Add ward MAR board plus nursing notes and SBAR handovers.
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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
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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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