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Installation Site Survey

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1. 4 SLS Formulary Will you be importing your own database Yes No If yes provide requirements for a csv file The final csv file must be provided seven 7 business days in advance of installation for review by Codonics Instructions for creating a csv file are located on pages 10 through 12 Will you be using the Lexicomp database included with SLS __Yes __No If yes please identify which routes Provide Excel template as a worksheet for preparation The final worksheet file must be provided seven 7 business days in advance of installation for review by Codonics For a sample of the template please reference Page 13 Codonics Confidential Page 9 of 13 ts form 006 03 5 2 2012 Note This form is for software v 1 3 0 Instructions for Preparing a CSV for Import into the SLS Administration Tool The following is intended to supplement the instruction in the Safe Label System Administration Tool User s Manual Questions should be addressed to Codonics Technical Support at 1 800 444 1198 The following instructions assume that the CSV file being prepared is for use in the U S A or a country using the U S NDC code system Please confirm that the Administration Tool application is configured for NDC Mode within the Configure Locale settings For instructions please refer to section 7 of the Safe Label System Administration Tool User s Manual Creating a CSV File Vv The key fields that need to be
2. E mail Notifier Will you be using the E Mail Notifier Yes No Physical location of the E Mail Notifier PC Administrator of E Mail Notifier E Mail Notifier Server Name or IP Address E Mail Notifier Server Port E Mail Notifier SMTP Username and Password required Yes____ No____ E Mail Notifier SMTP Username E Mail Notifier SMTP Password E Mail address to be used as from on e mails sent from the E mail Notifier Will you be using SSL Secure Sockets Layer Yes No Are you adding any SLS units to an existing MDL E Mail Notifier Yes No If yes remember to update the MDL and restart the E Mail Notifier to accept any changes Customer Notice The default settings shown in this document section 2 and 3 and provided by the Administration Tool and Safe Label System are provided for your convenience The settings are not industry standards or Codonics recommended settings but are commonly used in practice You can change any or all of them through the Administration Tool and apply the changes to the SLS Your signature below indicates that you are the responsible party for this installation and have read and acknowledge the Customer Notice above and the Warnings and notes on the remaining pages of this Site Survey Please sign and fax back to Codonics at 440 243 1334 Signature Date Print Name _ Inability to complete installation in quoted timeframe due to the lack of availability of required customer authoritie
3. Default Password password Safety Tab Settings Factory Default Adjusted Value Setting Description Enable Test Prints Yes Test Prints on First Login Yes Test Print Every 24 Hours Verify on SLS Yes Confirm Before Print Yes Confirm After Print Yes Speak Drug Names Yes Speak Concentration Yes Security Tab Settings Setting Description Factory Default Adjusted Value Maximum Invalid Login Attempts Require PIN Yes Logout Timeout 900 Seconds Final Timeout Countdown 30 Seconds System Tab Settings Setting Description Factory Default Adjusted Value Button Title Syringe Drug Not Found Mode Switch Blank Barcode Definition CID EXD EXT Codonics Confidential Page 5 of 13 ts form 006 03 5 2 2012 Note This form is for software v 1 3 0 3 SLS Configuration Custom Labels Setting Description Custom Button 1 Factory Default Yellow Solid Expiration 0 Quantity 1 Adjusted Value Custom Button 2 Orange Solid Expiration 24 Quantity 1 Custom Button 3 Orange Striped Expiration 24 Quantity 1 Custom Button 4 Blue Solid Expiration 24 Quantity 1 Custom Button 5 Blue Striped Expiration 24 Quantity 1 Custom Button 6 Red Solid Expiration 24 Quantity 1 Custom Button 7 Red Striped Expiration 24 Quantity 1 Custom Button 8 Violet Solid Expiration 24 Quantity
4. No If yes do you support Ethernet RJ 45 Enterprise Wifi requires a certificate or Non Enterprise Wifi Ethernet Enterprise Wifi Non Enterprise Wifi Both Codonics Confidential Page 1 of 13 ts form 006 03 5 2 2012 Note This form is for software v 1 3 0 Note If Ethernet support is required please note the SLS only supports Full Duplex 100Base T at this time Will the network be configured as Static or DHCP Static DHCP Enterprise Wifi and Non Enterprise Wifi The SLS with Codonics optional USB 2 Wifi adapter operates on the 802 11b g standards at 2 4 GHz and supports None WEP WPA PSK WPA2 PSK WPA WPA2 PSK WPA Enterprise WPA2 Enterprise WPA WPA2 Enterprise security protocols Do you support 802 11b or 802 11g Yes No Which security protocol do you support None WEP WPA PSK WPA2 PSK WPA WPA2 PSK WPA Enterprise WPA2 Enterprise WPA WPA2 Enterprise If using an Enterprise Wifi what type of certificate do you use EAP TLS PEAP SSID public name of the Wifi network the SLS will use Is the network name broadcasted Yes No Static Network Addresses IP Address IP Address spots below are for additional units IP Address IP Address IP Address IP Address IP Address IP Address IP Address IP Address IP Address continue on back if needed Subnet Gateway Primary DNS optional Secondary DNS optional Codonics Confidential Page 2 of 13 ts form 006 03 5 2 2012 Note This form is for software v 1 3 0
5. included in the CSV in order from left to right in a row are Master ID 11 digit NDC Container ID 10 digit NDC Drug Name 1 Drug Name 2 Tallman Lettering Concentration 1 Concentration 2 Route and Status Notes o Do NOT put the names field names such as Master ID Container ID Drug Name Tallman Lettering and Concentration in a field at the top of the CSV o Be sure that the NDC code being used is the NDC of a single vial or ampoule There is a different NDC code assigned for a multi pack 6 packs 12 packs 24 packs etc The individual containers will have a different bar code on it than the multi pack v All fields must be included in the CSV file o The NDC can be either 10 or 11 digits in length depending upon the source If you are using the NDC from a vial or ampoule it is 10 digits in length Be sure to put the NDC in the proper field i e 11 s in the first column 10 s in the second column o The Master ID field must be null empty or exactly 11 digits no more and no less and can only contain numbers no hyphens etc o The Container ID field must be null empty or exactly 10 digits no more and no less and can only contain numbers no hyphens etc Note For each drug record either Master ID or Container ID or both must be populated The system will not accept both of these fields being empty for any single drug record o If using a text editor e g Notepad to create CSV files and the Master ID
6. 0 2 mg mL 6332326201 Heparin 5000 units mL Codonics Confidential Page 12 of 13 ts form 006 03 5 2 2012 Note This form is for software v 1 3 0 Codonics Confidential Page 13 of 13 ts form 006 03 5 2 2012 Note This form is for software v 1 3 0
7. 1 Custom Button 9 Custom Button 10 Violet Striped Expiration 24 Quantity 1 Green Solid Expiration 24 Quantity 1 Custom Button 11 Salmon Solid Expiration 24 Quantity 1 Custom Button 12 Gray Solid Expiration 24 Quantity 1 Custom Button 13 White Solid Expiration 0 Quantity 1 Custom Button 14 Blue and Salmon Striped Expiration 24 Quantity 1 Custom Button 15 Yellow Solid Expiration 6 Quantity 1 Name Propofol Codonics Confidential Note This form is for software v 1 3 0 ts form 006 03 5 2 2012 3 SLS Configuration continued Custom Labels Setting Description Mode Button Name Factory Default Lines Adjusted Value Custom Button 16 ARTERIAL Red Solid Expiration 0 Quantity Custom Button 17 CVP Blue Solid Expiration 0 Quantity 1 Custom Button 18 PA Yellow Solid Expiration 0 Quantity Custom Button 19 ICP White Solid Expiration 0 Quantity 1 Custom Button 20 EPIDURAL Yellow Striped Expiration 0 Quantity 1 Mode Button Name Custom Button 21 IV Pink Solid Expiration 48 Quantity 2 Custom Button 22 Orange Solid Expiration 48 Quantity 2 Custom Button 23 Green Solid Expiration 48 Quantity 2 Custom Button 24 Yellow Solid Expiration 48 Quantity 2 Custom Button 25 Custom Button 26 Blue Solid Expiration 48 Quantity 2 S
8. Safe Label System Administration Tool Installation Site Surve Please note This information must be completed and returned to Codonics at least seven 7 business days prior to product installation A user with Administrative Privileges a Pharmacist IT and Bio Med ARE REQUIRED to be present at the installation Main Site Information Name Address City State Site Phone Number Site Contact Person Pharmacy Phone Email Address Site Contact Person O R Phone Email Address Site Contact Person Bio Med Phone Email Address Site Contact Person IT IS Site Vendor Registration check one or fill in yours Reptrax Vendormate Other of system s being installed SLS Administration Tool AT SLS 500i of units Do you currently have any SLS systems installed Yes No If yes what version software do you have installed on these units Do you want to use the same formulary and configuration on the new system s as you have on the existing ones If yes complete only the cover page of this form Yes No Network Functionality The SLS supports only one network connection at a time either Ethernet or Wi Fi Do not connect both an Ethernet cable and the Wi Fi adapter at the same time The network uses SSH Secure Shell SCP Secure Copy and SSL Secure Sockets Layer protocols to access SLS from Codonics authorized applications Do you require network functionality Yes
9. almon Solid Expiration 48 Quantity 2 Custom Button 27 Red Solid Expiration 48 Quantity 2 Codonics Confidential Page 7 of 13 Note This form is for software v 1 3 0 ts form 006 03 5 2 2012 3 SLS Configuration continued Custom Labels Setting Description Factory Default Adjusted Value Mode Button Name Patient Custom Button 27 Yellow Solid Patient Label Expiration 0 Quantity 1 Custom Button 28 Blue Solid Patient Label Expiration 0 Quantity 1 Custom Button 30 White Solid Patient Label Expiration 0 Quantity 1 Custom Button 31 Yellow Solid Patient ID Label Expiration 0 Quantity 1 Custom Button 32 Blue Solid Patient ID Label Expiration 0 Quantity 1 Custom Button 33 White Solid Patient ID Label Expiration 0 Quantity 1 Additional Labels Description Color Expiration Quantity Description Color Expiration Quantity Description Color Expiration Quantity Description Color Expiration Quantity Codonics Confidential Page 8 of 13 ts form 006 03 5 2 2012 Note This form is for software v 1 3 0 3 SLS Configuration continued Custom Labels Setting Description Factory Default Adjusted Value Description Color Expiration Quantity Description Color Expiration Quantity Description Color Expiration Quantity Description Color Expiration Quantity Description Color Expiration Quantity
10. d be followed by one of the listed concentration units ex mg mL O Listed concentrations include g g L g mL mg mg L mg mL mcg mcg L mcg mL Units Units L Units mL K Units M Units and If you have a combination drug like Bupivacaine Epinephrine and Lidocaine Epinephrine you should assign the drug names and concentrations individually in separate fields Drug Name 1 Drug Name 2 Concentration 1 and Concentration 2 Concentrations should be reduced to the lowest common denominator such that the denominator is actually one Ex 4 mg 2 mL should be entered as 2 mg mL Y Other things to know O In Excel no fields may contain a comma The comma is an end of field marker and tells the system that any data following it belongs in a new data field When importing a CSV file into the Administration Tool it is necessary to select a key field either the Master ID or Container ID If you have a mix of drug records in your file some with only a Master ID and some with only a Container ID it will be necessary to separate your file into two files based upon the key field they contain Drug records with both a Master ID and Container ID may be put into either file but should not be duplicated in both The sound WAV files included with the Safe Label System include generic drug names not brand names It is recommended that generic names be used Additional sound files can be added to the system so this is a reco
11. is not available place a comma before the Container ID If the Container ID is not available then place two commas after the Master ID Note When using a text editor a comma must be used to separate each of the values fields whether there is a value or not o If using Microsoft Excel to create CSV files be aware that drugs containing standard 10 or 11 digit NDCs must have all of the digits present within the CSV file for the file to be imported This includes any leading zeros at the beginning of the drug s NDCs This may require Custom formatting of the cells containing the Master ID and Container ID See instructions below for properly formatting a CSV in Excel yY The Drug Name and Tallman Lettering fields may container upper and lower case letters numbers and special characters Neither field should start or end with a space character Codonics Confidential Page 10 of 13 ts form 006 03 5 2 2012 Note This form is for software v 1 3 0 O A space as the first character in the Tallman Lettering field may result in the drug name not being displayed on the label when viewed in the Drug Edit screen If this occurs edit the drug in the Master Drug Database and remove the space A space as the last character in the Drug Name field may result in the system not automatically selecting the appropriate audio file If this occurs select the audio file manually via the drop down menu yY The Concentration fields must begin with a number an
12. mmendation not a requirement Route may be any text string This field is used for searching and sorting in the MDD It may also be left blank Status has two valid values ACTIVE and OBSOLETE If left blank the system will assign the status as ACTIVE Codonics Confidential Page 11 of 13 ts form 006 03 5 2 2012 Note This form is for software v 1 3 0 Properly Formatting a CSV in Excel 1 In Excel to properly format the Master ID and Container ID column select the column header right click and select Format Cells from the pop up menu 2 In the result dialog box select the Custom format category on the left side In the Type box on the right side enter the number of zeros to represent the length of the ID for the current column i e 11 zeros for the Master ID and 10 zeros for the Container ID 3 Click OK 4 Save the file as a CSV file on a location on the PC The CSV file created from this Excel spreadsheet should now present and output data in the format expected Note If you close the file and reopen the file the file is no longer properly formatted as a CSV and the file needs to be reformatted again Removing Hyphens From a CSV File in Excel v If the data in the CSV file was downloaded from another system the NDC numbers may have hyphens in them The following instructions can be used to remove all hyphens from 10 and 11 digit NDCs Select the column you want to remove hyphens f
13. rom a b Edit menu Replace or Ctrl H G In Find What type without the quotes d In Replace With leave blank e Click Replace All v The above process will delete any leading zeros Reformat the column as the Master ID or Container ID using the instructions above Properly Formatting a CSV in Excel Viewing a CSV File in a Text Editor Y Before importing your CSV into the Administration Tool it is recommended that you open the CSV with a text editor ex Notepad Notepad or Microsoft Word and review it to be sure that you have followed all of the recommendations included within this document v A properly formatted CSV with only Container IDs will look like the following I Codonics_Drug_Vials csy Notepad BAE File Edit Format View Help 0517040125 Atropine 0 4 mg mL 1001925039 Atropine 0 4 mg mL 0781945170 Cefazolin ceFAZolin 1 g 6050507495 Cefazolin ceFAZolin 1 g 0074437805 Cisatracurium 2 mg mL 0409405001 Clindamycin 150 mg mL 0517490125 Dexamethasone 4 mg mL 70517490525 Dexamethasone 4 mg mL 6332316505 Dexamethasone 4 mg mL 0641037621 Diphenhydramine 50 mg mL 5539034010 Esmolol 10 mg mL 0409909425 Fentanyl fentaNYL 50 meg mL 0409909431 Fentanyl fentaNYL 50 meg mL 1001903339 Fentanyl fentaNYL 50 meg mL 1001903839 Fentanyl fentaNYL 50 meg mL 1001903705 Fentanyl fentaNYL 50 meg mL 0517460125 Glycopyrrolate 0 2 mg mL 0517460525 Glycopyrrolate
14. s may result in additional installation fees Codonics Confidential Page 3 of 13 ts form 006 03 5 2 2012 Note This form is for software v 1 3 0 l Computer requirements for AT User must have Administrator Privileges Hardware Intel Core 2 Duo Processor 2 GB RAM CD ROM driver Available USB port Printer Optional O S Windows XP or newer Software Java 6 23 or newer 32 bit only Internet Explorer 8 or newer Bar Code 2D Scanner Optional Scanner Must be configured in Wedge mode Must be configured to report AIM code Must be configured for GS1 DataBar Limited RSS Limited GS1 DataBar Stacked RSS 14 Stacked UPC A symbologies This section for Codonics Use Only Date confirmed Date completed Installation Requirements at site System compliance confirmed SLS configuration received SLS Formulary files information received Media ordered Pharmacy and OR contacts received and confirmed Bio Med involvement determined and confirmed Site computer system meets requirements prior to install at install Codonics Confidential Page 4 of 13 ts form 006 03 5 2 2012 Note This form is for software v 1 3 0 2 Administration Tool Security Configuration WARNING Disabling any of these safety tab settings will remove an important safety check in the label creation process Safety Tab Settings Setting Description Factory Default Adjusted Value Default Login Administrator

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