@kenyaemr/esm-ward-app 8.5.4-pre.83 → 8.5.4-pre.9

package/README.md

@@ -22,6 +22,37 @@ Please see the [EMR API README](https://github.com/openmrs/openmrs-module-emrapi
 
 See the [config-schema](./src/config-schema.ts) for details on the configuration options available to the ward app.
 
+## Ward Patient Table Tab Extension Slots
+
+The default ward table view renders four fixed tabs (Awaiting Admission, Admitted, Discharge In, Discharged). Each tab panel is backed by an extension slot so implementers can replace the default table UI without forking the ward app.
+
+| Tab | Slot name | Default extension name |
+|-----|-----------|------------------------|
+| Awaiting Admission | `ward-patients-awaiting-admission-slot` | `ward-patients-awaiting-admission` |
+| Admitted | `ward-patients-admitted-slot` | `ward-patients-admitted` |
+| Discharge In | `ward-patients-discharge-in-slot` | `ward-patients-discharge-in` |
+| Discharged | `ward-patients-discharged-slot` | `ward-patients-discharged` |
+
+### Custom component requirements
+
+- Render under `DefaultWardView` so `useAppContext('ward-view-context')` provides ward patient data.
+- Reuse types from [`src/types/index.ts`](./src/types/index.ts): `WardViewContext`, `WardPatient`, etc.
+- Optional shared UI helpers: `HyperLinkPatientCell`, `EmptyState`, `ErrorState`, `getOpenmrsId`.
+
+### Replacing a default table
+
+In your module's `routes.json`, register the replacement extension:
+
+```json
+{
+  "name": "my-custom-awaiting-admission",
+  "component": "myAwaitingAdmissionTable",
+  "slot": "ward-patients-awaiting-admission-slot"
+}
+```
+
+The default table components are exported from this module (`wardPatientsAwaitingAdmissionTable`, `wardPatientsAdmittedTable`, `wardPatientsDischargeInTable`, `wardPatientsDischargedTable`) if you need to wrap or extend them.
+
 ## Bed Management
 
 The ward app is designed to support patient bed assignments and to be used in conjunction with the bedmanagement module and the bed-management-app ESM. However, bed management is entirely optional. Patients will appear on a ward if they:

package/package.json

@@ -1,6 +1,6 @@
 {
   "name": "@kenyaemr/esm-ward-app",
-  "version": "8.5.4-pre.83",
+  "version": "8.5.4-pre.9",
   "description": "Ward and bed management module for O3",
   "browser": "dist/kenyaemr-esm-ward-app.js",
   "main": "src/index.ts",

package/src/config-schema.ts

@@ -45,6 +45,7 @@ export const labourCareGuideConceptUuids = {
   UUID_URINE_ONE_PLUS: '1362AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA',
   UUID_URINE_TWO_PLUS: '1363AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA',
   UUID_URINE_THREE_PLUS: '1364AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA',
+  UUID_URINE_NOT_DONE: '1118AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA',
   UUID_URINE_TEST_TIME_SLOT: 'bb3724c9-fbcc-49c5-9702-6cde0be325ca',
   UUID_PARTOGRAPHY_ENCOUNTER: '022d62af-e2a5-4282-953b-52dd5cba3296',
   UUID_MEDICATION_OXYTOCIN_ADMINISTERED: '82580974-ff46-41c5-b218-4bea7f53bf7e',
@@ -83,6 +84,19 @@ export const labourCareGuideConceptUuids = {
   UUID_URGE_TO_PUSH: '9ad5b56d-597c-4a40-ade6-387802daa44a',
   UUID_EMERGENCY_OVERRIDE: '1670AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA',
   UUID_EMERGENCY_REASON: '163761AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA',
+  UUID_SHARED_DECISION_TERMINATE_ONGOING_PROGRESS: '737fa73a-509f-40d8-9e84-91dc71db7f4c',
+  UUID_LCG_TERMINATION_REASON_TYPE: '6098AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA',
+  UUID_LCG_TERMINATION_REASON_WRONG_PATIENT: '164144AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA',
+  UUID_LCG_TERMINATION_REASON_OTHER: '5622AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA',
+  UUID_LCG_CORRECTION_ENCOUNTER_TYPE: 'b2c4d5e6-7f8a-4e9b-8c1d-2e3f8e4a3b8f',
+  UUID_LCG_CORRECTION_TYPE: '4b3eb27b-43c0-4862-bd83-be06beb3d699',
+  UUID_LCG_CORRECTION_TYPE_WRONG_PATIENT_TRANSFER: '1286AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA',
+  UUID_LCG_CORRECTION_SOURCE_PATIENT_UUID: '162720AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA',
+  UUID_LCG_CORRECTION_SOURCE_TERMINATE_ENCOUNTER_UUID: '1671AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA',
+  UUID_LCG_CORRECTION_TERMINATION_REASON: '162704AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA',
+  UUID_LCG_CORRECTION_SOURCE_PATIENT_DISPLAY: '850a960b-e8b5-4775-ba74-aaddb2abbf51',
+  UUID_LCG_CORRECTION_TERMINATED_AT: '163286AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA',
+  UUID_LCG_CORRECTION_TRANSFER_NOTES: '1056dc03-ce4d-45cb-a1eb-87707162e6ee',
   FETAL_HEART_RATE_CONCEPT: '1440AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA',
   FETAL_HEART_RATE_TIME_CONCEPT: 'bb3724c9-fbcc-49c5-9702-6cde0be325ca',
   FETAL_HEART_RATE_HOUR_CONCEPT: '160632AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA',
@@ -98,7 +112,7 @@ export const labourCareGuideConceptUuids = {
   CONTRACTION_LEVEL_MODERATE_CONCEPT: '1499AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA',
   CONTRACTION_LEVEL_STRONG_CONCEPT: '166788AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA',
   UTERINE_CONTRACTION_FREQUENCY_CONCEPT: 'd266dee4-bbe8-4736-b94d-c33300f55bca',
-  UTERINE_CONTRACTION_DURATION_CONCEPT: 'd266dee4-bbe8-4736-b94d-c33300f55bca',
+  UTERINE_CONTRACTION_DURATION_CONCEPT: '159368AAAAAAAAAAAAAAAAAAAAAAAAAAAAAA',
   OXYTOCIN_TIME_CONCEPT: 'bb3724c9-fbcc-49c5-9702-6cde0be325ca',
   OXYTOCIN_DROPS_PER_MINUTE_CONCEPT: '1d109b10-7b30-4bfa-8a7c-6ecb73357fc2',
   OXYTOCIN_DOSE_CONCEPT: '81369AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA',
@@ -920,6 +934,11 @@ export const configSchema: ConfigSchema = {
     _description: 'Labour care guide partography module configuration',
     _default: labourCareGuidePartographyConfig,
   },
+  lcgSessionCorrectionPrivilege: {
+    _type: Type.String,
+    _description: 'OpenMRS privilege required to open the LCG wrong-patient correction wizard',
+    _default: 'Correct LCG Wrong Patient',
+  },
 } as const;
 
 export interface WardConfigObject {
@@ -1030,6 +1049,7 @@ export interface WardConfigObject {
   treatmentChartNameConceptUuid: string;
   treatmentChartTimeConceptUuid: string;
   partography: LabourCareGuidePartographyConfig;
+  lcgSessionCorrectionPrivilege: string;
 }
 export interface PendingItemsElementConfig {
   id: string;

package/src/in-patient/inpatient-tabs.component.tsx

@@ -6,6 +6,7 @@ import {
   ExtensionSlot,
   type FHIRResource,
   useAssignedExtensions,
+  useConfig,
   usePatient,
   useRenderableExtensions,
 } from '@openmrs/esm-framework';
@@ -14,14 +15,71 @@ import { useTranslation } from 'react-i18next';
 import { ComponentContext, translateFrom } from '@openmrs/esm-framework/src/internal';
 import styles from './inpatient.scss';
 import { moduleName } from '../constant';
+import useCurrentPatientAdmissionEncounter from '../hooks/useCurrentPatientAdmissionEncounter';
+import { useAdmissionLocationTags } from './in-patient.resource';
+import type { WardConfigObject } from '../config-schema';
 
 type InpatientTabsProps = {
   patientUuid: string;
 };
 const INPATIENT_TABS_EXTENSION_SLOT = 'inpatient-dashboard-tabs-slot';
+const LABOUR_CARE_GUIDE_EXTENSION_NAME = 'maternal-and-child-health-labour-care-guide';
+
+const getPatientGenderValue = (patient: any): string => {
+  const gender = patient?.gender;
+  if (typeof gender === 'string') {
+    return gender;
+  }
+
+  if (gender && typeof gender === 'object') {
+    return String(gender.display ?? gender.name ?? gender.value ?? '');
+  }
+
+  return '';
+};
+
+const isFemalePatient = (patient: any): boolean => {
+  const gender = getPatientGenderValue(patient).trim().toLowerCase();
+  return gender === 'f' || gender === 'female' || gender.startsWith('female ');
+};
+
+const getPatientAge = (patient: any): number => {
+  const ageFromPatient = Number(patient?.age);
+  if (Number.isFinite(ageFromPatient)) {
+    return ageFromPatient;
+  }
+
+  const birthDate = patient?.birthDate;
+  if (!birthDate) {
+    return NaN;
+  }
+
+  const birth = new Date(birthDate);
+  if (Number.isNaN(birth.getTime())) {
+    return NaN;
+  }
+
+  const now = new Date();
+  let age = now.getFullYear() - birth.getFullYear();
+  const hasNotHadBirthdayYet =
+    now.getMonth() < birth.getMonth() || (now.getMonth() === birth.getMonth() && now.getDate() < birth.getDate());
+  if (hasNotHadBirthdayYet) {
+    age -= 1;
+  }
+
+  return age;
+};
+
 const InpatientTabs: FC<InpatientTabsProps> = ({ patientUuid }) => {
   const { t } = useTranslation();
   const { patient, isLoading, error } = usePatient(patientUuid);
+  const { inpatientLocationTags } = useConfig<WardConfigObject>();
+  const {
+    admissionEncounter,
+    isLoading: isLoadingAdmission,
+    isPatientAdmitted,
+  } = useCurrentPatientAdmissionEncounter(patientUuid);
+  const { tags, isLoading: isLoadingTags } = useAdmissionLocationTags(admissionEncounter?.location?.uuid);
   const state = useMemo(() => ({ patientUuid, patient }), [patientUuid, patient]);
   const assignedExtensions = useAssignedExtensions(INPATIENT_TABS_EXTENSION_SLOT);
   const extensions = useRenderableExtensions(INPATIENT_TABS_EXTENSION_SLOT);
@@ -32,7 +90,30 @@ const InpatientTabs: FC<InpatientTabsProps> = ({ patientUuid }) => {
         (a.order ?? Infinity) - (b.order ?? Infinity),
     );
   }, [assignedExtensions]);
-  if (isLoading) {
+
+  const isAdmittedToAllowedWard = useMemo(() => {
+    const allowedWardTags = [
+      inpatientLocationTags?.labourWard,
+      inpatientLocationTags?.antenatalWard,
+      inpatientLocationTags?.maternityWard,
+    ].filter(Boolean);
+    return allowedWardTags.some((tagUuid) => tags.some((tag) => tag.uuid === tagUuid));
+  }, [inpatientLocationTags, tags]);
+
+  const canShowLabourCareGuideTab = useMemo(() => {
+    const age = getPatientAge(patient);
+    return isFemalePatient(patient) && Number.isFinite(age) && age > 9 && isPatientAdmitted && isAdmittedToAllowedWard;
+  }, [patient, isPatientAdmitted, isAdmittedToAllowedWard]);
+
+  const visibleExtensions = useMemo(
+    () =>
+      sortedExtensions.filter(
+        (extension) => extension.name !== LABOUR_CARE_GUIDE_EXTENSION_NAME || canShowLabourCareGuideTab,
+      ),
+    [sortedExtensions, canShowLabourCareGuideTab],
+  );
+
+  if (isLoading || isLoadingAdmission || isLoadingTags) {
     return <TabsSkeleton />;
   }
 
@@ -43,14 +124,14 @@ const InpatientTabs: FC<InpatientTabsProps> = ({ patientUuid }) => {
     <Layer>
       <Tabs>
         <TabList contained>
-          {sortedExtensions.map((ext) => (
+          {visibleExtensions.map((ext) => (
             <Tab key={ext.name}>{translateFrom(ext.moduleName, ext.meta.title, ext.meta.title)}</Tab>
           ))}
         </TabList>
         <TabPanels
           data-extension-slot-name={INPATIENT_TABS_EXTENSION_SLOT}
           data-extension-slot-module-name={moduleName}>
-          {sortedExtensions.map((ext) => (
+          {visibleExtensions.map((ext) => (
             <TabPanel key={ext.name}>
               <ComponentContext.Provider
                 key={ext.id}

package/src/in-patient/labourCareGuide/alert-rules.ts

@@ -29,13 +29,15 @@ export const isSupportiveAlertValue = (rowKey: SupportiveAlertKey, rawValue: str
     return false;
   }
 
+  const isNoValue = value === 'N' || value === 'NO' || value.includes('1066');
+
   switch (rowKey) {
     case 'posture':
-      return value === 'SP';
+      return value === 'SP' || value.includes('SUPINE');
     case 'companion':
     case 'painRelief':
     case 'oralFluid':
-      return value === 'N';
+      return isNoValue;
     default:
       return false;
   }
@@ -46,22 +48,22 @@ export const getSupportiveAlertGuidance = (t: TFunction, rowKey: SupportiveAlert
     case 'companion':
       return t(
         'supportiveCompanionAlertGuidance',
-        'Companion N: Placeholder guidance. No companion documented; add supportive-care action.',
+        "Companion N: Immediately facilitate the woman's chosen companion to be present and oriented in the room. If unavailable, assign a dedicated midwife, nurse, or doula for continuous one-on-one support.",
       );
     case 'painRelief':
       return t(
         'supportivePainReliefAlertGuidance',
-        'Pain relief N: Placeholder guidance. Pain-relief action not documented; add action plan.',
+        'Pain relief N: Assess pain using a standard scale, offer non-pharmacological options first (breathing, massage, warm compress, position changes), and give prescribed pharmacological analgesia if needed per protocol.',
       );
     case 'oralFluid':
       return t(
         'supportiveOralFluidAlertGuidance',
-        'Oral fluid N: Placeholder guidance. Fluid support not documented; add supportive-care action.',
+        'Oral fluid N: Encourage oral hydration and energy fluids (water, clear juice, isotonic drinks) unless there is a clear documented contraindication such as imminent general anesthesia.',
       );
     case 'posture':
       return t(
         'supportivePostureAlertGuidance',
-        "Posture, Supine, SP: Encourage the woman to walk around freely during first stage of labour. Support the woman's choice of position (left lateral, squatting, kneeling, standing supported by companion).",
+        'Posture SP: Encourage walking or upright mobility; if in bed, support lateral, upright, or semi-recumbent positions. Avoid prolonged supine position to reduce aortocaval compression risk.',
       );
     default:
       return '';
@@ -94,32 +96,32 @@ export const getSupportiveAlertTokenGuidance = (t: TFunction, token: string) =>
   if (normalized.includes('COMPANION')) {
     return t(
       'supportiveCompanionTokenHoverGuidance',
-      'Companion N: Placeholder guidance. No companion documented; add supportive-care action.',
+      "Companion N: Immediately facilitate the woman's chosen companion to be present and oriented in the room. If unavailable, assign a dedicated midwife, nurse, or doula for continuous one-on-one support.",
     );
   }
 
   if (normalized.includes('PAIN RELIEF')) {
     return t(
       'supportivePainReliefTokenHoverGuidance',
-      'Pain relief N: Placeholder guidance. Pain-relief action not documented; add action plan.',
+      'Pain relief N: Assess pain using a standard scale, offer non-pharmacological options first (breathing, massage, warm compress, position changes), and give prescribed pharmacological analgesia if needed per protocol.',
     );
   }
 
   if (normalized.includes('ORAL FLUID')) {
     return t(
       'supportiveOralFluidTokenHoverGuidance',
-      'Oral fluid N: Placeholder guidance. Fluid support not documented; add supportive-care action.',
+      'Oral fluid N: Encourage oral hydration and energy fluids (water, clear juice, isotonic drinks) unless there is a clear documented contraindication such as imminent general anesthesia.',
     );
   }
 
   if (normalized.startsWith('SP')) {
     return t(
       'supportivePostureTokenHoverGuidance',
-      "Posture, Supine, SP: Encourage the woman to walk around freely during first stage of labour. Support the woman's choice of position (left lateral, squatting, kneeling, standing supported by companion).",
+      'Posture SP: Encourage walking or upright mobility; if in bed, support lateral, upright, or semi-recumbent positions. Avoid prolonged supine position to reduce aortocaval compression risk.',
     );
   }
 
-  return t('supportiveTokenHoverPlaceholder', 'Placeholder: supportive-care guidance to be added.');
+  return t('supportiveTokenHoverPlaceholder', 'Supportive-care alert: correct the identified care gap immediately.');
 };
 
 export const getBabyAlertTokenGuidance = (t: TFunction, _token: string) => {
@@ -131,40 +133,49 @@ export const getBabyAlertTokenGuidance = (t: TFunction, _token: string) => {
   if (normalized.includes('BASELINE FHR')) {
     return t(
       'babyBaselineFhrTokenHoverGuidance',
-      `Baseline FHR ${code}: Placeholder guidance. Value is <110 or >=160; review and act.`,
+      `Baseline FHR ${code}: Reposition mother to left lateral, give IV fluids if hypotensive, and reduce/stop oxytocin if hyperstimulation is present. Reassess FHR promptly; if persistent, start continuous fetal monitoring and prepare for expedited delivery if distress is confirmed.`,
     );
   }
 
   if (normalized.includes('FHR DECELERATION')) {
-    return t('babyFhrDecelerationTokenHoverGuidance', 'FHR deceleration L: Placeholder guidance. Review and act.');
+    return t(
+      'babyFhrDecelerationTokenHoverGuidance',
+      'FHR deceleration: optimize maternal position and perfusion, reassess immediately, and escalate to continuous monitoring. Prepare expedited delivery if abnormal tracing persists.',
+    );
   }
 
   if (normalized.includes('AMNIOTIC FLUID')) {
     return t(
       'babyAmnioticFluidTokenHoverGuidance',
-      `Amniotic fluid ${code}: Placeholder guidance. Alert values are M+++ or B; review and act.`,
+      `Amniotic fluid ${code}: For thick meconium, increase FHR surveillance or initiate continuous CTG. For foul-smelling liquor, start broad-spectrum IV antibiotics for suspected chorioamnionitis, monitor maternal temperature closely, and prepare neonatal resuscitation support.`,
     );
   }
 
   if (normalized.includes('FETAL POSITION')) {
     return t(
       'babyFetalPositionTokenHoverGuidance',
-      `Fetal position ${code}: Placeholder guidance. Alert values are P or T; review and act.`,
+      `Fetal position ${code}: reassess position and descent trend, support corrective maternal positioning, and escalate obstetric review if persistent malposition is associated with poor progress.`,
     );
   }
 
   if (normalized.includes('CAPUT')) {
-    return t('babyCaputTokenHoverGuidance', 'Caput +++: Placeholder guidance. Marked caput detected; review and act.');
+    return t(
+      'babyCaputTokenHoverGuidance',
+      'Caput +++: reassess for possible cephalopelvic disproportion or malposition, correlate with cervical progress/descent, and prepare operative delivery if labour is not progressing safely.',
+    );
   }
 
   if (normalized.includes('MOULDING')) {
     return t(
       'babyMouldingTokenHoverGuidance',
-      'Moulding +++: Placeholder guidance. Significant moulding detected; review and act.',
+      'Moulding +++: reassess for possible cephalopelvic disproportion or malposition, correlate with cervical progress/descent, and prepare operative delivery if labour is not progressing safely.',
     );
   }
 
-  return t('babyTokenHoverPlaceholder', 'Placeholder: baby-alert guidance to be added.');
+  return t(
+    'babyTokenHoverPlaceholder',
+    'Baby alert: optimize fetal condition and escalate monitoring/intervention promptly.',
+  );
 };
 
 export const isBabyAlertValue = (rowKey: BabyAlertKey, rawValue: string) => {
@@ -181,9 +192,16 @@ export const isBabyAlertValue = (rowKey: BabyAlertKey, rawValue: string) => {
       return Number.isFinite(numericValue) && (numericValue < 110 || numericValue >= 160);
     }
     case 'fhrDeceleration':
-      return value === 'L';
+      return value === 'L' || value.includes('LATE');
     case 'amnioticFluid':
-      return value === 'M+++' || value === 'B';
+      return (
+        value === 'B' ||
+        value === 'M' ||
+        value === 'M+' ||
+        value === 'M++' ||
+        value === 'M+++' ||
+        value.startsWith('M+')
+      );
     case 'fetalPosition':
       return value === 'P' || value === 'T';
     case 'caput':
@@ -199,29 +217,32 @@ export const getBabyAlertGuidance = (t: TFunction, rowKey: BabyAlertKey) => {
     case 'baselineFhr':
       return t(
         'babyBaselineFhrAlertGuidance',
-        'Baseline FHR: Placeholder guidance. Value is <110 or >=160; review and act.',
+        'Baseline FHR alert: reposition left lateral, optimize perfusion, stop/reduce oxytocin if needed, reassess quickly, and escalate to continuous monitoring with expedited delivery preparation when persistent.',
       );
     case 'fhrDeceleration':
       return t(
         'babyFhrDecelerationAlertGuidance',
-        'FHR deceleration L: Placeholder guidance. Deceleration documented; review and act.',
+        'FHR deceleration alert: optimize maternal condition and monitor continuously; prepare for expedited delivery if recurrent or persistent.',
       );
     case 'amnioticFluid':
       return t(
         'babyAmnioticFluidAlertGuidance',
-        'Amniotic fluid M+++ or B: Placeholder guidance. Abnormal fluid status; review and act.',
+        'Amniotic fluid alert: increase fetal surveillance for meconium and start broad-spectrum IV antibiotics for suspected infection when foul odor is present.',
       );
     case 'fetalPosition':
       return t(
         'babyFetalPositionAlertGuidance',
-        'Fetal position P or T: Placeholder guidance. Position alert documented; review and act.',
+        'Fetal position alert: reassess fetal position and descent, use corrective maternal positioning, and escalate review if persistent with poor progress.',
       );
     case 'caput':
-      return t('babyCaputAlertGuidance', 'Caput +++: Placeholder guidance. Marked caput detected; review and act.');
+      return t(
+        'babyCaputAlertGuidance',
+        'Caput +++ alert: evaluate for cephalopelvic disproportion or malposition and prepare operative delivery if progress is halted.',
+      );
     case 'moulding':
       return t(
         'babyMouldingAlertGuidance',
-        'Moulding +++: Placeholder guidance. Significant moulding detected; review and act.',
+        'Moulding +++ alert: evaluate for cephalopelvic disproportion or malposition and prepare operative delivery if progress is halted.',
       );
     default:
       return '';
@@ -286,26 +307,29 @@ export const isWomanAlertValue = (rowKey: WomanAlertKey, rawValue: string) => {
 export const getWomanAlertGuidance = (t: TFunction, rowKey: WomanAlertKey) => {
   switch (rowKey) {
     case 'pulse':
-      return t('womanPulseAlertGuidance', 'Pulse alert: Placeholder guidance. Value is <60 or >=120; review and act.');
+      return t(
+        'womanPulseAlertGuidance',
+        'Pulse alert: assess for dehydration, pain, anxiety, fever, or bleeding; optimize hydration and pain control, then recheck promptly and manage hemorrhage urgently when suspected.',
+      );
     case 'systolicBp':
       return t(
         'womanSystolicAlertGuidance',
-        'Systolic BP alert: Placeholder guidance. Value is <80 or >=140; review and act.',
+        'Systolic BP alert: for elevated BP, evaluate pre-eclampsia signs and urine protein; treat severe hypertension per protocol including antihypertensives and magnesium sulfate when indicated. For low BP, left lateral tilt, rapid IV fluids, and assess for bleeding.',
       );
     case 'diastolicBp':
       return t(
         'womanDiastolicAlertGuidance',
-        'Diastolic BP alert: Placeholder guidance. Value is >=90; review and act.',
+        'Diastolic BP alert: evaluate and manage hypertensive disease urgently, including proteinuria screening and severe-feature assessment; escalate treatment per protocol.',
       );
     case 'temperature':
       return t(
         'womanTemperatureAlertGuidance',
-        'Temperature alert: Placeholder guidance. Value is <35 or >=37.5; review and act.',
+        'Temperature alert: confirm hydration, institute cooling and infection assessment, check liquor odor and maternal pulse, start empirical IV antibiotics when intrapartum infection is suspected, and increase FHR monitoring frequency.',
       );
     case 'urine':
       return t(
         'womanUrineAlertGuidance',
-        'Urine alert: Placeholder guidance. Alert values are P++ or A++; review and act.',
+        'Urine alert: correlate proteinuria with BP for pre-eclampsia assessment; treat ketonuria with oral intake support or IV dextrose where indicated.',
       );
     default:
       return '';
@@ -329,7 +353,7 @@ export const getLabourContractionAlertInfo = (
       guidance: isAlert
         ? t(
             'contractionsPer10AlertGuidance',
-            'Contractions per 10 min alert: Placeholder guidance. Value is <=2 or >5; review and act.',
+            'Contractions per 10 min alert: if >5 (hyperstimulation), stop/reduce oxytocin, left-lateral position, and consider tocolysis when fetal distress is present. If <2 (inadequate), consider amniotomy or oxytocin augmentation after confirming fetal well-being.',
           )
         : '',
     };
@@ -341,7 +365,7 @@ export const getLabourContractionAlertInfo = (
     guidance: isAlert
       ? t(
           'contractionDurationAlertGuidance',
-          'Duration of contractions alert: Placeholder guidance. Value is <20 or >60; review and act.',
+          'Contraction duration alert: reassess labour powers and fetal condition; if contractions are inadequate support augmentation, if excessive with distress reduce stimulation and stabilize mother/fetus.',
         )
       : '',
   };
@@ -367,23 +391,29 @@ export const getWomanAlertTokenGuidance = (t: TFunction, token: string): string
     .trim()
     .toUpperCase();
   if (normalized.includes('PULSE'))
-    return t('womanPulseTokenGuidance', 'Pulse <60 or ≥120 bpm: Abnormal pulse rate detected; review and act.');
+    return t(
+      'womanPulseTokenGuidance',
+      'Pulse alert: assess cause (dehydration, pain, anxiety, fever, hemorrhage), optimize hydration and pain control, and recheck promptly.',
+    );
   if (normalized.includes('SYSTOLIC'))
     return t(
       'womanSystolicTokenGuidance',
-      'Systolic BP <80 or ≥140 mmHg: Abnormal systolic blood pressure; review and act.',
+      'Systolic BP alert: for high values evaluate pre-eclampsia and severe features; for low values position left lateral, give IV fluids, and assess for bleeding.',
     );
   if (normalized.includes('DIASTOLIC'))
-    return t('womanDiastolicTokenGuidance', 'Diastolic BP ≥90 mmHg: Elevated diastolic pressure; review and act.');
+    return t(
+      'womanDiastolicTokenGuidance',
+      'Diastolic BP alert: evaluate hypertensive disease urgently with proteinuria and danger-sign review; escalate treatment per protocol.',
+    );
   if (normalized.includes('TEMPERATURE'))
     return t(
       'womanTemperatureTokenGuidance',
-      'Temperature <35.0°C or ≥37.5°C: Abnormal maternal temperature; review and act.',
+      'Temperature alert: evaluate for intrapartum infection, hydrate/cool, start empirical IV antibiotics when indicated, and increase fetal monitoring.',
     );
   if (normalized.includes('URINE'))
     return t(
       'womanUrineTokenGuidance',
-      'Urine P++ or A++: Significant proteinuria or ketonuria detected; review and act.',
+      'Urine protein/ketone alert: correlate proteinuria with BP for pre-eclampsia, and manage ketonuria with nutrition support or IV dextrose as indicated.',
     );
   return t('womanAlertTokenGuidancePlaceholder', 'Woman vital-sign alert: review and act.');
 };
@@ -420,12 +450,12 @@ export const getContractionAlertTokenGuidance = (t: TFunction, token: string): s
   if (normalized.includes('CONTRACTIONS/10MIN'))
     return t(
       'contractionCountTokenGuidance',
-      'Contractions ≤2 or >5 per 10 min: Abnormal contraction frequency; review and act.',
+      'Contractions <=2 or >5 per 10 min: for hyperstimulation stop/reduce oxytocin and stabilize; for inadequate contractions consider amniotomy/oxytocin after fetal safety check.',
     );
   if (normalized.includes('CONTRACTION DURATION'))
     return t(
       'contractionDurationTokenGuidance',
-      'Contraction duration <20s or >60s: Abnormal contraction duration; review and act.',
+      'Contraction duration <20s or >60s: reassess powers, passenger, and passage; optimize uterine activity while maintaining fetal safety.',
     );
   return t('contractionAlertTokenGuidancePlaceholder', 'Contraction alert: review and act.');
 };
@@ -439,7 +469,91 @@ export const getCervixStallTokenGuidance = (t: TFunction, token: string): string
   if (normalized.includes('CM') && normalized.includes('NO PROGRESS'))
     return t(
       'cervixStallTokenGuidance',
-      'Cervical dilation stall: No progress at this dilation level for the expected duration; review and consider action.',
+      'Cervical dilation stall: perform a full three-P assessment (powers, passenger, passage). If contractions are inadequate consider amniotomy/oxytocin; if adequate but no progress, evaluate for CPD and prepare for operative delivery.',
     );
   return t('cervixStallTokenGuidancePlaceholder', 'Labour progress alert: review and act.');
 };
+
+// ─── Shared Decision Making assessment prefill ───────────────────────────────
+
+export type SharedDecisionAlertItem = {
+  id?: string;
+  section: string;
+  code: string;
+  guidance: string;
+  timestampCreatedMs?: number;
+};
+
+export type SharedDecisionAssessmentLine = {
+  label: string;
+  comment: string;
+};
+
+export const formatAlertItemAsAssessmentLabel = (item: SharedDecisionAlertItem): string => {
+  const code = String(item.code ?? '').trim();
+  if (!code) {
+    return '';
+  }
+
+  const parenMatch = code.match(/^(.+?)\s+\((.+)\)$/);
+  if (parenMatch) {
+    return `${parenMatch[2].trim()} ${parenMatch[1].trim()}`;
+  }
+
+  const guidancePrefix = item.guidance.match(/^([^:\n]+):/);
+  if (guidancePrefix?.[1]) {
+    return guidancePrefix[1].trim();
+  }
+
+  return code;
+};
+
+export const buildAssessmentPrefillFromAlerts = (items: SharedDecisionAlertItem[]): string => {
+  const seen = new Set<string>();
+  const lines: string[] = [];
+
+  for (const item of items) {
+    if (!item?.code) {
+      continue;
+    }
+
+    const label = formatAlertItemAsAssessmentLabel(item);
+    const dedupeKey = label.toLowerCase();
+    if (!label || seen.has(dedupeKey)) {
+      continue;
+    }
+
+    seen.add(dedupeKey);
+    lines.push(`${label}: `);
+  }
+
+  return lines.join('\n');
+};
+
+export const parseAssessmentValue = (value: string): SharedDecisionAssessmentLine[] => {
+  if (!value.trim()) {
+    return [];
+  }
+
+  return value
+    .split('\n')
+    .map((line) => {
+      const colonIndex = line.indexOf(':');
+      if (colonIndex === -1) {
+        return { label: line.trim(), comment: '' };
+      }
+
+      return {
+        label: line.slice(0, colonIndex).trim(),
+        comment: line.slice(colonIndex + 1).replace(/^\s/, ''),
+      };
+    })
+    .filter((line) => line.label);
+};
+
+export const serializeAssessmentLines = (lines: SharedDecisionAssessmentLine[]): string => {
+  return lines
+    .map(({ label, comment }) => (label ? `${label}: ${comment}` : ''))
+    .filter(Boolean)
+    .join('\n');
+};