\App\Services\Care\CarePermissions::class);
|
||||
$canManageUnit = $permissions->can($member, 'admin.departments.manage');
|
||||
$canMar = $permissions->can($member, 'mar.view');
|
||||
$canNotes = $permissions->can($member, 'nursing.notes.view');
|
||||
$canHandover = $permissions->can($member, 'nursing.handover.view');
|
||||
@endphp
|
||||
@if ($canMar)
|
||||
<a href="{{ route('care.care-units.mar', $unit) }}" class="btn-primary">MAR board</a>
|
||||
@endif
|
||||
@if ($canNotes)
|
||||
<a href="{{ route('care.care-units.notes', $unit) }}" class="btn-secondary">Nursing notes</a>
|
||||
@endif
|
||||
@if ($canHandover)
|
||||
<a href="{{ route('care.care-units.handovers', $unit) }}" class="btn-secondary">Handovers</a>
|
||||
@endif
|
||||
@if ($canManageUnit)
|
||||
<a href="{{ route('care.care-units.edit', $unit) }}" class="btn-secondary">Edit unit</a>
|
||||
<a href="{{ route('care.staff-assignments.create', ['care_unit_id' => $unit->id]) }}" class="btn-secondary">Assign staff</a>
|
||||
@@ -37,7 +49,7 @@
|
||||
<div class="flex flex-wrap items-center justify-between gap-3">
|
||||
<div>
|
||||
<h2 class="text-base font-semibold text-slate-900">Patients on this unit</h2>
|
||||
<p class="text-sm text-slate-500">Active visit placements — foundation for MAR and ward boards.</p>
|
||||
<p class="text-sm text-slate-500">Active visit placements — open MAR, notes, and handovers from the actions above.</p>
|
||||
</div>
|
||||
<p class="text-sm font-medium text-slate-700">{{ $placedVisits->count() }} placed</p>
|
||||
</div>
|
||||
@@ -64,6 +76,9 @@
|
||||
<td class="py-3 pr-4">{{ $visit->bed?->label ?? '—' }}</td>
|
||||
<td class="py-3 pr-4 whitespace-nowrap">{{ $visit->placed_at?->format('d M Y H:i') ?? '—' }}</td>
|
||||
<td class="py-3 text-right whitespace-nowrap">
|
||||
@if ($canMar ?? false)
|
||||
<a href="{{ route('care.visits.mar', $visit) }}" class="mr-2 text-indigo-600 hover:text-indigo-800">MAR</a>
|
||||
@endif
|
||||
@if ($canPlace)
|
||||
<form method="POST" action="{{ route('care.visits.placement.destroy', $visit) }}" class="inline" onsubmit="return confirm('Discharge placement and free the bed?')">
|
||||
@csrf @method('DELETE')
|
||||
|
||||
@@ -0,0 +1,83 @@
|
||||
@php
|
||||
$summaries = old('patient_summaries', $patientSummaries ?? $handover?->patient_summaries ?? []);
|
||||
@endphp
|
||||
|
||||
<x-app-layout title="New handover · {{ $unit->name }}">
|
||||
<div class="mx-auto max-w-3xl space-y-6">
|
||||
<div>
|
||||
<p class="text-sm text-slate-500">
|
||||
<a href="{{ route('care.care-units.handovers', $unit) }}" class="text-indigo-600 hover:text-indigo-800">Handovers</a>
|
||||
<span class="text-slate-300">/</span>
|
||||
New
|
||||
</p>
|
||||
<h1 class="mt-1 text-2xl font-semibold text-slate-900">SBAR ward handover</h1>
|
||||
</div>
|
||||
|
||||
<form method="POST" action="{{ route('care.care-units.handovers.store', $unit) }}" class="space-y-5 rounded-2xl border border-slate-200 bg-white p-6">
|
||||
@csrf
|
||||
<div class="grid gap-4 sm:grid-cols-3">
|
||||
<div>
|
||||
<label class="block text-sm font-medium">From shift</label>
|
||||
<select name="from_shift" class="mt-1 w-full rounded-lg border-slate-300 text-sm">
|
||||
<option value="">—</option>
|
||||
@foreach ($shiftCodes as $value => $label)
|
||||
<option value="{{ $value }}" @selected(old('from_shift') === $value)>{{ $label }}</option>
|
||||
@endforeach
|
||||
</select>
|
||||
</div>
|
||||
<div>
|
||||
<label class="block text-sm font-medium">To shift</label>
|
||||
<select name="to_shift" class="mt-1 w-full rounded-lg border-slate-300 text-sm">
|
||||
<option value="">—</option>
|
||||
@foreach ($shiftCodes as $value => $label)
|
||||
<option value="{{ $value }}" @selected(old('to_shift') === $value)>{{ $label }}</option>
|
||||
@endforeach
|
||||
</select>
|
||||
</div>
|
||||
<div>
|
||||
<label class="block text-sm font-medium">Received by</label>
|
||||
<input type="text" name="received_by" value="{{ old('received_by') }}" class="mt-1 w-full rounded-lg border-slate-300 text-sm" placeholder="Incoming nurse name">
|
||||
</div>
|
||||
</div>
|
||||
|
||||
<div>
|
||||
<label class="block text-sm font-medium">Situation</label>
|
||||
<textarea name="situation" rows="2" class="mt-1 w-full rounded-lg border-slate-300 text-sm">{{ old('situation') }}</textarea>
|
||||
</div>
|
||||
<div>
|
||||
<label class="block text-sm font-medium">Background</label>
|
||||
<textarea name="background" rows="2" class="mt-1 w-full rounded-lg border-slate-300 text-sm">{{ old('background') }}</textarea>
|
||||
</div>
|
||||
<div>
|
||||
<label class="block text-sm font-medium">Assessment</label>
|
||||
<textarea name="assessment" rows="2" class="mt-1 w-full rounded-lg border-slate-300 text-sm">{{ old('assessment') }}</textarea>
|
||||
</div>
|
||||
<div>
|
||||
<label class="block text-sm font-medium">Recommendation</label>
|
||||
<textarea name="recommendation" rows="2" class="mt-1 w-full rounded-lg border-slate-300 text-sm">{{ old('recommendation') }}</textarea>
|
||||
</div>
|
||||
|
||||
<div>
|
||||
<h2 class="text-sm font-semibold text-slate-900">Patients on unit</h2>
|
||||
<div class="mt-3 space-y-3">
|
||||
@forelse ($summaries as $i => $summary)
|
||||
<div class="rounded-xl border border-slate-100 bg-slate-50 p-3">
|
||||
<input type="hidden" name="patient_summaries[{{ $i }}][visit_id]" value="{{ $summary['visit_id'] ?? '' }}">
|
||||
<input type="hidden" name="patient_summaries[{{ $i }}][patient_name]" value="{{ $summary['patient_name'] ?? '' }}">
|
||||
<input type="hidden" name="patient_summaries[{{ $i }}][bed]" value="{{ $summary['bed'] ?? '' }}">
|
||||
<p class="text-sm font-medium">{{ $summary['patient_name'] ?? 'Patient' }} @if (!empty($summary['bed'])) · {{ $summary['bed'] }} @endif</p>
|
||||
<textarea name="patient_summaries[{{ $i }}][note]" rows="2" class="mt-2 w-full rounded-lg border-slate-300 text-sm" placeholder="Handover points for this patient">{{ $summary['note'] ?? '' }}</textarea>
|
||||
</div>
|
||||
@empty
|
||||
<p class="text-sm text-slate-500">No placed patients to include.</p>
|
||||
@endforelse
|
||||
</div>
|
||||
</div>
|
||||
|
||||
<div class="flex flex-wrap gap-2">
|
||||
<button type="submit" class="btn-secondary">Save draft</button>
|
||||
<button type="submit" name="complete" value="1" class="btn-primary">Complete handover</button>
|
||||
</div>
|
||||
</form>
|
||||
</div>
|
||||
</x-app-layout>
|
||||
@@ -0,0 +1,73 @@
|
||||
<x-app-layout title="Handover · {{ $unit->name }}">
|
||||
<div class="mx-auto max-w-3xl space-y-6">
|
||||
<div>
|
||||
<p class="text-sm text-slate-500">
|
||||
<a href="{{ route('care.care-units.handovers', $unit) }}" class="text-indigo-600 hover:text-indigo-800">Handovers</a>
|
||||
<span class="text-slate-300">/</span>
|
||||
{{ $statuses[$handover->status] ?? $handover->status }}
|
||||
</p>
|
||||
<h1 class="mt-1 text-2xl font-semibold text-slate-900">
|
||||
{{ $shiftCodes[$handover->from_shift] ?? ($handover->from_shift ?: 'Shift') }}
|
||||
→
|
||||
{{ $shiftCodes[$handover->to_shift] ?? ($handover->to_shift ?: 'Shift') }}
|
||||
</h1>
|
||||
<p class="mt-1 text-sm text-slate-500">
|
||||
{{ ($handover->handed_over_at ?? $handover->created_at)?->format('d M Y H:i') }}
|
||||
@if ($handover->received_by) · Received by {{ $handover->received_by }} @endif
|
||||
</p>
|
||||
</div>
|
||||
|
||||
<div class="space-y-4 rounded-2xl border border-slate-200 bg-white p-6 text-sm">
|
||||
<div>
|
||||
<h2 class="font-semibold text-slate-900">Situation</h2>
|
||||
<p class="mt-1 text-slate-700 whitespace-pre-wrap">{{ $handover->situation ?: '—' }}</p>
|
||||
</div>
|
||||
<div>
|
||||
<h2 class="font-semibold text-slate-900">Background</h2>
|
||||
<p class="mt-1 text-slate-700 whitespace-pre-wrap">{{ $handover->background ?: '—' }}</p>
|
||||
</div>
|
||||
<div>
|
||||
<h2 class="font-semibold text-slate-900">Assessment</h2>
|
||||
<p class="mt-1 text-slate-700 whitespace-pre-wrap">{{ $handover->assessment ?: '—' }}</p>
|
||||
</div>
|
||||
<div>
|
||||
<h2 class="font-semibold text-slate-900">Recommendation</h2>
|
||||
<p class="mt-1 text-slate-700 whitespace-pre-wrap">{{ $handover->recommendation ?: '—' }}</p>
|
||||
</div>
|
||||
</div>
|
||||
|
||||
<div class="rounded-2xl border border-slate-200 bg-white p-6">
|
||||
<h2 class="text-sm font-semibold text-slate-900">Patient summaries</h2>
|
||||
<div class="mt-3 space-y-3">
|
||||
@forelse ($handover->patient_summaries ?? [] as $summary)
|
||||
<div class="rounded-xl border border-slate-100 bg-slate-50 p-3 text-sm">
|
||||
<p class="font-medium">{{ $summary['patient_name'] ?? 'Patient' }} @if (!empty($summary['bed'])) · {{ $summary['bed'] }} @endif</p>
|
||||
<p class="mt-1 text-slate-600 whitespace-pre-wrap">{{ $summary['note'] ?: '—' }}</p>
|
||||
</div>
|
||||
@empty
|
||||
<p class="text-sm text-slate-500">No patient lines.</p>
|
||||
@endforelse
|
||||
</div>
|
||||
</div>
|
||||
|
||||
@if ($canWrite)
|
||||
<form method="POST" action="{{ route('care.care-units.handovers.complete', [$unit, $handover]) }}">
|
||||
@csrf
|
||||
<input type="hidden" name="from_shift" value="{{ $handover->from_shift }}">
|
||||
<input type="hidden" name="to_shift" value="{{ $handover->to_shift }}">
|
||||
<input type="hidden" name="received_by" value="{{ $handover->received_by }}">
|
||||
<input type="hidden" name="situation" value="{{ $handover->situation }}">
|
||||
<input type="hidden" name="background" value="{{ $handover->background }}">
|
||||
<input type="hidden" name="assessment" value="{{ $handover->assessment }}">
|
||||
<input type="hidden" name="recommendation" value="{{ $handover->recommendation }}">
|
||||
@foreach ($handover->patient_summaries ?? [] as $i => $summary)
|
||||
<input type="hidden" name="patient_summaries[{{ $i }}][visit_id]" value="{{ $summary['visit_id'] ?? '' }}">
|
||||
<input type="hidden" name="patient_summaries[{{ $i }}][patient_name]" value="{{ $summary['patient_name'] ?? '' }}">
|
||||
<input type="hidden" name="patient_summaries[{{ $i }}][bed]" value="{{ $summary['bed'] ?? '' }}">
|
||||
<input type="hidden" name="patient_summaries[{{ $i }}][note]" value="{{ $summary['note'] ?? '' }}">
|
||||
@endforeach
|
||||
<button type="submit" class="btn-primary">Mark completed</button>
|
||||
</form>
|
||||
@endif
|
||||
</div>
|
||||
</x-app-layout>
|
||||
@@ -0,0 +1,51 @@
|
||||
<x-app-layout title="Handovers · {{ $unit->name }}">
|
||||
<div class="space-y-6">
|
||||
<div class="flex flex-wrap items-start justify-between gap-4">
|
||||
<div>
|
||||
<p class="text-sm text-slate-500">
|
||||
<a href="{{ route('care.care-units.show', $unit) }}" class="text-indigo-600 hover:text-indigo-800">{{ $unit->name }}</a>
|
||||
<span class="text-slate-300">/</span>
|
||||
Ward handovers
|
||||
</p>
|
||||
<h1 class="mt-1 text-2xl font-semibold text-slate-900">Shift handovers</h1>
|
||||
<p class="mt-1 text-sm text-slate-500">SBAR handovers scoped to this care unit.</p>
|
||||
</div>
|
||||
@if ($canWrite)
|
||||
<a href="{{ route('care.care-units.handovers.create', $unit) }}" class="btn-primary">New handover</a>
|
||||
@endif
|
||||
</div>
|
||||
|
||||
<div class="overflow-hidden rounded-2xl border border-slate-200 bg-white">
|
||||
<table class="min-w-full text-sm">
|
||||
<thead class="bg-slate-50 text-left text-xs uppercase text-slate-500">
|
||||
<tr>
|
||||
<th class="px-4 py-3">When</th>
|
||||
<th class="px-4 py-3">Shifts</th>
|
||||
<th class="px-4 py-3">Status</th>
|
||||
<th class="px-4 py-3"></th>
|
||||
</tr>
|
||||
</thead>
|
||||
<tbody class="divide-y divide-slate-50">
|
||||
@forelse ($handovers as $handover)
|
||||
<tr>
|
||||
<td class="px-4 py-3 whitespace-nowrap">
|
||||
{{ ($handover->handed_over_at ?? $handover->created_at)?->format('d M Y H:i') }}
|
||||
</td>
|
||||
<td class="px-4 py-3">
|
||||
{{ $shiftCodes[$handover->from_shift] ?? ($handover->from_shift ?: '—') }}
|
||||
→
|
||||
{{ $shiftCodes[$handover->to_shift] ?? ($handover->to_shift ?: '—') }}
|
||||
</td>
|
||||
<td class="px-4 py-3">{{ $statuses[$handover->status] ?? $handover->status }}</td>
|
||||
<td class="px-4 py-3 text-right">
|
||||
<a href="{{ route('care.care-units.handovers.show', [$unit, $handover]) }}" class="text-sky-600">Open</a>
|
||||
</td>
|
||||
</tr>
|
||||
@empty
|
||||
<tr><td colspan="4" class="px-4 py-8 text-center text-slate-500">No handovers yet.</td></tr>
|
||||
@endforelse
|
||||
</tbody>
|
||||
</table>
|
||||
</div>
|
||||
</div>
|
||||
</x-app-layout>
|
||||
@@ -0,0 +1,99 @@
|
||||
@php
|
||||
$stateClass = [
|
||||
'due' => 'bg-amber-50 text-amber-800',
|
||||
'overdue' => 'bg-red-50 text-red-800',
|
||||
'given' => 'bg-emerald-50 text-emerald-800',
|
||||
'held' => 'bg-slate-100 text-slate-700',
|
||||
'refused' => 'bg-orange-50 text-orange-800',
|
||||
'missed' => 'bg-red-50 text-red-700',
|
||||
'prn_due' => 'bg-sky-50 text-sky-800',
|
||||
'prn_given' => 'bg-emerald-50 text-emerald-700',
|
||||
];
|
||||
@endphp
|
||||
|
||||
<x-app-layout title="MAR · {{ $unit->name }}">
|
||||
<div class="space-y-6">
|
||||
<div class="flex flex-wrap items-start justify-between gap-4">
|
||||
<div>
|
||||
<p class="text-sm text-slate-500">
|
||||
<a href="{{ route('care.care-units.show', $unit) }}" class="text-indigo-600 hover:text-indigo-800">{{ $unit->name }}</a>
|
||||
<span class="text-slate-300">/</span>
|
||||
Medication round
|
||||
</p>
|
||||
<h1 class="mt-1 text-2xl font-semibold text-slate-900">MAR board</h1>
|
||||
<p class="mt-1 text-sm text-slate-500">Due doses for patients placed on this unit.</p>
|
||||
</div>
|
||||
<form method="GET" class="flex items-end gap-2">
|
||||
<div>
|
||||
<label class="block text-xs font-medium uppercase text-slate-500">Date</label>
|
||||
<input type="date" name="date" value="{{ $day->toDateString() }}" class="mt-1 rounded-lg border-slate-300 text-sm">
|
||||
</div>
|
||||
<button type="submit" class="btn-secondary">Go</button>
|
||||
</form>
|
||||
</div>
|
||||
|
||||
<div class="overflow-hidden rounded-2xl border border-slate-200 bg-white">
|
||||
<table class="min-w-full text-sm">
|
||||
<thead class="bg-slate-50 text-left text-xs uppercase text-slate-500">
|
||||
<tr>
|
||||
<th class="px-4 py-3">Time</th>
|
||||
<th class="px-4 py-3">Patient / bed</th>
|
||||
<th class="px-4 py-3">Drug</th>
|
||||
<th class="px-4 py-3">Dose / route</th>
|
||||
<th class="px-4 py-3">Status</th>
|
||||
<th class="px-4 py-3"></th>
|
||||
</tr>
|
||||
</thead>
|
||||
<tbody class="divide-y divide-slate-50">
|
||||
@forelse ($rows as $row)
|
||||
@php
|
||||
$order = $row['order'];
|
||||
$state = $row['state'];
|
||||
$scheduled = $row['scheduled_for'];
|
||||
$done = in_array($state, ['given', 'held', 'refused', 'missed', 'prn_given'], true);
|
||||
@endphp
|
||||
<tr>
|
||||
<td class="px-4 py-3 whitespace-nowrap font-medium">
|
||||
{{ $scheduled?->format('H:i') ?? 'PRN' }}
|
||||
</td>
|
||||
<td class="px-4 py-3">
|
||||
{{ $row['patient']?->fullName() }}
|
||||
<div class="text-xs text-slate-400">{{ $row['bed']?->label ?? 'No bed' }}</div>
|
||||
</td>
|
||||
<td class="px-4 py-3">
|
||||
{{ $order->drug_name }}
|
||||
<div class="text-xs text-slate-400">{{ strtoupper($order->frequency_code) }}</div>
|
||||
</td>
|
||||
<td class="px-4 py-3">
|
||||
{{ $order->dosage ?: '—' }}
|
||||
<div class="text-xs text-slate-400">{{ $order->route ?: '—' }}</div>
|
||||
</td>
|
||||
<td class="px-4 py-3">
|
||||
<span class="inline-flex rounded-full px-2 py-0.5 text-xs font-medium {{ $stateClass[$state] ?? 'bg-slate-100 text-slate-700' }}">
|
||||
{{ $stateLabels[$state] ?? $state }}
|
||||
</span>
|
||||
</td>
|
||||
<td class="px-4 py-3 text-right whitespace-nowrap">
|
||||
<a href="{{ route('care.visits.mar', $row['visit']) }}" class="text-sky-600 hover:text-sky-800">Chart</a>
|
||||
@if ($canAdminister && ! $done)
|
||||
<form method="POST" action="{{ route('care.mar.administer', $order) }}" class="mt-2 inline-flex flex-wrap items-center justify-end gap-1">
|
||||
@csrf
|
||||
<input type="hidden" name="redirect_to" value="{{ url()->full() }}">
|
||||
@if ($scheduled)
|
||||
<input type="hidden" name="scheduled_for" value="{{ $scheduled->toDateTimeString() }}">
|
||||
@endif
|
||||
<button name="status" value="given" class="rounded border border-emerald-200 px-2 py-1 text-xs text-emerald-700 hover:bg-emerald-50">Given</button>
|
||||
<button name="status" value="held" class="rounded border border-slate-200 px-2 py-1 text-xs text-slate-600 hover:bg-slate-50" onclick="this.form.reason.value=prompt('Reason for hold')||''; return !!this.form.reason.value;">Hold</button>
|
||||
<input type="hidden" name="reason" value="">
|
||||
</form>
|
||||
@endif
|
||||
</td>
|
||||
</tr>
|
||||
@empty
|
||||
<tr><td colspan="6" class="px-4 py-8 text-center text-slate-500">No MAR doses for this date. Place patients and ensure active prescriptions exist.</td></tr>
|
||||
@endforelse
|
||||
</tbody>
|
||||
</table>
|
||||
</div>
|
||||
</div>
|
||||
</x-app-layout>
|
||||
@@ -0,0 +1,110 @@
|
||||
@php
|
||||
$stateClass = [
|
||||
'due' => 'bg-amber-50 text-amber-800',
|
||||
'overdue' => 'bg-red-50 text-red-800',
|
||||
'given' => 'bg-emerald-50 text-emerald-800',
|
||||
'held' => 'bg-slate-100 text-slate-700',
|
||||
'refused' => 'bg-orange-50 text-orange-800',
|
||||
'missed' => 'bg-red-50 text-red-700',
|
||||
'prn_due' => 'bg-sky-50 text-sky-800',
|
||||
'prn_given' => 'bg-emerald-50 text-emerald-700',
|
||||
];
|
||||
@endphp
|
||||
|
||||
<x-app-layout title="MAR · {{ $visit->patient?->fullName() }}">
|
||||
<div class="space-y-6">
|
||||
<div class="flex flex-wrap items-start justify-between gap-4">
|
||||
<div>
|
||||
<p class="text-sm text-slate-500">
|
||||
@if ($visit->careUnit)
|
||||
<a href="{{ route('care.care-units.mar', $visit->careUnit) }}" class="text-indigo-600 hover:text-indigo-800">{{ $visit->careUnit->name }} MAR</a>
|
||||
<span class="text-slate-300">/</span>
|
||||
@endif
|
||||
Patient chart
|
||||
</p>
|
||||
<h1 class="mt-1 text-2xl font-semibold text-slate-900">{{ $visit->patient?->fullName() }}</h1>
|
||||
<p class="mt-1 text-sm text-slate-500">
|
||||
{{ $visit->careUnit?->name ?? 'Not placed' }}
|
||||
@if ($visit->bed) · Bed {{ $visit->bed->label }} @endif
|
||||
</p>
|
||||
</div>
|
||||
<form method="GET" class="flex items-end gap-2">
|
||||
<div>
|
||||
<label class="block text-xs font-medium uppercase text-slate-500">Date</label>
|
||||
<input type="date" name="date" value="{{ $day->toDateString() }}" class="mt-1 rounded-lg border-slate-300 text-sm">
|
||||
</div>
|
||||
<button type="submit" class="btn-secondary">Go</button>
|
||||
</form>
|
||||
</div>
|
||||
|
||||
<div class="space-y-4">
|
||||
@forelse ($chart as $block)
|
||||
@php $order = $block['order']; @endphp
|
||||
<div class="rounded-2xl border border-slate-200 bg-white p-5">
|
||||
<div class="flex flex-wrap items-start justify-between gap-3">
|
||||
<div>
|
||||
<h2 class="text-base font-semibold text-slate-900">{{ $order->drug_name }}</h2>
|
||||
<p class="text-sm text-slate-500">
|
||||
{{ $order->dosage ?: 'Dose not set' }}
|
||||
· {{ $order->route ?: 'Route n/a' }}
|
||||
· {{ $frequencies[$order->frequency_code] ?? strtoupper($order->frequency_code) }}
|
||||
</p>
|
||||
@if ($order->instructions)
|
||||
<p class="mt-1 text-sm text-slate-600">{{ $order->instructions }}</p>
|
||||
@endif
|
||||
</div>
|
||||
</div>
|
||||
|
||||
<div class="mt-4 overflow-x-auto">
|
||||
<table class="min-w-full text-sm">
|
||||
<thead class="text-left text-xs uppercase text-slate-500">
|
||||
<tr>
|
||||
<th class="pb-2 pr-4">Scheduled</th>
|
||||
<th class="pb-2 pr-4">State</th>
|
||||
<th class="pb-2"></th>
|
||||
</tr>
|
||||
</thead>
|
||||
<tbody class="divide-y divide-slate-100">
|
||||
@foreach ($block['slots'] as $slot)
|
||||
@php
|
||||
$state = $slot['state'];
|
||||
$done = in_array($state, ['given', 'held', 'refused', 'missed', 'prn_given'], true);
|
||||
@endphp
|
||||
<tr>
|
||||
<td class="py-3 pr-4">{{ $slot['scheduled_for']?->format('d M Y H:i') ?? 'PRN' }}</td>
|
||||
<td class="py-3 pr-4">
|
||||
<span class="inline-flex rounded-full px-2 py-0.5 text-xs font-medium {{ $stateClass[$state] ?? 'bg-slate-100' }}">
|
||||
{{ $stateLabels[$state] ?? $state }}
|
||||
</span>
|
||||
@if ($slot['administration']?->reason)
|
||||
<div class="mt-1 text-xs text-slate-500">{{ $slot['administration']->reason }}</div>
|
||||
@endif
|
||||
</td>
|
||||
<td class="py-3 text-right">
|
||||
@if ($canAdminister && ! $done)
|
||||
<form method="POST" action="{{ route('care.mar.administer', $order) }}" class="inline-flex flex-wrap justify-end gap-1">
|
||||
@csrf
|
||||
@if ($slot['scheduled_for'])
|
||||
<input type="hidden" name="scheduled_for" value="{{ $slot['scheduled_for']->toDateTimeString() }}">
|
||||
@endif
|
||||
<button name="status" value="given" class="rounded border border-emerald-200 px-2 py-1 text-xs text-emerald-700">Given</button>
|
||||
<button name="status" value="held" class="rounded border border-slate-200 px-2 py-1 text-xs" onclick="const r=prompt('Reason'); if(!r) return false; this.form.reason.value=r;">Held</button>
|
||||
<button name="status" value="refused" class="rounded border border-orange-200 px-2 py-1 text-xs text-orange-700" onclick="const r=prompt('Reason'); if(!r) return false; this.form.reason.value=r;">Refused</button>
|
||||
<input type="hidden" name="reason" value="">
|
||||
</form>
|
||||
@endif
|
||||
</td>
|
||||
</tr>
|
||||
@endforeach
|
||||
</tbody>
|
||||
</table>
|
||||
</div>
|
||||
</div>
|
||||
@empty
|
||||
<div class="rounded-2xl border border-dashed border-slate-200 bg-slate-50 px-6 py-8 text-center text-sm text-slate-500">
|
||||
No active medication orders on this visit. Prescribe and activate medications first; dispensed Rxs also sync to MAR.
|
||||
</div>
|
||||
@endforelse
|
||||
</div>
|
||||
</div>
|
||||
</x-app-layout>
|
||||
@@ -0,0 +1,82 @@
|
||||
<x-app-layout title="Nursing notes · {{ $unit->name }}">
|
||||
<div class="space-y-6">
|
||||
<div>
|
||||
<p class="text-sm text-slate-500">
|
||||
<a href="{{ route('care.care-units.show', $unit) }}" class="text-indigo-600 hover:text-indigo-800">{{ $unit->name }}</a>
|
||||
<span class="text-slate-300">/</span>
|
||||
Nursing notes
|
||||
</p>
|
||||
<h1 class="mt-1 text-2xl font-semibold text-slate-900">Nursing notes</h1>
|
||||
<p class="mt-1 text-sm text-slate-500">Chronologic unit documentation — not overwritten like specialty forms.</p>
|
||||
</div>
|
||||
|
||||
@if ($canWrite)
|
||||
<form method="POST" action="{{ route('care.care-units.notes.store', $unit) }}" class="space-y-4 rounded-2xl border border-slate-200 bg-white p-6">
|
||||
@csrf
|
||||
<div class="grid gap-4 sm:grid-cols-3">
|
||||
<div class="sm:col-span-2">
|
||||
<label class="block text-sm font-medium">Patient visit</label>
|
||||
<select name="visit_id" required class="mt-1 w-full rounded-lg border-slate-300 text-sm">
|
||||
<option value="">Select…</option>
|
||||
@foreach ($placedVisits as $visit)
|
||||
<option value="{{ $visit->id }}">
|
||||
{{ $visit->patient?->fullName() }}
|
||||
@if ($visit->bed) · {{ $visit->bed->label }} @endif
|
||||
</option>
|
||||
@endforeach
|
||||
</select>
|
||||
</div>
|
||||
<div>
|
||||
<label class="block text-sm font-medium">Type</label>
|
||||
<select name="note_type" class="mt-1 w-full rounded-lg border-slate-300 text-sm">
|
||||
@foreach ($noteTypes as $value => $label)
|
||||
<option value="{{ $value }}" @selected(old('note_type', 'progress') === $value)>{{ $label }}</option>
|
||||
@endforeach
|
||||
</select>
|
||||
</div>
|
||||
</div>
|
||||
<div class="grid gap-4 sm:grid-cols-3">
|
||||
<div>
|
||||
<label class="block text-sm font-medium">Shift</label>
|
||||
<select name="shift_code" class="mt-1 w-full rounded-lg border-slate-300 text-sm">
|
||||
<option value="">—</option>
|
||||
@foreach ($shiftCodes as $value => $label)
|
||||
<option value="{{ $value }}">{{ $label }}</option>
|
||||
@endforeach
|
||||
</select>
|
||||
</div>
|
||||
<div class="sm:col-span-2">
|
||||
<label class="block text-sm font-medium">Note</label>
|
||||
<textarea name="body" rows="3" required class="mt-1 w-full rounded-lg border-slate-300 text-sm" placeholder="Observations, interventions, response…">{{ old('body') }}</textarea>
|
||||
</div>
|
||||
</div>
|
||||
<button type="submit" class="btn-primary">Save note</button>
|
||||
</form>
|
||||
@endif
|
||||
|
||||
<div class="overflow-hidden rounded-2xl border border-slate-200 bg-white">
|
||||
<table class="min-w-full text-sm">
|
||||
<thead class="bg-slate-50 text-left text-xs uppercase text-slate-500">
|
||||
<tr>
|
||||
<th class="px-4 py-3">When</th>
|
||||
<th class="px-4 py-3">Patient</th>
|
||||
<th class="px-4 py-3">Type</th>
|
||||
<th class="px-4 py-3">Note</th>
|
||||
</tr>
|
||||
</thead>
|
||||
<tbody class="divide-y divide-slate-50">
|
||||
@forelse ($notes as $note)
|
||||
<tr>
|
||||
<td class="px-4 py-3 whitespace-nowrap">{{ $note->recorded_at?->format('d M H:i') }}</td>
|
||||
<td class="px-4 py-3 font-medium">{{ $note->patient?->fullName() }}</td>
|
||||
<td class="px-4 py-3">{{ $noteTypes[$note->note_type] ?? $note->note_type }}</td>
|
||||
<td class="px-4 py-3 text-slate-700">{{ $note->body }}</td>
|
||||
</tr>
|
||||
@empty
|
||||
<tr><td colspan="4" class="px-4 py-8 text-center text-slate-500">No nursing notes yet.</td></tr>
|
||||
@endforelse
|
||||
</tbody>
|
||||
</table>
|
||||
</div>
|
||||
</div>
|
||||
</x-app-layout>
|
||||
@@ -16,6 +16,8 @@ use App\Http\Controllers\Care\CareUnitController;
|
||||
use App\Http\Controllers\Care\BedController;
|
||||
use App\Http\Controllers\Care\StaffAssignmentController;
|
||||
use App\Http\Controllers\Care\VisitPlacementController;
|
||||
use App\Http\Controllers\Care\MarController;
|
||||
use App\Http\Controllers\Care\NursingDocumentationController;
|
||||
use App\Http\Controllers\Care\DeviceController;
|
||||
use App\Http\Controllers\Care\DisplayPublicController;
|
||||
use App\Http\Controllers\Care\DisplayScreenController;
|
||||
@@ -433,6 +435,18 @@ Route::middleware(['auth', 'platform.session'])->group(function () {
|
||||
Route::post('/visits/{visit}/placement/transfer', [VisitPlacementController::class, 'transfer'])->name('care.visits.placement.transfer');
|
||||
Route::delete('/visits/{visit}/placement', [VisitPlacementController::class, 'destroy'])->name('care.visits.placement.destroy');
|
||||
|
||||
Route::get('/care-units/{careUnit}/mar', [MarController::class, 'unitBoard'])->name('care.care-units.mar');
|
||||
Route::get('/visits/{visit}/mar', [MarController::class, 'visitChart'])->name('care.visits.mar');
|
||||
Route::post('/mar/orders/{marOrder}/administer', [MarController::class, 'administer'])->name('care.mar.administer');
|
||||
|
||||
Route::get('/care-units/{careUnit}/notes', [NursingDocumentationController::class, 'unitNotes'])->name('care.care-units.notes');
|
||||
Route::post('/care-units/{careUnit}/notes', [NursingDocumentationController::class, 'storeNote'])->name('care.care-units.notes.store');
|
||||
Route::get('/care-units/{careUnit}/handovers', [NursingDocumentationController::class, 'handovers'])->name('care.care-units.handovers');
|
||||
Route::get('/care-units/{careUnit}/handovers/create', [NursingDocumentationController::class, 'createHandover'])->name('care.care-units.handovers.create');
|
||||
Route::post('/care-units/{careUnit}/handovers', [NursingDocumentationController::class, 'storeHandover'])->name('care.care-units.handovers.store');
|
||||
Route::get('/care-units/{careUnit}/handovers/{wardHandover}', [NursingDocumentationController::class, 'showHandover'])->name('care.care-units.handovers.show');
|
||||
Route::post('/care-units/{careUnit}/handovers/{wardHandover}/complete', [NursingDocumentationController::class, 'completeHandover'])->name('care.care-units.handovers.complete');
|
||||
|
||||
Route::get('/staff-assignments', [StaffAssignmentController::class, 'index'])->name('care.staff-assignments.index');
|
||||
Route::get('/staff-assignments/create', [StaffAssignmentController::class, 'create'])->name('care.staff-assignments.create');
|
||||
Route::post('/staff-assignments', [StaffAssignmentController::class, 'store'])->name('care.staff-assignments.store');
|
||||
|
||||
@@ -0,0 +1,268 @@
|
||||
<?php
|
||||
|
||||
namespace Tests\Feature;
|
||||
|
||||
use App\Http\Middleware\EnsurePlatformSession;
|
||||
use App\Models\Bed;
|
||||
use App\Models\Branch;
|
||||
use App\Models\CareUnit;
|
||||
use App\Models\Department;
|
||||
use App\Models\MarAdministration;
|
||||
use App\Models\MarOrder;
|
||||
use App\Models\Member;
|
||||
use App\Models\Organization;
|
||||
use App\Models\Patient;
|
||||
use App\Models\Prescription;
|
||||
use App\Models\PrescriptionItem;
|
||||
use App\Models\User;
|
||||
use App\Models\Visit;
|
||||
use App\Models\WardHandover;
|
||||
use App\Services\Care\MarService;
|
||||
use App\Services\Care\VisitPlacementService;
|
||||
use Illuminate\Foundation\Testing\RefreshDatabase;
|
||||
use Tests\TestCase;
|
||||
|
||||
class CareMarAndNursingTest extends TestCase
|
||||
{
|
||||
use RefreshDatabase;
|
||||
|
||||
protected User $owner;
|
||||
|
||||
protected Organization $organization;
|
||||
|
||||
protected Branch $branch;
|
||||
|
||||
protected CareUnit $unit;
|
||||
|
||||
protected Visit $visit;
|
||||
|
||||
protected PrescriptionItem $item;
|
||||
|
||||
protected function setUp(): void
|
||||
{
|
||||
parent::setUp();
|
||||
$this->withoutMiddleware(EnsurePlatformSession::class);
|
||||
|
||||
$this->owner = User::create([
|
||||
'public_id' => 'mar-nursing-owner',
|
||||
'name' => 'Owner',
|
||||
'email' => 'mar-owner@example.com',
|
||||
]);
|
||||
|
||||
$this->organization = Organization::create([
|
||||
'owner_ref' => $this->owner->public_id,
|
||||
'name' => 'MAR Hospital',
|
||||
'slug' => 'mar-hospital',
|
||||
'settings' => [
|
||||
'onboarded' => true,
|
||||
'facility_type' => 'hospital',
|
||||
'plan' => 'pro',
|
||||
'plan_expires_at' => now()->addMonth()->toIso8601String(),
|
||||
],
|
||||
]);
|
||||
|
||||
Member::create([
|
||||
'owner_ref' => $this->owner->public_id,
|
||||
'organization_id' => $this->organization->id,
|
||||
'user_ref' => $this->owner->public_id,
|
||||
'role' => 'hospital_admin',
|
||||
]);
|
||||
|
||||
$this->branch = Branch::create([
|
||||
'owner_ref' => $this->owner->public_id,
|
||||
'organization_id' => $this->organization->id,
|
||||
'name' => 'Main',
|
||||
'is_active' => true,
|
||||
]);
|
||||
|
||||
$department = Department::create([
|
||||
'owner_ref' => $this->owner->public_id,
|
||||
'branch_id' => $this->branch->id,
|
||||
'name' => 'Medicine',
|
||||
'type' => 'general',
|
||||
'is_active' => true,
|
||||
]);
|
||||
|
||||
$this->unit = CareUnit::create([
|
||||
'owner_ref' => $this->owner->public_id,
|
||||
'organization_id' => $this->organization->id,
|
||||
'department_id' => $department->id,
|
||||
'name' => 'Medical Ward',
|
||||
'kind' => 'inpatient',
|
||||
'is_active' => true,
|
||||
]);
|
||||
|
||||
$bed = Bed::create([
|
||||
'owner_ref' => $this->owner->public_id,
|
||||
'organization_id' => $this->organization->id,
|
||||
'care_unit_id' => $this->unit->id,
|
||||
'label' => 'MW-01',
|
||||
'status' => 'available',
|
||||
'is_active' => true,
|
||||
]);
|
||||
|
||||
$patient = Patient::create([
|
||||
'owner_ref' => $this->owner->public_id,
|
||||
'organization_id' => $this->organization->id,
|
||||
'branch_id' => $this->branch->id,
|
||||
'patient_number' => 'P-MAR-1',
|
||||
'first_name' => 'Kofi',
|
||||
'last_name' => 'Asante',
|
||||
'gender' => 'male',
|
||||
]);
|
||||
|
||||
$this->visit = Visit::create([
|
||||
'owner_ref' => $this->owner->public_id,
|
||||
'organization_id' => $this->organization->id,
|
||||
'branch_id' => $this->branch->id,
|
||||
'patient_id' => $patient->id,
|
||||
'status' => Visit::STATUS_IN_PROGRESS,
|
||||
'checked_in_at' => now(),
|
||||
]);
|
||||
|
||||
app(VisitPlacementService::class)->place(
|
||||
$this->visit,
|
||||
$this->unit,
|
||||
$bed,
|
||||
$this->owner->public_id,
|
||||
$this->owner->public_id,
|
||||
);
|
||||
|
||||
$rx = Prescription::create([
|
||||
'owner_ref' => $this->owner->public_id,
|
||||
'organization_id' => $this->organization->id,
|
||||
'visit_id' => $this->visit->id,
|
||||
'patient_id' => $patient->id,
|
||||
'status' => Prescription::STATUS_ACTIVE,
|
||||
'prescribed_by' => $this->owner->public_id,
|
||||
]);
|
||||
|
||||
$this->item = PrescriptionItem::create([
|
||||
'owner_ref' => $this->owner->public_id,
|
||||
'prescription_id' => $rx->id,
|
||||
'name' => 'Paracetamol',
|
||||
'dosage' => '1g',
|
||||
'frequency' => 'TDS',
|
||||
'route' => 'oral',
|
||||
'sort_order' => 1,
|
||||
]);
|
||||
}
|
||||
|
||||
public function test_mar_syncs_orders_and_records_given(): void
|
||||
{
|
||||
$mar = app(MarService::class);
|
||||
$orders = $mar->syncOrdersForVisit($this->visit->fresh(), $this->owner->public_id);
|
||||
$this->assertCount(1, $orders);
|
||||
$this->assertSame('tds', $orders->first()->frequency_code);
|
||||
|
||||
$order = $orders->first();
|
||||
$scheduled = now()->startOfDay()->setTime(8, 0);
|
||||
|
||||
$this->actingAs($this->owner)
|
||||
->post(route('care.mar.administer', $order), [
|
||||
'status' => 'given',
|
||||
'scheduled_for' => $scheduled->toDateTimeString(),
|
||||
])
|
||||
->assertRedirect();
|
||||
|
||||
$this->assertDatabaseHas('care_mar_administrations', [
|
||||
'mar_order_id' => $order->id,
|
||||
'status' => MarAdministration::STATUS_GIVEN,
|
||||
]);
|
||||
|
||||
$this->actingAs($this->owner)
|
||||
->get(route('care.care-units.mar', $this->unit))
|
||||
->assertOk()
|
||||
->assertSee('Paracetamol')
|
||||
->assertSee('Kofi');
|
||||
}
|
||||
|
||||
public function test_hold_requires_reason(): void
|
||||
{
|
||||
$order = app(MarService::class)
|
||||
->syncOrdersForVisit($this->visit->fresh(), $this->owner->public_id)
|
||||
->first();
|
||||
|
||||
$this->actingAs($this->owner)
|
||||
->from(route('care.visits.mar', $this->visit))
|
||||
->post(route('care.mar.administer', $order), [
|
||||
'status' => 'held',
|
||||
'scheduled_for' => now()->startOfDay()->setTime(8, 0)->toDateTimeString(),
|
||||
])
|
||||
->assertRedirect()
|
||||
->assertSessionHasErrors('reason');
|
||||
}
|
||||
|
||||
public function test_nursing_note_and_handover(): void
|
||||
{
|
||||
$this->actingAs($this->owner)
|
||||
->post(route('care.care-units.notes.store', $this->unit), [
|
||||
'visit_id' => $this->visit->id,
|
||||
'note_type' => 'progress',
|
||||
'shift_code' => 'day',
|
||||
'body' => 'Vitals stable; pain controlled.',
|
||||
])
|
||||
->assertRedirect(route('care.care-units.notes', $this->unit));
|
||||
|
||||
$this->assertDatabaseHas('care_nursing_notes', [
|
||||
'visit_id' => $this->visit->id,
|
||||
'body' => 'Vitals stable; pain controlled.',
|
||||
]);
|
||||
|
||||
$this->actingAs($this->owner)
|
||||
->post(route('care.care-units.handovers.store', $this->unit), [
|
||||
'from_shift' => 'day',
|
||||
'to_shift' => 'night',
|
||||
'situation' => 'Quiet ward',
|
||||
'background' => '4 patients',
|
||||
'assessment' => 'Stable',
|
||||
'recommendation' => 'Continue observations',
|
||||
'complete' => '1',
|
||||
])
|
||||
->assertRedirect(route('care.care-units.handovers', $this->unit));
|
||||
|
||||
$this->assertDatabaseHas('care_ward_handovers', [
|
||||
'care_unit_id' => $this->unit->id,
|
||||
'status' => WardHandover::STATUS_COMPLETED,
|
||||
'from_shift' => 'day',
|
||||
'to_shift' => 'night',
|
||||
]);
|
||||
|
||||
$this->actingAs($this->owner)
|
||||
->get(route('care.care-units.notes', $this->unit))
|
||||
->assertOk()
|
||||
->assertSee('Vitals stable');
|
||||
|
||||
$this->actingAs($this->owner)
|
||||
->get(route('care.care-units.handovers', $this->unit))
|
||||
->assertOk()
|
||||
->assertSee('Completed');
|
||||
}
|
||||
|
||||
public function test_duplicate_scheduled_dose_rejected(): void
|
||||
{
|
||||
$order = app(MarService::class)
|
||||
->syncOrdersForVisit($this->visit->fresh(), $this->owner->public_id)
|
||||
->first();
|
||||
$scheduled = now()->startOfDay()->setTime(8, 0)->toDateTimeString();
|
||||
|
||||
$this->actingAs($this->owner)
|
||||
->post(route('care.mar.administer', $order), [
|
||||
'status' => 'given',
|
||||
'scheduled_for' => $scheduled,
|
||||
])
|
||||
->assertRedirect();
|
||||
|
||||
$this->actingAs($this->owner)
|
||||
->from(route('care.visits.mar', $this->visit))
|
||||
->post(route('care.mar.administer', $order), [
|
||||
'status' => 'given',
|
||||
'scheduled_for' => $scheduled,
|
||||
])
|
||||
->assertRedirect()
|
||||
->assertSessionHasErrors('scheduled_for');
|
||||
|
||||
$this->assertSame(1, MarAdministration::query()->where('mar_order_id', $order->id)->count());
|
||||
$this->assertSame(1, MarOrder::query()->where('visit_id', $this->visit->id)->count());
|
||||
}
|
||||
}
|
||||
Reference in New Issue
Block a user