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INTAKE AND OUTPUT USER MANUAL Version 4.0 April 1997

1. 1 LEFT SUBCLAVIAN TRIPLE LUMEN 1 DISTAL LOCK PORT Converted on 02 14 97 15 03 2 LEFT SUBCLAVIAN TRIPLE LUMEN 1 MEDIAL D5W 2 NS 500 A 30 ml hr Added on 02 14 97 14 53 3 LEFT SUBCLAVIAN TRIPLE LUMEN 1 PROXIMAL DEXTROSE 5 AMINOSYN 7 SODIUM CHLORIDE 2 5 MEQ ML 40 MEQ H 100 ml hr Added on 02 14 97 14 44 Start new IV Pleas nter a new DATE TIME n FEB 14 1997 15 05 23 Select from the following IV sites 1 HAN 7 JUGULAR 2 WRIST 8 ANKLE FOOT 3 LOWER ARM 9 LEG 4 UPPER ARM 10 FEMORAL 5 ANTECUBITTAL 11 UMBILICAL 6 SUBCLAVIAN 12 PEDAL Enter a number with a qualifier L for LEFT R for RIGHT default L eft e g 2R for RIGHT WRIST 2 or 2L for LEFT WRIST 2r RIGHT WRIST The ADP coordinator can add entries to the display list through the Configure I O Files option specifically the IV Site option Select from the following IV CATHs 1 ANGIO CATH 14 12 TRIPLE LUMEN CVP 2 ANGIO CATH 16 13 RA PA CATH 3 ANGIO CATH 18 14 VENOUS INTRODUCER 4 ANGIO CATH 20 15 HICKMAN LOCK 5 ANGIO CATH 22 16 DOUBLE LUMEN PERIPHERAL 6 BUTTERFLY 16 17 SUBCLAVIAN 7 BUTTERFLY 18 18 DOUBLE LUMEN SUBCLAVIAN 8 NEEDLE 1 1 4 IN 14 19 DOUBLE LUMEN 1 9 NEEDLE 1 1 4 IN 16 20 TRIPLE LUMEN 1 10 NEEDLE
2. 40 MEQ 1 LEFT ANTECUBITTAL ANGIO CATH 18 D5W 2 3NS 1000 A 50 ml hr Started on 02 14 97 15 15 2 LEFT SUBCLAVIAN TRIPLE LUMEN 1 PROXIMAL DEXTROSE AMINOSYN 7 SODIUM CHLORIDE 2 5 MEQ ML 100 ml hr Added on 02 14 97 15 13 3 RIGHT WRIST ANGIO CATH 14 NS A 30 ml hr Started on 02 14 97 15 05 4 LEFT SUBCLAVIAN TRIPLE LUMEN 1 DISTAL LOCK PORT Converted on 02 14 97 15 03 5 LEFT SUBCLAVIAN TRIPLE LUMEN 1 MEDIAL D5W 2 3NS 500 A 30 ml hr Added on 02 14 97 14 53 Select a number to be discontinued 3 Discontinued NS 500 mls A RIGHT WRIST started on FEB 14 1997 15 05 Select one of the following reasons for DCing or to exit ACCIDE CLOTT DATA INFI INFUSED ORDER CHANGED ORDER EXPIRE R D R TLY Boe TRY ERROR RATED HOE EMOVED BY ESTART OUT 10 SITE CONDITION 11 TRIPPED 12 WRONG PATI 000 10Y 01 CO PO S GI Z H INFUSED 6 Select a number between 1 and 12 ORDER CHANGED DATE TIME DC ED NOW RET FEB 14 4 22 Intake and Output V 4 0 User Manual 1997 15 17 55 April 1997 Enter Edit Patient Intake and Output Enter for AMOUNT LI Enter solution left in the container on FEB 14 1997015 17 EFT if amount of solu
3. Note This protocol displays solutions locks ports discontinued within 24 hours Select IV site for care maintenance flush 1 Pleas nter date time NOW FEB 14 1997 14 43 57 1 NO REDNESS PAIN SWELLING 2 NON TENDER 3 TENDER 4 RED 5 SWOLLEN 6 DRAINAGE 7 SLOUGH 8 FRANK PUS Select from 1 to 8 enter 1 3 5 etc to describe the infusion site 1 NO REDNESS PAIN SWELLING DRESSING CHANGED lt RET gt LEFT LOWER ARM ANGIO CATH 18 1 D5wW 2 NS 1000 A 1000 mis 02 14 97 14 39 oh AMPICILLIN 1GM in NS 9 P 50 mls 02 14 97 14 39 Enter the number s of the line associated with the TUBING CHANGE lt RET gt I The user will notice that all of the patient s IV sites were displayed and when the IV s were DC ed If a previous IV site indicated a problem this protocol can be used to document the condition of the site The prompts are the same but the user must enter RET at the TUBING CHANGE prompt Start IV Solution Replace DC Convert Finish Solution Replace Same Solution DC IV Lock Port and Site Care Maintenance Flush Add Additional Solution s Restart DC d IV Adjust Infusion Rate Flush 000 10y 01 QC SO ES 6 Add additional solutions Select from 1 to 9 enter 1 3 5 etc or RET to exit 6 This example shows an admixture add to the medial port of a multi lumen catheter
4. 02 05 93 12 48 D5W1 2NS 1000 120 1000 0 RIGHT HSU Y 113 31 HSU Y 10 11000 12 48 KCL 20MEQ 10 10 RIGHT HSU Y 113 31 HSU Y 10 110 02 01 93 10 34 D5W 1000 1125 1000 0 RIGHT THOMAS A 10 37 THOMAS A 1990 10 10 37 HEPARIN LOCK RIGHT THOMAS A l l 110 39 02 17 93 11 50 D5W 1000 1125 1000 0 RIGHT THOMAS A 114 36 THOMAS A 10 11000 l I 14 36 HEPARIN LOCK l RIGHT THOMAS A 14 41 NS 9 100 125 100 0 RIGHT THOMAS A 02 05 93 13 27 HSU Y LEFT l BELL FRED 232 77 8976 JAN 23 1954 43 YRS UNIT RM BED DIVISION 5 10 TUBE DRSG CATHETER FEMORAL lyes lyes lyes Ino lyes FEMORAL Ino no lyes l l lyes WRIST l l WRIST l lyes l l WRIST lyes lyes l lyes WRIST HAND NEEDLE 1 1 4 IN yes lyes Ino no lyes HAND lyes LOWER ARM lyes lyes lyes l LOWER ARM l l Ino no lyes LOWER ARM ANGIO CATH 18 lyes lyes lyes
5. ADD ADDITIONAL SOLUTION S April 1997 Intake and Output V 4 0 4 27 User Manual Enter Edit Patient Intake and Output 1 LEFT LOWER ARM ANGIO CATH 18 D5W 23NS 1000 A 1000 mis 02 14 97 14 39 AMPICILLIN 1GM in NS 9 P 50 mls 02 14 97 14 39 2 LEFT SUBCLAVIAN TRIPLE LUMEN 1 DISTAL DEXTROSE HEPARIN 1 000 U ML 05 UNITS AMPHOTERICIN B 50MG A 1000 mls 02 14 97 14 44 PROXIMAL DEXTROSE 5 AMINOSYN 7 SODIUM CHLORIDE 2 5 MEQ ML 40 MEQ H 1000 mls 02 14 97 14 44 Select an IV site to add additional solutions 2 Pleas nter a new DATE TIME n FEB 14 1997 14 53 19 1 DISTAL 2 MEDIAL 3 PROXIMAL Select the port number used for medication infusion or to quit 2 Select one of the IV types listed below A admixture B blood blood product H hyperal I intralipid P piggyback L locks ports Please enter a character a admixture pharmacy active IV order for the patient 1 5 DEXTROSE HEPARIN 1 000 U ML 05 UNITS AMPHOTERICIN B 50MG 1000 100 ml hr Select a number between 1 and 1 lt RET gt Since the solution was an ordered item the user will select from the GMRY NUR IV Solution 126 9 file Select a n admixture from the following Nursing Solution file listing 1 OTHER O mls 15 D5
6. SELECT OPTION NAME GMRYMGR Patient Intake Output Menu Enter Edit Patient Intake Enter Edit Patient Output Start Add DC IV and Maintenance Print I O Summary by Patient by Shift amp Day s Print I O Summary Midnight to Present Print I O Summary 48 Hrs 24 Hours Itemized Shift Report Intravenous Infusion Flow Sheet Configure I O Files ADP Coordinator Only o0 00 10Y01 5 CO P2 2 Screen Prints Select Patient Intake Output Menu Option 6 Print I O Summary 48 Hrs By A ll patients on a ward S elected Rooms on ward or P atient P Select PATIENT NAME PARKER PETER P 08 04 18 931848807 SC VETERAN Enter patient name DEVICE Enter appropriate response April 1997 Intake and Output V 4 0 5 5 User Manual Intake and Output Reports PATIENT INTAKE OUTPUT SUMMARY 48 HRS DEC 11 1991 DEC 12 1991 WARD SICU PAGE 1 INPUT OUTPUT IV BLOOD PARNT FLUID PRDCT NUTRI PO TUBE IRRIG OTHER URINE N G EMESI DRAIN FECES OTHER RM BED 560 2 PARKER PETER P 931 84 8807 12 11 91 4001 0 100 250 0 0 0 500 0 0 0 0 0 D 500 0 100 300 0 0 0 400 0 0 0 0 0 l 400 0 100 200 0 0 0 400 0 0 0 0 0 TOTAL 1300 0 300 750 0 0 0 13
7. Additional Information This information is used in the following options Enter Edit Patient Output Print I O Summary by Patient by Shift amp Day s Print I O Summary Midnight to Present Print I O Summary 48 Hrs 24 Hours Itemized Shift Report The entries in the GMRY Output Type file cannot be deleted except by IRMS staff A user may change the entry name by editing the information When entering and editing the output type the coordinator needs to be aware that only the first 5 characters print in the header of the following reports Print I O Summary by Patient by Shift amp Day s Print I O Summary Midnight to Present Print I O Summary 48 Hrs Menu Display Select Patient Intake Output Menu Option 9 Configure I O Files ADP Coordinator Only Intake Type Output Type Output Subtype Intake Items IV Site IV Solution Shift Starting Hour and Other Parameters IV Site Description IV Catheter 0 IV DC ed Reason HUOT OAO QC 0 ES Screen Prints Select Configure I O Files ADP Coordinator Only Option 2 Output Type 2 6 Intake and Output V 4 0 April 1997 User Manual Maintenance of Site Files Select GMRY OUTPUT TYPE OTHER Are you adding OTHER as a new GMRY OUTPUT TYPE the 6TH No Y Yes Answer with appropriate output type The following is an example of possible choices found in the field DRAINAGE 4 EMESIS 3 FECES 5 N G 2 URINE 1 OUTPUT TYPE OTHER lt R
8. LOWER ARM LOWER ARM lyes lyes LOWER ARM lyes Ino CHNG CHNG D C D REASON D C INFILTRATED NO REDNESS PA ORDER EXPIRED Isite d c d ORDER NO REDNESS PA EXPIRED DC ED ORDER CHANGED ACCIDENTLY INFUSED TENDER INFUSED DATA ENTRY ERROR NO REDNESS PA MEDICAL RECORD FLOW SHEET VERTICAL IV FLOW SHEET Intake and Output V 4 0 User Manual SITE CONDITION April 1997 Intake and Output Reports Menu Access The Intravenous Infusion Flow Sheet option is accessed through the Patient Intake Output Menu April 1997 Intake and Output V 4 0 5 11 User Manual Glossary Access Code A unique sequence of characters known by and assigned only to the user the system manager and or designated alternate s The access code in conjunction with the verify code is used by the computer to identify authorized users Administration Schedule This is a common abbreviation for a schedule A schedule is the frequency for which an action is to take place such as every eight hours Q8H or every other day QOD ADP Coordinator ADPAC Application Coordinator Automated Data Processing Application Coordinator The person responsible for implementing a set of computer programs application package developed to support a specific functional area such as nursing PIMS etc Application A system of computer progr
9. Ld DEXTROSE 5 AMINOSYN 7 SODIUM CHLORIDE 2 5 MEQ ML 40 MEQ H 1000 mls 02 14 97 14 44 you want to add another solution to MEDIAL port No RET No DISTAL MEDIAL PROXIMAL Select the port number used for medication infusion or to quit Since the user wishes to exit an is entered Start IV Solution Replace DC Convert Finish Solution Replace Same Solution DC IV Lock Port and Site Care Maintenance Flush Add Additional Solution s Restart DC d IV Adjust Infusion Rate Flush Restart DC d IV from 1 to 9 enter 1 3 5 etc or RET to exit 7 START DC d IV Ej ct ect one of the following IV s to restart DEXTROSE HEPARIN 1 000 U ML 05 UNITS AMPHOTERICIN B 50MG A 1000 ml started on FEB 14 1997 14 44 DC d on FEB 14 1997 15 03 250 ml left DC reason ORDER CHANGED D5W 23NS 1000 A 1000 ml 50 ml hr started on FEB 14 1997 14 39 DC d on FEB 14 1997 14 59 900 ml left DC reason ORDER CHANGED Note An IV can t be restarted for one or more of the following reasons 1 The specific item has been running over 24 hrs 2 The solution has been discontinued for over 8 hrs 3 The remaining solution is under 5 mls 4 The reason for discontinuation is INFUSED April 1997 Intake and Output V 4 0 4 29 User Manual Enter Edit Patient Intake and Output Please enter your choice 2 After the IV solution is select
10. Y Yes Select PORT DISTAL Are you adding DISTAL as a new PORT the 2ND for this GMRY IV CATHETER No Y Yes Select PORT RET Menu Access The IV Catheter option is accessed through the Configure I O Files ADP Coordinator Only option of the Patient Intake Output Menu 2 20 Intake and Output V 4 0 April 1997 User Manual Maintenance of Site Files GMRY DC REASON IV DC ed Reason Description This option allows the ADP coordinator to enter and edit reasons for discontinuing an IV into the GMRY IV DC ed Reason 2126 76 file Additional Information The information in this file can be edited or deleted through this option Editing or deleting of information will not affect existing patient I amp O information Menu Display Select Patient Intake Output Menu Option 9 Configure I O Files ADP Coordinator Only Intake Type Output Type Output Subtype Intake Items IV Site IV Solution Shift Starting Hour and Other Parameters IV Site Description IV Catheter 0 IV DC ed Reason H OOO nT OAU C 0 ES Screen Prints Select Configure I O Files ADP Coordinator Only Option 10 IV DC ed Reason Select GMRY IV DC ED REASON NAME WRONG PATIENT Are you adding WRONG PATIENT as a new GMRY IV DC ED REASON the 8TH No Y Yes Answer with IV DC ed reason name The following is a list of choices ACCIDENTALLY D C D CLOTTED COMPLETE A BOTTLE INFUSE
11. 4 23 Enter Edit Patient Intake and Output 3 LEFT SUBCLAVIAN TRIPLE LUMEN 1 MEDIAL D5W 29 NS 500 A 30 ml hr Added on 02 14 97 14 53 4 LEFT SUBCLAVIAN TRIPLE LUMEN 1 PROXIMAL DEXTROSE 5 AMINOSYN 7 SODIUM CHLORIDE 2 5 MEQ ML 40 MEQ H 100 ml hr Added on 02 14 97 14 44 Select a number to be discontinued 4 Discontinued DEXTROSE 5 AMINOSYN 7 SODIUM CHLORIDE 2 5 MEQ ML 40 M 1000 mls H Lil SUBCLAVIAN started on FEB 14 1997 14 44 eal 10 E trj Select one of the following reasons for DCing or to exit ACCIDENTLY DC ED CLOTTED DATA ENTRY ERROR INFILTRATED NFUSED RDER CHANGED D HOE RDER EXPIRE EMOVED BY ESTART OUTDATE 10 SITE CONDITION 11 TRIPPED 12 WRONG PATI OON OY O1 4S CO PO 2S DDOOH E33 Z H Select a number between 1 and 12 INFUSED 5 INFUSED DATE TIME DC ED NOW RET FEB 14 1997015 13 23 Enter solution left in the container on FEB 14 1997 15 13 Enter for AMOUNT LEFT if amount of solution absorbed is unknown Unit mls is not required AMOUNT LEFT 0 RET Enter the amount left in the IV bag bottle Intake for this period 1000 mls Yes RET Yes The user validates the amount of the IV fluid absorbed
12. Print I O Summary 48 Hrs Menu Display Select Patient Intake Output Menu Option 9 Configure I O Files ADP Coordinator Only Intake Type Output Type Output Subtype Intake Items IV Site IV Solution Shift Starting Hour and Other Parameters IV Site Description IV Catheter 0 IV DC ed Reason F2 0 00 10Y O1 4 C0 P2 ES Screen Prints Select Configure I O Files ADP Coordinator Only Option 1 Intake Type 2 4 Intake and Output V 4 0 April 1997 User Manual Maintenance of Site Files Select GMRY INPUT TYPE NAME GAVAGE Are you adding GAVAGE as a new GMRY INPUT TYPE the 5TH No Y Yes Enter appropriate input type name The following is an example of possible choices associated with this field IRRIGATION 3 OTHER 4 PO 1 TUBE FEEDING 2 NAME GAVAGE lt RET gt ORDER 5 This field is used to print the intake type headers in a specific order on the intake and output reports Select GMRY INPUT TYPE NAME RET Menu Access The Intake Type option is accessed through the Configure I O Files ADP Coordinator Only option of the Patient Intake Output Menu April 1997 Intake and Output V 4 0 2 5 User Manual Maintenance of Site Files GMRY OUTPUT FILE1 Output Type Description This option is provided for the ADP coordinator to configure the entries for the GMRY Output Type 4126 58 file URINE STOOL and DRAINS for example are major output types
13. Program A set of M commands and arguments created stored and retrieved as a single unit in M Protocol A single entry point referencing multiple routine entry points to execute several inter related required processes which perform specific functions When multiple protocols are associated with a single procedure i e intravenous lines or IV lines they are found grouped under a single option GL 4 Intake and Output V 4 0 April 1997 User Manual Glossary Qualifier A word that gives a more detailed description of an item Queuing The scheduling of a process task to occur at a later time Queuing is normally done if a task uses up a lot of computer resources Response Time The average amount of time the user must wait between the time the user responded to a question at the terminal and the time the system responds by displaying data and or the next question Restart Recovery Procedures The actions necessary to restore a system s data files and computational capability after a system failure or penetration RET Carriage return Routine A set of M commands and arguments created stored and retrieved as a single unit in M Risk Analysis An analysis of system assets and vulnerabilities to establish an expected loss from certain events based on estimated probabilities of the occurrence of such events Security Key A function which unlocks specific options and makes them accessible to an authorized user Security System
14. e g 2R for RIGHT WRIST 2 or 2L for LEFT WRIST 6 LEFT SUBCLAVIAN The ADP coordinator can add entries to the display list through the Configure I O Files option specifically the IV Site option Select from the following IV CATHs April 1997 Intake and Output V 4 0 4 15 User Manual Enter Edit Patient Intake and Output 1 ANGIO CATH 14 12 TRIPLE LUMEN CVP 2 ANGIO CATH 16 13 RA PA CATH 3 ANGIO CATH 18 14 VENOUS INTRODUCER 4 ANGIO CATH 20 15 HICKMAN LOCK 5 ANGIO CATH 22 16 DOUBLE LUMEN PERIPHERAL 6 BU ERFLY 16 17 SUBCLAVIAN 7 BUTTERFLY 18 18 DOUBLE LUMEN SUBCLAVIAN 8 NEEDLE 1 1 4 IN 14 19 DOUBLE LUMEN 1 9 NEEDLE 1 1 4 IN 16 20 TRIPLE LUMEN 1 10 NEEDLE 1 1 4 IN 18 21 ANGIOCATH 14 11 BUTTERFLY 20 Select a number between 1 and 21 20 The ADP coordinator can add entries to the display list through the Configure I O Files option specifically the IV Catheter option 1 DISTAL 2 MEDIAL 3 PROXIMAL Selec Selec the port number used for medication infusion or to quit 1 ne of the IV types listed below admixture blood blood product hyperal intralipid piggyback L locks ports Please enter a character a admixture pharmacy active IV order for the patient O UH uU D ctc 1 5 DEXTROSE HEPARIN 1 000 U ML 05 UN
15. one of the IV types listed below admixture Active pharmacy IV order for the patient 5 oe DEXTROS E HEPARIN 1 000 U ML Select a number between 1 and 1 05 UNITS AMPHOT RET ERICIN B 50MG 1000 100 ml hr Enter Return to bypass the pharmacy orders and to select an entry from the Nursing Solution file Select a n admixture 1 OTHER 2 1 2 NS 3 1 2 NS 500 500 mis 4 10 DEXTRAN 40 500 ml 5 D10W 1000 1000 ml 6 7 8 9 1 0 mls 1000 1000 mls LS S D10W 9NS 1000 1000 mis D10W1 2NS 1000 1000 mis 1000 mls 250 250 mls 500 500 mls D5 2NS b5W 0 D5W April 1997 from the following Nursing Solution file listing 15 D5W 2SNS 500 16 D5W 9NS 1000 17 D5W 9NS 250 2 18 D5W 9NS 500 5 19 D5W1 2NS 1000 20 D5W1 2NS 250 21 D5W1 2NS 500 22 KCL 20MEQ 50 23 LACTATED RINGERS 24 NS 500 mls Intake and Output V 4 0 User Manual 500 mls 1000 mls 50 mls 00 mls 1000 mls 250 mls 500 mls 50 mls 1000 1000 mls 4 13 Enter Edit Patient Intake and Output 11 D5W 1000 1000 mls 25 NS 9 1000 1000 mls 12 D5W 23NS 100 100 mls 26 NS 9 250 250 mls 13 D5W 22NS 1000 1000 mls 27 NS 9 500 500 mls 14 D5W 2SNS 250 250 mls 28 SODIUM BICARBINATE 5 500 500 mls Enter a number name for your selection Enter additional vitamins electrolytes using a for example 4 mu
16. 1 1 4 IN 18 21 ANGIOCATH 14 11 BUTTERFLY 20 Select a number between 1 and 21 1 The ADP coordinator can add entries to the display list through the Configure I O Files option specifically the IV Catheter option Selec TH mw DP d Please enter a character a one of the IV types listed below admixture blood blood product hyperal intralipid piggyback locks ports admixture pharmacy active IV order for the patient 4 18 Intake and Output V 4 0 User Manual April 1997 Enter Edit Patient Intake and Output 5 DEXTROSE HEPARIN 1 000 U ML 05 UNITS AMPHOTERICIN B 50MG 1000 100 ml hr Select a number between 1 and 1 RET Select a n admixture from the following Nursing Solution file listing 1 OTHER 0 mls 15 D5W 2 NS 500 500 mls 2 1 2 NS 1000 1000 mls 16 D5W 9NS 1000 1000 mls 3 1 2 NS 500 500 mls 17 D5W 9NS 250 250 mls 4 10 DEXTRAN 40 500 mls 18 D5W 9NS 500 500 mls 5 D10W 1000 1000 mls 19 D5W1 2NS 1000 1000 mls 6 D10W 9NS 1000 1000 mls 20 D5W1 2NS 250 250 mls 7 D10W1 2NS 1000 1000 mls 21 D5W1 2NS 500 500 mls 8 D5 2NS 1000 mls 22 KCL 20MEQ 50 50 mls 9 D5W 250 250 mls 23 LACTATED RINGERS 1000 1000 mls 10 D5W 500 500 mis 24 NS 500 mls 11 D5W 1000 1000 mls 25 NS 9 1000 1000 mls 12 D5W 2 NS 100 100 mls 26 NS 9 250 250 mis 13 D5W 2 NS
17. 1 2 1 3 2 1 2 2 4 2 4 8 4 12 5 1 5 3 5 6 5 8 5 10 Implementation and Maintenance eeeeeeeeesesseseeeeeen enne nennen nnns 1 1 Intake and Output Reports 521 dives ed eis eva ledeiseuleiveveviectiedtd viv iee v vL i ois dedia 5 1 Intak BUE RR 2 10 Intake T VE cese ette ka ier rarer enn Mn tie ifc ette feuecaten o ere cere irene 2 4 Intravenous Infusion Flow Sheet cccccssessseseseeeeseeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeees 5 10 IRM Saa e sisdtdca ei sut dod cb deti du bad dadi abusi odi added basi odi adde i 1 1 2 4 2 6 2 8 2 10 TV Cate RR I Utt 2 20 IS DC ed Reason ni aa mtu cH CUN M DUIS RU TCU TESCO i he 2 22 ll Koir e E a 2 12 IV Sit Desci ptio i Selen vleteissul eeu tis ise niece a eise ni vd Ea fot ues 2 18 IV SO UUIOTIS S tied aseo S Cree aa ERAN DURS U o DERART DURS Moa DU RMERI DURS ensue sweated dWensuesinintiass 2 14 Maintenance of Site Files oiecatcconidvei cott Dru coitu tiui deitate bai diu ut Dea 2 1 Name spacing and file listing sees nnne eene nnne nnns 1 1 Non Virgin Installation of Software cccccccccsssssssseeeeccceeeecceesseseeeccceeeeeasaeeseeeeeees 1 4 Output SUbtyp eas et pitt o C RERO aD aD nT RET D REDE HH Eo e CU o dapes eu d Sdn 2 8 OUtDUL OL DO Sob UR E RR DINE OM SKIRT IE RR CON RR AUR TIEN I dn UE curr Tree ie 2 6 Package Operations xis rtr On OW E VE E n v EVEN 3 1 Patient Intake Output Metu ds
18. 48 hours Note The system alerts the user when no information for this output type has been documented in the previous 48 hours If entries are present the program displays those entered within the last 48 hours Pleas nter a new DATE TIME N DEC 28 1996 09 05 04 Enter appropriate date time Enter URINE dated DEC 28 1996 09 05 Unit ml is not required 1 VOIDED 3 SUPRAPUBIC CATHETER 2 FOLEY CATHETER Note The above screen display of urine subtypes can be adjusted by editing the Output Subtype file through the Configure I O Files ADP Coordinator Only option You may document how the output was obtained by entering a urine output subtype i e voided foley catheter suprapubic catheter If you do not wish to enter a subtype enter RET The user is then asked to enter an amount that is a numeric entry you do not have to enter cc ml If the actual amount cannot be determined an estimated amount using S small M medium and L large may also be entered Select a number for the URINE SUBTYPE optional 2 FOLEY CATHETER Enter appropriate subtype Enter numeric value for measured output in cc ml or enter S mall M edium or L arge for estimated output OUTPUT AMOUNT 340 The following example demonstrates patient intake using specific entries right column This display can be changed by editing the intake type data through the
19. A part of Kernel that controls user access to the various computer applications When a user signs on the security system determines the privileges of the user assigns security keys tracks usage and controls the menus or options the user may access It operates in conjunction with MenuMan Sensitive Information Any information which requires a degree of protection and which should be made available only to authorized users Site Configurable A term used to refer to features in the system that can be modified to meet the needs of each site Software A generic term referring to a related set of computer programs Generally this refers to an operating system that enables user programs to run Subroutine A part of a program which performs a single function Task Manager or TaskMan A part of Kernel which allows programs or functions to begin at specified times or when devices become available See Queuing Telecommunications Any transmission emission or reception of signs signals writing images sounds or other information by wire radio visual or any electromagnetic system April 1997 Intake and Output V 4 0 GL 5 User Manual Glossary Terminal A device used to send and receive data from a computer system i e keyboard and CRT or printer with a keyboard TIU Text Integration Utility UCI User Class Identifier The major delimiter of information structure within the operating system User A person who enters and or ret
20. Adding DEXTROSE 5 AMINOSYN 7 SODIUM CHLORIDE 2 5 MEQ ML 40 M 1000 mls ia 10 ges HS Infusion rate ml hr 100 RET New infusion rate is 100 VOLUME 1000 RET 1 Start IV 2 Solution Replace DC Convert Finish Solution 3 Replace Same Solution 4 DC IV Lock Port and Site 4 24 Intake and Output V 4 0 April 1997 User Manual Enter Edit Patient Intake and Output Care Maintenance Flush Add Additional Solution s Restart DC d IV Adjust Infusion Rate Flush 4o000 10Y 01 4 DC IV lock port and site Select from 1 to 9 enter 1 3 5 etc or RET to exit 4 DC IV LOCK PORT AND SITE 1 LEFT LOWER ARM ANGIO CATH 18 D5W 29 NS 1000 A 1000 mls 02 14 97 14 39 AMPICILLIN 1GM in NS 9 P 50 mls 02 14 97 14 39 2 LEFT SUBCLAVIAN TRIPLE LUMEN 1 DISTAL DEXTROSE HEPARIN 1 000 U ML 05 UNITS AMPHOTERICIN B 50MG A 1000 mls 02 14 97814 44 MEDIAL D5W 23NS 500 A 500 mls 02 14 97 14 53 PROXIMAL DEXTROSE 5 AMINOSYN 7 SODIUM CHLORIDE 2 5 MEQ ML 40 MEQ H 1000 mis 02 14 97 14 44 Note The IV solutions and locks ports are associated with the IV site The locks ports are treated just like solutions The following protocols infiltrated infused and order changed display IV lines by IV site The user is asked to enter the number of the IV site to be
21. CHLORIDE 2 5 MEQ ML 40 MEQ H 100 ml hr Added on 02 14 97 14 44 4 LEFT LOWER ARM ANGIO CATH 18 D5W 2 3NS 1000 A 50 ml hr Started on 02 14 97 14 39 5 LEFT LOWER ARM ANGIO CATH 18 AMPICILLIN 1GM in NS 9 P 100 ml hr Added on 02 14 97 14 39 Select the number of solution amp rate to be adjusted 5 AMPICILLIN 1GM in NS 9 50 mls P LEFT LOWER ARM started on F 14 1997814 39 ial w Pleas nter Date Time NOW RET FEB 14 1997 14 58 12 Infusion rate ml hr 100 60 COMMENT RET The nurse may enter in this comment field any additional documentation 1 50 characters in length supporting the rate change Start IV Solution Replace DC Convert Finish Solution Replace Same Solution DC IV Lock Port and Site Care Maintenance Flush Add Additional Solution s Restart DC d IV Adjust Infusion Rate Flush 000 10 Yy 01 CO 0 ES April 1997 Intake and Output V 4 0 4 31 User Manual Enter Edit Patient Intake and Output 9 Flushing the IV line lock or port Select from 1 to 9 enter 1 3 5 etc or RET to exit 9 K K FLUSH K K 1 LEFT SUBCLAVIAN TRIPLE LUMEN 1 DISTAL LOCK PORT 02 14 97 15 03 MEDIAL D5W 23NS 500 A 500 mls 02 14 97 14 53 PROXIMAL DEXTROSE 5 AMINOSYN 7 SODIUM CHLORIDE 2 5 MEQ ML 40 MEQ H 1000 mis 02 14 97 14 44 2 RIGHT WR
22. DC IV and Maintenance Print I O Summary by Patient by Shift amp Day s Print I O Summary Midnight to Present Print I O Summary 48 Hrs 24 Hours Itemized Shift Report Intravenous Infusion Flow Sheet Configure I O Files ADP Coordinator Only Oo 00 10Y O1 45 C0 P2 2S Screen Prints Select Patient Intake Output Menu Option 5 Print I O Summary Midnight to Present By A ll patients on a ward S elected Rooms on ward or P atient S Select WARD LOCATION NAME SICU Enter appropriate ward location Ward SICU has the following rooms April 1997 Intake and Output V 4 0 5 3 User Manual Intake and Output Reports NUMBER ROOM bx 301 2 302 34 550 4 560 Ss 570 Select the NUMBER S of the rooms 4 Enter the number s associated with the rooms you want separated by commas or hyphens if there is more than one room e g 1 3 5 would be entries 1 2 3 and 5 DEVICE Enter appropriate response PATIENT INTAKE OUTPUT SUMMARY CURRENT DEC 12 1991 WARD SICU PAGE 1 INPUT OUTPUT IV BLOOD PARNT FLUID PRDCT NUTRI PO TUBE IRRIG OTHER URINE N G EMESI DRAIN FECES OTHER RM BED 560 1 KCCK GEORGE R 593 48 2726 0 01 0 0 0 0 01 01 01 01 01 01 01 D
23. DDeSCEIDUOT a cm ned eo d e Ioco HM ates SEE HE e pere hee tI id 2 17 IV C athelepu e ea es i RELIER HAE AER CHOSE REUS CAL rer There Ty oN 2 19 TA DC ed Reasons cosa eve cure ubi sca U E pe cUR a CUL DU dis 2 21 Section 2 Package Operation Chapter 3 Package Operation 2 nier a pecietr ier oth kn Pair rua Pb PLE UN n c Pria PHA Pe En Pu ea ga POR 3 1 Chapter 4 Enter Edit Patient Intake and Output sese 4 1 E ter Edit Patient Intake ieesteci eei tei vestir Eo eH Een EFE Re tot liane E Eee PEE nee 4 1 Enter Edit Patient Outputs dai RR HIE HD LEVE HEY deds 4 8 Start Add DC IV and Maintenance cc cesssssssseessssssssssssssssssssssssssssseeeeesseees 4 11 Start IV using a single lumen catheter cccccccccccccessssssseeeeeeeeeeeeeees 4 12 Start IV using a multi lumen catheter eeeeeeeeeeeeeeeeeeeeeeeee 4 15 Hanging a unit of blood or blood products esee 4 17 Discontinuing converting an IV solution using Solution Replace DC Convert Finish Solution sess 4 20 Finishing a solution and discontinuing the IV using Solution Replace DC Convert Finish Soblbi0ti ooi oied edens kac 002i e2ecc oec E2 coco eco eto reads 4 22 Replace Same Solution ccccccccccccccssssssseececccceecaceeeseeecccceeaassaaaaseeeeeees 4 23 DC IV Lock Port and Hle conu dci cedido ice deccu eruere coute ridere dod 4 25 Documenting IV site care tubing c
24. Enter Edit Patient Intake Enter Edit Patient Output Start Add DC IV and Maintenance Print I O Summary by Patient by Shift amp Day s Print I O Summary Midnight to Present Print I O Summary 48 Hrs 24 Hours Itemized Shift Report Intravenous Infusion Flow Sheet Configure I O Files ADP Coordinator Only o0 00 1001 45 C0 ho 2 Screen Prints Select Patient Intake Output Menu Option 7 24 Hours Itemized Shift Report Enter start DATE for this report T 3 RET FEB 23 1997 Enter appropriate start date Go to DATE NOW RET FEB 26 1997 10 25 25 Enter appropriate end date April 1997 Intake and Output V 4 0 5 7 User Manual Intake and Output Reports By A ll patients on a ward S elected Rooms on ward or P atient P Select PATIENT NAME ANDERSON AL 08 08 88 333333331 102A 1 Enter patient name DEVICE Enter appropriate response PATIENT INTAKE OUTPUT REPORT BY SHIFT AND EVENT TYPE PAGE 1 FEB 23 1997 FEB 26 1997 02 25 97 DAY ITEMIZED IV INTAKE 08 00 SALINE LOCK started Site LEFT LEG IV cath HICKMAN LOCK YH OTH Discontinued on 03 17 94 08 01 YH OTH HEPARIN LOCK added Site LEFT LEG YH OTH Discontinued on 03 17 94 12 33 YH OTH EFT LEG NO REDNESS
25. FileMan is a set of M routines used to enter edit print and sort search related data in a file a data base Focus Group Previously referred to as the Expert Panel or SIUG Special Interest User Group A committee which advises programmers about the development of a particular system package Global An M term used when referring to a file stored on a storage medium usually a magnetic disk In the Intake and Output software for example intake and output data is stored in one global and patient data is stored in another global GL 2 Intake and Output V 4 0 April 1997 User Manual Glossary GMRV This signifies the namespace assigned to the Vitals Measurements application GMRY This signifies the namespace assigned to the Intake and Output application Hardware The physical or mechanical components of a computer system such as CPU CRT disk drives etc I amp O Intake and output Intake Output Type The type denotes a category from where the intake or output is derived i e oral intravenous etc IRMS Information Resource Management Service IV Intravenously by intravenous injection Kernel A set of software utilities These utilities provide data processing support for the application packages developed within the VA They are also tools used in configuring the local computer site to meet the particular needs of the hospital The components of this operating system include MenuMan TaskMan Device Handler Log on Se
26. Intake Output Menu Option 9 Configure I O Files ADP Coordinator Only Intake Type Output Type Output Subtype Intake Items IV Site IV Solution Shift Starting Hour and Other Parameters IV Site Description IV Catheter 0 IV DC ed Reason r4000 10y01 5 C 0 ES Screen Prints Select Configure I O Files ADP Coordinator Only Option 7 Shift Starting Hour and Other Parameters Select GMRY NUR SHIFT OTHER NAME HOSPITAL The data selected at this prompt cannot be edited NIGHT 2400 April 1997 Intake and Output V 4 0 2 15 User Manual Maintenance of Site Files Enter start time of night shift Use military time DAY 0700 Enter start time of day shift Use military time EVENING 330 Enter start time of evening shift Use military time Note The program did not accept this entry as valid Only military time is accepted EVENING 1530 Select GMRY NUR SHIFT NAME OTHER RET Menu Access The Shift Starting Hour and Other Parameters option is accessed through the Configure I O Files ADP Coordinator Only option of the Patient Intake Output Menu 2 16 Intake and Output V 4 0 April 1997 User Manual Maintenance of Site Files GMRY SITE DESCRP IV Site Description Description This option allows the ADP coordinator to enter IV site descriptions into the GMRY IV Site Description 4126 72 file This information describes the condition of the
27. O Files ADP Coordinator Only option Enter PO dated DEC 28 1996 11 15 Unit ml is not required Select INTAKE ITEM SOUP Enter appropriate intake item VOLUME 120 150 Enter amount ingested The user may either accept the default by entering RET or enter a different amount Select INTAKE ITEM MILK VOLUME 240 RET Select INTAKE ITEM lt RET gt The software displays a total intake volume associated with this oral intake type Total PO intake for this time 390 mls Enter intake TUBE FEEDING No records in the database within the last 48 hours Pleas nter a new DATE TIME N DEC 28 1996 11 15 20 April 1997 Intake and Output V 4 0 4 5 User Manual Enter Edit Patient Intake and Output Enter appropriate date time A list of items found in the Intake Items file is displayed MILK 240 mls WATER 125 mls SOUP 180 mls SUSTACAL 240 mls You may have more or less items listed depending on what the ADP coordinator entered into the Intake Items file through the Configure I O Files ADP Coordinator Only option Enter TUBE FEEDING dated DEC 28 1996011 15 Unit ml is not required Select INTAKE ITEM SOUP Enter the tube feeding product VOLUME 180 300 Enter amount ingested Select INTAKE ITEM WATER VOLUME 125 60 Select INTAKE ITEM RET Tot
28. O Files ADP Coordinator Only o0 00 10Y 01 CO PD ES Screen Prints Select Patient Intake Output Menu Option 8 Intravenous Infusion Flow Sheet Enter start DATE for this report T 3 2 1 FEB 01 1993 Enter appropriate start date Go to DATE NOW 2 18 FEB 18 1993 T Enter appropriate end date by A ll patients on a ward S elected Rooms on ward or P atient P Select PATIENT NAME Bell Fred Enter patient name THIS REPORT NEEDS 132 COLUMNS PORT LAND T DEVICE Enter appropriate response April 1997 Intake and Output V 4 0 5 9 User Manual Intake and Output Reports Page 1 RATE AMT AMT DATE TIME SOLUTIONS BLOOD ML S LEFT ABSRB SITE 02 04 93 09 59 NS 9 100 150 1100 0 LEFT THOMAS A 11 45 THOMAS A 100 10 110 02 11 45 HEPARIN LOCK LEFT THOMAS A 111 47 02 05 93 09 55 HSU Y 1900 100 11 50 HSU Y 1700 300 112 53 HSU Y 1500 1500 12 53 HEPARIN LOCK LEFT HSU Y 13 21 MANNITOL 1100 500 0 LEFT HSU Y 113 30 HSU Y 5 i l l 13 24 10 FAT EMULSION 250 150 250 0 LEFT HSU Y 13 26 HSU Y 10 1250 l 13 26 10 FAT EMULSION 250 150 250 0 LEFT HSU Y 02 08 93 10 28 HSU Y l 150 1200
29. PAIN SWELLING dressing changed HICKMAN LOCK tubing changed YH OTH 12233 HEPARIN LOCK added Site LEF EG Rate 2 ml hr YH OTH Discontinued on 03 17 94 12 34 YH OTH 12 34 SALINE LOCK added Site LEFT LEG YH OTH Discontinued on 03 17 94 12 35 YH OTH HEPARIN LOCK added Site LEF EG YH OTH Discontinued on 03 17 94 12 36 YH OTH 12 36 HEPARIN LOCK added Site LEF EG Rate 2 ml hr YH OTH DAY shift total Intake Output Summary for 02 25 97 Intake Output Total intake measured 0 mls Total output measured 0 mls Menu Access The 24 Hours Itemized Shift Report option is accessed through the Patient Intake Output Menu 5 8 Intake and Output V 4 0 April 1997 User Manual Intake and Output Reports GMRY IV FLOW Intravenous Infusion Flow Sheet Description This option prints intravenous flow sheets by ward room or by individual patient Data is stored in the GMRY Patient I O 126 file Additional Information The information displayed in the report has been entered through the following option Start Add DC IV and Maintenance Menu Display SELECT OPTION NAME Gl GMRYMGR Patient Intake Output Menu Enter Edit Patient Intake Enter Edit Patient Output Start Add DC IV and Maintenance Print I O Summary by Patient by Shift amp Day s Print I O Summary Midnight to Present Print I O Summary 48 Hrs 24 Hours Itemized Shift Report Intravenous Infusion Flow Sheet Configure I
30. WRIST 8 ANKLE FOOT 3 LOWER ARM 9 LEG 4 UPPER ARM 10 FEMORAL 5 ANTECUBITTAL 11 UMBILICAL 6 SUBCLAVIAN 12 PEDAL 4 12 Intake and Output V 4 0 April 1997 User Manual Enter Edit Patient Intake and Output e g 2R for RIGHT WRIST LEFT LOWER ARM Enter a number with a qualifier L for LEFT R for RIGHT 2 or 2L for LEFT WRIST 3 default L eft The ADP coordinator can add entries to the display list through the Configure I O Files option specifically the IV Site option Select from the following IV CATHs ANGIO NGIO NGIO CATH 14 CATH 16 CATH 18 NGIO CATH 20 NGIO CATH 22 UTTERFLY 16 TERFLY 18 EDLE 1 1 4 IN 14 EDLE 1 1 4 IN 16 E 1 1 4 IN 18 RFLY 20 Zi zi Uu tz AA c GE HE HU bj FPRPOOMOTNADOBWNE o Select a number between 1 and 21 3 12 TRIPLE LUMEN CVP 13 RA PA CATH 14 VENOUS INTRODUCER 15 HICKMAN LOCK 16 DOUBLE LUMEN PERIPHERAL 17 SUBCLAVIAN 18 DOUBLE LUMEN SUBCLAVIAN 19 DOUBLE LUMEN 1 20 TRIPLE LUMEN 1 21 ANGIOCATH 14 The ADP coordinator can add entries to the display list through the Configure I O Files option specifically the IV Catheter option Select A admixture B blood blood product H hyperal I intralipid P piggyback L locks ports Please enter a character A
31. devedededeasdsdy dastbedsdedsdedydeatd dedidadedideatd dtdesadedudears 2 1 Print UO Summary 48 Hrs ee oot vio ie e eE EANES e aee c a eti qs 5 6 Print I O Summary Midnight to Present eeeeeeeeesesseseeeeeeennnennen 5 3 Print I O Summary by Patient by Shift amp Day s eese 5 1 Printer related TISSUES fi cece debeo nPnksE ae Ent dne Penes ak Purdue bog dete Print E araa a rint a Pal eP as Pug r 1 4 Queueinis Task Man J0bSucnetio pti iie e Et ebrei Cel ri niue aequis 1 2 Resource Bequibenmenbeo i e Pea IR I GREEN EE QU OFURN ERU RR GAGNER RAS CHR UE RIP 1 4 Setting up the software environment eeeeeesssseseeseeeen nnne eene nnne nnne nnns 1 1 Shift Starting Hour and Other Parameters eeeeeeeeeeeneeeeeeeen 2 16 Start Add DC IV and Maintenance sess eene eene eene een nennen 4 11 Virgin Installation of Software ccccccccssssssseccceeccccecesesseeecccccceseaueesnesenceceeeseaeagenss 1 1 April 1997 Intake and Output V 4 0 IN 1 User Manual Index IN 2 Intake and Output V 4 0 April 1997 User Manual
32. discontinued and all solutions locks ports associated with this IV site sill be DC ed after the user provides additional closing information i e fluid left absorbed Select an IV site to discontinue 1 4 EFT LOWER ARM D5W 23NS 1000 A 1000 mls 02 14 97 14 39 AMPICILLIN 1GM in NS 9 P 50 mls 02 14 97 14 39 Please enter DATE TIME NOW FEB 14 1997 14 59 45 Select one of the following reasons for DCing or to exit ACCID CLOTT DATA INFIL INFUSI ORDER CHANGED ORDER EXPIRE R D R zZ TLY DC ED E p D zZ RY ERROR RATED D HE GI EMOVED BY RESTART OUTDATED 10 SITE CONDITION 11 TRIPPED 12 WRONG PATI Oo 00 10Y O1 4 C0 P2 ES ial Z H Select a number between 1 and 12 INFUSED 6 ORDER CHANGED April 1997 Intake and Output V 4 0 4 25 User Manual Enter Edit Patient Intake and Output Discontinued D5W 2 NS 1000 1000 mls A LEFT LOWER ARM started on FEB 14 1997 14 39 Enter solution left in the container on FEB 14 1997 14 59 Enter for AMOUNT LEFT if amount of solution absorbed is unknown Unit mls is not required AMOUNT LEFT 900 Enter the amount left in the IV admixture bag bottle Intake for this period 100 mls Yes RET Yes The user validates the amount of the IV fluid absorbed Now the user will
33. document the amount of piggyback solution remaining Discontinued AMPICILLIN 1GM in NS 9 50 mls P LEFT LOWER ARM started on FEB 14 1997 14 39 Eri nter solution left in the container on FEB 14 1997 14 59 Enter for AMOUNT LEFT if amount of solution absorbed is unknown Unit mls is not required AMOUNT LEFT 0 RET Enter the amount left in the IV bag bottle Intake for this period 50 mls Yes RET Yes The user validates the amount of the IV fluid absorbed NO REDNESS PAIN SWELLING NON TENDER TENDER RAINAGE FRANK PUS elect from 1 to 8 enter 1 3 5 etc to describe the infusion site 1 NO REDNESS PAIN SWELLING Do you want to restart the DC d IV Yes n No Start IV Solution Replace DC Convert Finish Solution Replace Same Solution DC IV Lock Port and Site Care Maintenance Flush Add Additional Solution s Restart DC d IV Adjust Infusion Rate Flush Oo COO 1 OY O1 4 C0 P2 ES 4 26 Intake and Output V 4 0 April 1997 User Manual Enter Edit Patient Intake and Output 5 Documenting IV site care tubing change and flushing of lines Select from 1 to 9 enter 1 3 5 etc or RET to exit 5 CARE MAINTENANCE FLUSH T py EFT LOWER ARM ANGIO CATH 18 D5W 23NS 1000 A 1000 mis 02 14 97 14 39 AMPICILLIN 1GM in NS 9 P 50 mls 02 14 97 14 39
34. environment where a previous version of the application has been installed Resource Requirements 1 Data Entry and Printer Devices The minimal hardware requirements for input and output devices is dependent upon the location in which patient care is provided and the quality of reports generated Input devices In an inpatient setting there should be a sufficient number of data input devices at the point of care in the nurse s station physician offices and conference rooms Ambulatory Care settings should provide input devices at the point of care physician offices conference rooms and reception areas Output devices There should be minimally one to two laser printers on an inpatient unit to support this application Ambulatory care area should have a printer in both the reception area and a centralized location in each clinic 2 Disk Storage The following statistics regarding the disk storage requirements of the Intake and Output software were compiled by the Alpha Beta test sites Globals Type of Data Size DDs 90 k GMR Patient data for the 5 20 k Text Generator patient Vitals Measurements and Intake and Output Modules 1 4 Intake and Output V 4 0 April 1997 User Manual Package Management Globals Type of Data Size GMRD Static data for the 20 k depending Text Generator on the global Vitals Measurements efficiency and Intake and Output Modules Future Plans Intake and Output will be enhanced in later v
35. information is used in the following options Enter Edit Patient Intake 24 Hours Itemized Shift Report The entries of the GMRY Intake Items Name prompt cannot be deleted except by IRMS staff A user may change the entry name by editing the information Menu Display Select Patient Intake Output Menu Option 9 Configure I O Files ADP Coordinator Only Intake Type Output Type Output Subtype Intake Items IV Site IV Solution Shift Starting Hour and Other Parameters IV Site Description IV Catheter 0 IV DC ed Reason F2 0 00 1 OY O1 4 C0 P2 ES Screen Prints Select Configure I O Files ADP Coordinator Only Option 4 Intake Items Select GMRY INTAKE ITEMS NAME SODA Are you adding SODA as a new GMRY INTAKE ITEMS the 14TH No Y Yes Enter appropriate intake item 2 10 Intake and Output V 4 0 April 1997 User Manual Maintenance of Site Files NAME SODA RET VOLUME 360 Enter amount of intake item Select INPUT TYPE PO Are you adding PO as a new INPUT TYPE the 1ST for this GMRY INTAKE ITEMS No Y Yes Enter appropriate input type Select INPUT TYPE RET Select GMRY INTAKE ITEMS NAME RET Menu Access The Intake Items option is accessed through the Configure I O Files ADP Coordinator Only option of the Patient Intake Output Menu April 1997 Intake and Output V 4 0 2 11 User Manual Maintenance of Site Fil
36. 00 0 0 0 0 0 OTAL INTAKE MEASURED 2350 OTAL OUTPUT MEASURED 1300 12 12 91 550 0 30 420 0 0 0 600 0 0 0 0 0 D 500 0 80 300 0 30 0 250 0 50 0 0 0 D25 0 0 200 0 0 0 450 0 0 0 0 0 TOTAL 15751 0 110 1020 0 30 0 1300 0 501 0 0 0 OTAL INTAKE MEASURED 2735 OTAL OUTPUT MEASURED 1350 PARKER PETER P 931 84 8807 AUG 4 1918 73 YRS MALE UNIT SICU RM BED 560 2 DIVISION HINES IL Menu Access The Print I O Summary 48 Hrs option is accessed through the Patient Intake Output Menu 5 6 Intake and Output V 4 0 User Manual April 1997 Intake and Output Reports GMRY T O SHIFT AND EVENT 24 Hours Itemized Shift Report Description This option produces itemized patient intake and output reports by shift for a period of time as defined by the user Patient data is stored in the GMRY Patient I O 126 file Additional Information The aggregation of I amp O data by shift is determined from the shift start time information stored in the GMRY NUR Shift Other 1126 95 file Patient I amp O may be printed for all patients on a ward for patients in selected rooms and for individual patients The information displayed in the report has been entered through the following options Enter Edit Patient Intake Enter Edit Patient Output Start Add DC IV and Maintenance Menu Display SELECT OPTION NAME GMRYMCR Patient Intake Output Menu
37. 01 0 0 0 0 0 0 200 0 0 20 0 0 E 01 0 0 0 0 0 0 650 0 0 0 0 0 TOTAL 01 0 0 0 0 0 0 850 0 0 20 0 0 OTAL INTAKE MEASURED 0 OTAL OUTPUT MEASURED 870 RM BED 560 2 PARKER PETER P 931 84 8807 4501 0 0 0 0 0 0 500 0 0 0 0 0 D 300 0 0 300 0 30 ol 250 0 50 0 OF 0 E 400 0 0 0 0 0 0 350 0 0 0 01 0 TOTAL 1150 0 0 300 0 30 0 1100 0 50 0 0 0 OTAL INTAKE MEASURED 1480 OTAL OUTPUT MEASURED 1150 PARKER PETER P 931 84 8807 AUG 4 1918 73 YRS MALE UNIT SICU RM BED 560 2 DIVISION HINES IL Menu Access The Print I O Summary Midnight to Present option is accessed through the Patient Intake Output Menu 5 4 Intake and Output V 4 0 April 1997 User Manual Intake and Output Reports GMRY I O 48HRS Print I O Summary 48 Hrs Description This option summarizes patient intake output for the previous and current day Patient data is stored in the GMRY Patient I O 126 file Additional Information The aggregation of I amp O data by shift is determined from the shift start time information stored in the GMRY NUR Shift Other 126 95 file Patient I amp O may be printed for all patients on a ward for patients in selected rooms and for individual patients The information displayed in the report has been entered through the following options Enter Edit Patient Intake Enter Edit Patient Output Menu Display
38. 1000 1000 mls 27 NS 9 500 500 mls 14 D5W 22NS 250 250 mls 28 SODIUM BICARBINATE 5 500 500 mls Enter a number name for your selection Enter additional vitamins electrolytes using a to separate for example 4 multivits 24 Amount of solution in mls in the container 500 RET Enter a number for infusion rate Example 125 125 ml hr 30 NS admixture 500 mls 30 ml hr Is it correct Yes RET Yes NS A 500 mis 02 14 97 15 05 Do you want to add another solution to this line No RET No To document the hanging of blood use the Add Additonal Solution s protocol Solution Replace DC IV Lo Start IV Replace DC Convert Finish Solution Same Solution ck Port and Site Care Maintenance Flush o000 10Y 01 CO 0 ES Select from 1 to 9 Add Additional Solution s Restart DC d IV Adjust Infusion Ra Flush ADD ADDITIONAL SOL nt tc or RET to exit k k EFT SUBCLAVIAN T DISTAL LOCK PO MEDIAL D5W 2 5NS PROXIMAL DEXTROSE 1000 mls RIGHT WRIST ANGIO NS A 500 mls RT 500 A April 1997 AMINOSYN 7 SODIUM CHLORIDE 02 14 97 14 44 RIPLE LUMEN 02 14 97 15 03 500 mis 02 14 97 14 53 2 5 MEQ ML 40 M E CATH 14 02 14 97 15 05 Intake and Output V 4 0 User Manual Ej 10 4 19 Enter Edit Patient Intake and Output Select an IV site to add a
39. ASURED 1300 12 12 96 550 OI 30 420 0 0 0 600 0 0 0 0 0 D 500 0 80 300 0 30 0 250 0 50 0 0 0 525 0 0 200 0 0 0 450 0 0 0 0 0 TOTAL 1575 0 110 1020 0 301 0 1300 0 50 0 0 0 OTAL INTAKE MEASURED 2735 OTAL OUTPUT MEASURED 1350 PARKER PETER P 931 84 8807 AUG 4 1918 73 YRS MALE UNIT SICU RM BED 560 2 DIVISION HINES IL Note In the above report only the first 5 characters of the intake and output types print in the header Menu Access The Print I O Summary by Patient by Shift amp Day s option is accessed through the Patient Intake Output Menu 5 2 Intake and Output V 4 0 User Manual April 1997 Intake and Output Reports GMRY I O CURRENT Print I O Summary Midnight to Present Description This option summarizes the current day s intake and output information for all patients on a ward in a selected room on a ward and individual patients Patient data is stored in GMRY Patient I O 126 file Additional Information The aggregation of I amp O data by shift is determined from the shift start time information stored in the GMRY NUR Shift Other 126 95 file The information displayed in the report has been entered through the following options Enter Edit Patient Intake Enter Edit Patient Output Menu Display SELECT OPTION NAME GMRYMCR Patient Intake Output Menu Enter Edit Patient Intake Enter Edit Patient Output Start Add
40. April 1997 User Manual Maintenance of Site Files GMRY IV CATH IV Catheter Description This option allows the ADP coordinator to enter different types of IV catheters needles etc into the GMRY IV Catheter 4126 74 file Additional Information This file contains a list of IV instrumentation i e needles catheters locks butterflys etc that might be used by clinicians to establish an IV infusion continuous or intermittent of fluids or drugs Both the type and size of the catheter should be contained in the IV catheter name when appropriate Refer to the example illustrated under Screen Prints Deleting data in this file does not affect existing patient I amp O information Menu Display Select Patient Intake Output Menu Option 9 Configure I O Files ADP Coordinator Only Intake Type Output Type Output Subtype Intake Items IV Site IV Solution Shift Starting Hour and Other Parameters IV Site Description IV Catheter 0 IV DC ed Reason oO r 5000 10y01 5 C 0 ES Screen Prints Select Configure I O Files ADP Coordinator Only Option 9 IV Catheter Example 1 Enter the name of a single lumen catheter Select GMRY IV CATHETER IV CATHETER TYPE SIZE ANGIO CATH 14 Are you adding ANGIO CATH 14 as a new GMRY IV CATHETER the 21ST No X Yes IV CATHETER TYPE SIZE ANGIOCATH 14 RET April 1997 Intake and Output V 4 0 2 19 User Ma
41. D Note INFUSED is the default IV INFILTRATED ORDER EXPIRED DC D SITE CONDITION NAME WRONG PATIENT RET April 1997 Intake and Output V 4 0 2 21 User Manual Maintenance of Site Files Select GMRY IV DC ED REASON NAME RET Menu Access The IV DC ed Reason option is accessed through the Configure I O Files ADP Coordinator Only option of the Patient Intake Output Menu 2 22 Intake and Output V 4 0 April 1997 User Manual Section 2 Package Operation April 1997 Intake and Output V 4 0 User Manual Package Operation ii Intake and Output V 4 0 April 1997 User Manual Chapter 3 Package Operation Having completed the instructions for implementing the software as indicated in the Package Management section you are now ready to use the options The content contained in the following sections provides information on all software options which can be assigned to clinical staff This information includes the name description or purpose of the option screen prints menu access and other information that supports the use of the options Remember that on line help is available when questions arise The user can type or after any prompt to get a help message that generally tells the user what to do In some instances a specific list of possible responses is displayed All field names in the Intake and Output application have descriptions associated with them Help is also available at the menu
42. EB E EB E EB E EB E URINE 2 1996 08 45 2 1996 08 00 1 1996 14 24 1 1996 09 49 240 245 455 100 mls mls mls mls VOIDED VOIDED FOLEY CATHETER SUPRAPUBIC CATHE 1 to delete or N to add Are you sure you want to delete this record Yes lt RET gt URINE Entered on F EB 2 1996 08 00 has been deleted tog Yes uit The user can reenter the date time and enter the correct amount if appropriate Menu Access The Enter Edit Patient Output option is accessed through the Patient Intake Output Menu option 4 10 Intake and Output V 4 0 User Manual April 1997 Enter Edit Patient Intake and Output GMRY IV CARE Start Add DC IV and Maintenance Description This option contains seven protocols associated with intravenous therapy 1 Start IV Start a new IV line or heparin saline lock port 2 Solution Replace DC Convert Finish Solution DC current solution then replace a new solution to the selected IV line or convert the IV according to the user s choice 3 Replace Same Solution Replace the same solution to a selected IV 4 D C IV Lock Port and Site Remove IV lock port from a selected IV site 5 Care Maintenance Flush Check site condition dressing change tube change and flush 6 Add Additional Solutions s Add additional solution s without discontinuing an existing one 7 Restart DC d IV Restart an IV whi
43. ET gt ORDER 6 This field is used to print the output type headers in a specific order on the intake and output reports Select GMRY OUTPUT TYPE lt RET gt Menu Access The Output Type option is accessed through the Configure I O Files ADP Coordinator Only option of the Patient Intake Output Menu April 1997 Intake and Output V 4 0 2 7 User Manual Maintenance of Site Files GMRY OUTPUT FILE2 Output Subtype Description This option allows the ADP coordinator to enter the entries for the GMRY Output Subtype 4126 6 file pointed to by the GMRY Patient I O File 126 VOID FOLEY and STRAIGHT CATH for example are subtypes of URINE Additional Information This information is used in the following options Enter Edit Patient Output 24 Hours Itemized Shift Report The entries of the GMRY Output Subtype prompt cannot be deleted except by IRMS staff A user may change the entry name by editing the information Restrictions Only URINE and DRAINAGE output types should have associated output subtypes Menu Display Select Patient Intake Output Menu Option 9 Configure I O Files ADP Coordinator Only Intake Type Output Type Output Subtype Intake Items IV Site IV Solution Shift Starting Hour and Other Parameters IV Site Description IV Catheter 0 IV DC ed Reason FPOMOATAUOBWNE Screen Prints Select Configure I O Files ADP Coordinator Only Option 3 Output Subtype Select GMRY OUT
44. ILTRATED 5 INFUSED 6 0 V c9 8 R 9v R ESTART OUTDATED 10 SITE CONDITION 11 TRIPPED 12 WRONG PATI Fe A H Select a number between 1 and 12 INFUSED 6 ORDER CHANGED DATE TIME DC ED NOW RET FEB 14 1997015 03 01 Enter solution left in the container on FEB 14 1997815 03 Enter for AMOUNT LEFT if amount of solution absorbed is unknown Unit mls is not required E AMOUNT LEFT 250 Enter the amount left in the IV bag bottle Intake for this period 750 mls Yes RET Yes The user validates the amount of the IV fluid absorbed Do you wish to Convert to lock port Hang a new solution Pleas nter the FIRST character for your selection or press return to continue c Convert to lock port Did you flush No y Yes April 1997 Intake and Output V 4 0 4 21 User Manual Enter Edit Patient Intake and Output Start IV Solution Replace DC Convert Finish Solution Replace Same Solution DC IV Lock Port and Site Care Maintenance Flush Add Additional Solution s Restart DC d IV Adjust Infusion Rate Flush 000 10 Y 01 CO SNB ES 2b Finishing a solution and discontinuing the IV using Solution Replace DC Convert Finish Solution Select from 1 to 9 enter 1 3 5 etc or REI to exit 2 SOLUTION REPLACE DC CONVERT FINISH SOLUTION
45. IST ANGIO CATH 14 NS A 500 mls 02 14 97 15 05 PACKED RBC B 350 mls 02 14 97 15 06 Select IV site to flush 2 Please enter DATE TIME NOW lt RET gt FEB 14 1997 15 10 18 Start IV Solution Replace DC Convert Finish Solution Replace Same Solution DC IV Lock Port and Site Care Maintenance Flush Add Additional Solution s Restart DC d IV Adjust Infusion Rate Flush Oo O0 1 OY O1 4 C0 P2 ES Select from 1 to 9 enter 1 3 5 etc or RET to exit Menu Access The Start Add DC IV and Maintenance option is accessed through the Patient Intake Output Menu option 4 32 Intake and Output V 4 0 April 1997 User Manual Chapter 5 Intake and Output Reports GMRY I O SUM Print I O Summary by Patient by Shift amp Day s Description This option summarizes patient intake output by major category and shift for a period of time as defined by the user Patient data is stored in the GMRY Patient I O 126 file Additional Information Patient information displayed in the report has been entered through the following options Enter Edit Patient Intake Enter Edit Patient Output Start Add DC IV and Maintenance The aggregation of I amp O data by shift is determined from the shift start time information stored in the GMRY NUR Shift Other 126 95 file Menu Display SELECT OPTION NAME GMRYMCR Patient Intake Output Menu Enter Edit Patient Intake En
46. ITS AMPHOTERICIN B 50MG 1000 100 ml hr Select a number between 1 and 1 1 Amount of solution in mls in the container 1000 RET Enter a number for infusion rate Example 125 125 ml hr 100 RET DEXTROSE HEPARIN 1 000 U ML 05 UNITS AMPHOTERICIN B 50MG admixture 1000 mls 100 ml hr Is it correct Yes RET Yes DISTAL DEXTROSE HEPARIN 1 000 U ML 05 UNITS AMPHOTERICIN B 50MG A 1000 mls 02 14 97 14 44 Do you want to add another solution to DISTAL port No lt RET gt No The user could have added another solution to the distal port After the documentation specific to the distal port is completed the user is again prompted with the list of ports Documentation of a solution associated with another port can then be entered 1 DISTAL 2 MEDIAL 3 PROXIMAL 4 16 Intake and Output V 4 0 April 1997 User Manual Enter Edit Patient Intake and Output Select the port number used for medication infusion or to quit 3 Select one of the IV types listed below A admixture B blood blood product H hyperal I intralipid P piggyback L locks ports Please enter a character h hyperal pharmacy active IV order for the patient 1 DEXTROSE 5 AMINOSYN 7 SODIUM CHLORIDE 2 5 MEQ ML 40 MEQ 1000 100 ml hr I Select a number between 1 and 1 1 Amount of solution in mls in the contain
47. IV and Maintenance Print I O Summary by Patient by Shift amp Day s Print I O Summary Midnight to Present Print I O Summary 48 Hrs 24 Hours Itemized Shift Report Intravenous Infusion Flow Sheet Configure I O Files ADP Coordinator Only 000 10 Y 01 CO NB ES Screen Prints The following pages contain separate examples of each option s use There is no continuity in IV displays between individual examples Select Patient Intake Output Menu Option 3 Start Add DC IV and Maintenance by A ll patients on a unit S elected Rooms on unit or P atient P Select PATIENT NAME STARK ANTHONY L 11 04 85 112334443 500 3 NO NSC VETERAN When the patient is an outpatient a Hospital Location prompt appears and the patient s clinic or ward should be entered If the patient is an inpatient the location prompt does not appear Start IV Solution Replace DC Convert Finish Solution Replace Same Solution DC IV Lock Port and Site Care Maintenance Flush Add Additional Solution s Restart DC d IV Adjust Infusion Rate Flush 000 10Y 01 5 CO P2 ES la Start IV using a single lumen catheter Select from 1 to 9 enter 1 3 5 etc or RET to exit 1 START IV There is no IV running for this patient Start new IV Pleas nter a new DATE TIME N FEB 14 1997 14 39 34 Select from the following IV sites 1 HAND 7 JUGULAR 2
48. Intake Type option refer to chapter 2 Select Patient Intake Output Menu Option 1 Enter Edit Patient Intake by A ll patients on a unit S elected Rooms on unit or P atient P Select PATIENT NAME STARK ANTHONY L 01 19 25 589632111 NSC VETERAN Detailed input from 6 to 9 1 PO 6 PO 2 IV ACCESS 7 TUBE FEEDING 3 TUBE FEEDING 8 IRRIGATION 4 IRRIGATION 9 OTHER 5 OTHER Select from 1 to 9 enter 1 3 5 etc or to quit 6 7 Enter intake PO Te DEC 28 1996 09 02 Total 560 mls 4 4 Intake and Output V 4 0 April 1997 User Manual Enter Edit Patient Intake and Output In this example the software displays the previous oral intake documented within the last 48 hours Select a number i e 1 to edit 180 to delete or N to add to quit selection N You can edit the previous entry delete the entry or enter N for a new entry Pleas nter a new DATE TIME 1T 1115 DEC 28 1996 11 15 Enter appropriate date time Time can be entered for the past 48 hours or the present but cannot be entered in the future A list of items from the Intake Items file is displayed SOUP 120 mls ICE CREAM 50 mls JELLO 75 mls MILK 240 mls TEA 150 mls WATER 125 mls COFFEE 150 mls JUICE 125 mls SODA 360 mls Intake items are specific to the facility The ADP coordinator is responsible for maintaining the Intake Items file through the Configure I
49. OLEY CATHETER 35 FEB 1 1996 09 49 100 mls SUPRAPUBIC CATHETER Select a number i e 1 to edit 1 to delete or N to add to quit selection N Pleas nter a new DATE TIME 0845 FEB 02 1996 08 45 00 Enter date time of output Enter URINE dated FEB 2 1996 08 45 Unit ml is not required 1 VOIDED 3 SUPRAPUBIC CATHETER 2 FOLEY CATHETER Select a number for the URINE SUBTYPE optional 1 Enter numeric value for measured output in cc ml or enter S mall M edium or L arge for estimated output OUTPUT AMOUNT S 240 DELETING ERRORS The entry number followed by an deletes the entry as shown below Select Patient Intake Output Menu Option 2 Enter Edit Patient Output by A ll patients on a unit S elected Rooms on unit or P atient P Select PATIENT NAME MOUSE MICKEY 04 25 38 123222111 If the patient is an outpatient the hospital location prompt displays Select HOSPITAL LOCATION 1 EAST 1 URINE 2 N G 3 EMESIS 4 DRAINAGE 9 FECES 6 OTHER Select from 1 to 6 enter 1 3 5 etc or to quit URINE RET April 1997 Intake and Output V 4 0 4 9 User Manual Enter Edit Patient Intake and Output Urine is the software s default response Enter outpu F AWUN EF E lj Select a number i e 1 to edit 2Q selection Select the entry to be deleted
50. OTHER 3 OTHER Select from 1 to 9 enter 1 3 5 etc or to quit 1 Enter intake PO No records in the database within the last 48 hours Note The system alerts the user when no information for this intake type has been recorded in the previous 48 hours If entries are present the program displays data entered within the last 48 hours and a prompt which allows the user to edit delete and add a new entry i e Select a number i e 1 to edit 1 to delete or N to add to quit selection 6 Pleas nter a new DATE TIME T0902 DEC 28 1992809 02 00 Enter appropriate date time Enter PO dated DEC 28 1992 09 02 Unit ml is not required TOTAL AMOUNT 560 Enter the intake volume MI does not have to be entered after the volume Total PO intake for this time 560 mls Do you want to enter OUTPUT Yes RET Yes Enter N to exit if there is no output for this patient J URINE 2 N G 3 EMESIS 4 DRAINAGE 5 FECES 6 OTHER Select from 1 to 6 enter 1 3 5 etc or to quit URINE lt RET gt Note The above screen display can be changed edited through the Output Type option refer to Chapter 2 Enter output URINE Urine is the default but the user may enter another output type from the above list April 1997 Intake and Output V 4 0 4 3 User Manual Enter Edit Patient Intake and Output No records in the database within the last
51. PUT SUBTYPE CHEST TUBE LEFT Are you adding CHEST TUBE LEFT as a new GMRY OUTPUT SUBTYPE the 6TH No X Yes 2 8 Intake and Output V 4 0 April 1997 User Manual Maintenance of Site Files Answer with appropriate output subtype The following is an example of possible choices found in the field CHEST TUBE RIGHT DRAINAGE FOLEY URINE SHEATH CATH URINE STRAIGHT CATH URINE VOID URINE GMRY OUTPUT SUBTYPE OUTPUT TYPE DRAINAGE OUTPUT SUBTYPE CHEST TUBE LEFT lt RET gt OUTPUT TYPE DRAINAGE lt RET gt Select GMRY OUTPUT SUBTYPE lt RET gt Menu Access The Output Subtype option is accessed through the Configure I O Files ADP Coordinator Only option of the Patient Intake Output Menu April 1997 Intake and Output V 4 0 2 9 User Manual Maintenance of Site Files GMRY INTAKE ITEMS Intake Items Description This option allows the ADP coordinator to enter items into the GMRY Intake Items 1126 8 file pointed to by the GMRY Patient I O File 126 The entries in the 126 8 file are used to identify specific fluid intake items associated with detailed oral fluids tube feeding preparations irrigation solution etc The information collected includes the name of the intake item e g water the volume of the fluid s container and the input type associated with the intake item s name e g po irrigation Additional Information This
52. RIPLE LUMEN 1 10 NEEDLE 1 1 4 IN 18 21 ANGIOCATH 14 11 BUTTERFLY 20 Select a number between 1 and 21 3 The ADP coordinator can add entries to the display list through the Configure I O Files option specifically the IV Catheter option Select one of the following IV s to restart 1 DEXTROSE HEPARIN 1 000 U ML 05 UNITS AMPHOTERICIN B 50MG A 1000 ml 100 ml hr started on FEB 14 1997 14 44 DC d on FEB 14 1997 15 03 250 ml left DC reason ORDER CHANGED Please enter your choice lt RET gt 4 30 Intake and Output V 4 0 April 1997 User Manual Enter Edit Patient Intake and Output Start IV Solution Replace DC Convert Finish Solution Replace Same Solution DC IV Lock Port and Site Care Maintenance Flush Add Additional Solution s Restart DC d IV Adjust Infusion Rate Flush 000 10 01 CO PO ES 8 Adjust infusion rate Select from 1 to 9 enter 1 3 5 etc or RET to exit 8 ADJUST INFUSION RATE This protocol lists each IV solution seperately 1 LEFT SUBCLAVIAN TRIPLE LUMEN 1 MEDIAL D5W 2 NS 500 A 30 ml hr Added on 02 14 97 14 53 2 LEFT SUBCLAVIAN TRIPLE LUMEN 1 DISTAL 5 DEXTROSE HEPARIN 1 000 U ML 05 UNITS AMPHOTERICIN B 50MG A 100 ml hr Started on 02 14 97 14 44 3 LEFT SUBCLAVIAN TRIPLE LUMEN 1 PROXIMAL DEXTROSE AMINOSYN 7 SODIUM
53. W 2 NS 500 500 mls 2 1 2 NS 1000 1000 mls 16 D5W 9NS 1000 1000 mls 3 1 2 NS 500 500 mls 17 D5W 9NS 250 250 mls 4 10 DEXTRAN 40 500 mls 18 D5W 9NS 500 500 mis 5 D10W 1000 1000 mls 19 D5W1 2NS 1000 1000 mls 6 D10W 9NS 1000 1000 mls 20 D5W1 2NS 250 250 mls 7 D10W1 2NS 1000 1000 mls 21 D5W1 2NS 500 500 mls 8 D5 2NS 1000 mls 22 KCL 20MEQ 50 50 mls 9 D5W 250 250 mls 23 LACTATED RINGERS 1000 1000 mls 10 D5W 500 500 mls 24 NS 500 mis 11 D5W 1000 1000 mls 25 NS 9 1000 1000 mls 12 D5W 2 3NS 100 100 mls 26 NS 9 250 250 mls 13 D5W 2 NS 1000 1000 mls 27 NS 9 500 500 mls 14 D5W 2 NS 250 250 mls 28 SODIUM BICARBINATE 5 500 500 mls Enter a number name for your selection Enter additional vitamins electrolytes using a to separate for example 4 multivits 15 4 28 Intake and Output V 4 0 April 1997 User Manual Enter Edit Patient Intake and Output Amount of solution in mls in the container 500 RET Enter a number for infusion rate Example 125 125 ml hr 30 D5W 2 NS 500 admixture 500 mls 30 ml hr Is it correct Yes RET Yes DISTAL DEXTROSE HEPARIN 1 000 U ML 05 UNITS AMPHOTERICIN B 50MG A 1000 mls 02 14 97 14 44 MEDIAL Do 1 2 3 o000 10Yy 01 2 CO SNO ES se sel 1 100 ml hr 2 lec KKK R D5W 2 NS 500 A 500 mis 02 14 97 14 53 PROXIMAL
54. able files eeeeeeeeeeeeeeeeeen nnne 1 2 Queueing TaskMan jobs cccccccccccccccsssssssseseeeeccecsseeseeeecccceeeeeseesaaaneesces 1 2 GMRY and NUR I amp O options eeeesssssseeeeeeeeeee nennen nennen nnne 1 2 ASSIEHITID enisi iore a ev E LOVER CH CIS FOR EY ECSS doa Fd edunt 1 3 Printer related 15506822 9 9 501 cie sei T wan RT wa da RERO ad FUOD De oC us 1 4 Non Virgin Installation of software cccccccssssssseeecceccccceeeeeeeececcceeeeeeaaesseseees 1 4 Resource Requirements uice desee idet er CDI EE EUN S UDIN EI NEA EXE ERA NER EVER ben v 1 4 F t r Paris as idco e po NI REM rM RD Aden UR eR Mes aat 1 5 Chapter 2 Maintenance of Site Files ccccccssssssssseeseececcceeeceeeuseeccceseeaeasssaaeseeeeeeees 2 1 Patient Intake Output Menu ccseecccccccccceccessssseeccccceeeseeeeeeccceeeceeeeessansnees 2 1 Configure I O Files ADP Coordinator Only eeeeeeeeess 2 2 Intake Typ 4 tio ve iov S HW eras aden 2 4 Gini a Sure S DOR sess currat ttbi eser c M u eiS ict Mead ad 2 6 Output Subtype sinus nw RP sii anand mesa dnvesns 2 8 Irae TAA eds een odecdasodi ee peteretur E aun sdccdoced ure PE SERRE ats 2 10 EV Siten sananne a tar Cree Nat CR ONAS Denne Sor Siete et eer ROE bU a NGA 2 12 INCISODILIOTH du iturus Octo tree ety arp arse arm nner e rr are ate EE MU 2 13 Shift Starting Hour and Other Parameters ss 2 15 LV SIEe
55. ace Operating System The innermost layer of software that communicates with the hardware It controls the overall operation of the computer such as assigning places in memory processing input and output One of its primary functions is interpreting M computer programs into language the system can understand Option A functionality that is invoked by the user The information defined in the option is used to drive the menu system Options are created associated with others on menus or given entry exit actions For example the GMRVMGR is the main menu for the Vitals Measurements application Package Otherwise known as an application A set of M routines files documentation and installation procedures that support a specific function within VISTA e g the ADT and Vitals Measurements applications Password A protected word or string of characters that identifies or authenticates a user a specific resource or an access type synonymous with Verify Code PIMS Patient Information Management System previously known as the MAS Package PO Per orum refers to an item consumed orally or through the mouth Pointer A special data type of VA FileMan that takes its value from another file This is a method of joining files together and avoiding duplication of information Port Anoutlet in the back of the computer into which terminals can be connected Printer A device for printing on paper data which is processed by a computer system
56. al TUBE FEEDING intake for this time 360 mls Do you want to enter OUTPUT Yes N No IV Access Under this option the user is able to enter the amount of the IV solution left in the container at the end of the shift or at any time an IV intake total must be entered The Start Add DC IV and Maintenance option does not automatically calculate an accurate amount of absorbed solution per shift Select Patient Intake Output Menu Option 1 Enter Edit Patient Intake by A ll patients on a unit S elected Rooms on unit or P atient P Select PATIENT NAME STARK ANTHONY L 01 19 25 589632111 NSC VETERAN Detailed input from 6 to 9 1 PO 6 PO 2 IV ACCESS E TUBE FEEDING 3 TUBE FEEDING 8 IRRIGATION 4 IRRIGATION 9 OTHER 5 OTHER Select from 1 to 9 enter 1 3 5 etc or to quit 2 Enter intake IV ACCESS 1 D5W 1000 mls 1000 mls A LEFT HAND Started on FEB 11 1996 10 39 4 6 Intake and Output V 4 0 April 1997 User Manual Enter Edit Patient Intake and Output The software displays a list of the patient s IVs that were entered through the Start Add DC IV and Maintenance option Enter the number of the IV you wish to enter edit INTAKE 1 Enter IV INTAKE for D5W 1000 mls A LEFT HAND 1000 mls Started FEB 11 1996 10 39 Total amount absorbed 0 mls The software indicates the total IV intake previously documented through the
57. ams and files that have been specifically developed to meet the requirements of a user or group of users Examples of VISTA applications are the PIMS and Vitals Measurements application Archive The process of moving data to some other storage medium i e disk CD Rom and magnetic tape and deleting the information from active storage in order to free up disk space on the system Audit Trail Logging Features The use of automated software procedures to determine if the security controls implemented for protection of computer systems are being circumvented and to identify the potential source of the security breach Backup Procedures The provisions made for the recovery of data files and program libraries and for restart or replacement of ADP equipment after the occurrence of a system failure Baud Rate The rate at which data is being transmitted or received from a computer The baud rate is equivalent to the number of characters per second times 10 Block The unit of storage transferred to and from disk drives typically 512 1024 or 2048 bytes characters Boot The process of starting up the computer Bulletin A canned message that is automatically sent by MailMan to a user when something happens to the database Byte Aunit of computer space usually equivalent to one character April 1997 Intake and Output V 4 0 GL 1 User Manual Glossary CIOFO Chief Information Office Field Office formerly known as Information Resource M
58. anagement Field Office and Information Systems Center Contingency Plan A plan which assigns responsibility and defines procedures for use of the backup restart recovery and emergency preparedness procedures selected for the computer system based on risk analysis for that system CORE A collection of VA developed programs specific to PIMS Pharmacy Service and Laboratory Service which is run at VA Medical Centers CPRS Computerized Patient Record System CPU Central Processing Unit the heart of a computer system CRT Cathode Ray Tube similar to a TV monitor but used in computer systems for viewing data Also called a Video Display Terminal VDT Cursor A visual position indicator e g blinking rectangle or an underline on a CRT that moves along with each character as it is entered from the keyboard Data Dictionary A description of file structure and data elements within a file Device A hardware input output component of a computer system e g CRT printer Disk A magnetic storage device used to hold information Edit Used to change modify data typically stored in a file Field A data element in a file For example PATIENT is a field in the GMRY Patient I O File File The M construct in which data is stored for retrieval at a later time A computer record of related information e g GMRY Patient I O File Patient file File Manager or FileMan Within this manual FileManager or FileMan is a reference to VA FileMan
59. ay be specific to your facility c various needle sizes and other items associated with the Intake and Output software The package is exported with a few file entries but you have the opportunity to enter information which will meet the needs of your facility since these are site configurable files 4 Queueing TaskMan jobs No scheduled TaskMan options are associated with this application 5 GMRY and NUR I amp O options 1 2 Intake and Output V 4 0 April 1997 User Manual Package Management There is a separate set of similar options that are used to document and print I amp O data in both the Intake and Output and the Nursing applications In the Intake and Output package the software identifies a patient s ward or clinic location using the Hospital Location 44 file The Nursing package uses the Nursing Location 211 4 file to identify an inpatient s associated nursing unit Providing access to I amp O options through the Nursing application was done for the convenience of nursing to streamline their inpatient workload All data entered through either package is stored in the Intake and Output application s files 6 Assigning menus The GMRYMGR menu contains the following menus and options and is the primary menu for the application s ADP Coordinator Select OPTION NAME GMRYMGR Patient Intake Output Menu Enter Edit Patient Intake Enter Edit Patient Output Start Add DC IV and Maintenance Print I O Summary by Patie
60. ch was DC d due to infiltration or other reasons 8 Adjust Infusion Rate Adjust infusion rate for a selected IV 9 Flush Flush all IV line s for a selected infusion site Information on a patient s IV line solutions hung and absorbed IV site care etc are stored in the GMRY Patient I O 126 file Additional Information A patient s IV intake cannot be documented through the Enter Edit Patient Intake option IV ACCESS until an IV has been started through the Start IV option This software option does not automatically calculate the amount of fluid absorbed during a specific 8 hour shift There are multiple variables influencing the fluid s absorption rate such as positioning pathway etc therefore the total IV volume absorbed per shift must be manually entered through the Enter Edit Patient Intake option IV ACCESS When the intake of an IV is unknown the nurse may document this unknown amount by entering an asterisk The patient data entered through this option is reflected in the following reports 24 Hours Itemized Shift Report Intravenous Infusion Flow Sheet Restrictions Data can only be edited for the previous 48 hour period Future data cannot be entered April 1997 Intake and Output V 4 0 4 11 User Manual Enter Edit Patient Intake and Output Menu Display Select OPTION NAME LE GMRYMGR Patient Intake Output Menu Enter Edit Patient Intake Enter Edit Patient Output Start Add DC
61. curity and other specialized routines Kilobyte More commonly known as Kbyte or K A measure of storage capacity equivalent to 1024 characters LAYGO An acronym for Learn As You Go A technique used by VA FileMan to acquire new information as it goes about its normal procedure It permits a user to add new data to a file M Formerly known as MUMPS or the Massachusetts General Hospital Utility Multi Programming System This is the programming language used to write all VISTA applications MailMan An electronic mail teleconferencing and networking system Megabyte A measure of storage capacity approximately 1 million characters Abbreviated as Mbyte or Meg Memory A storage area used by the computer to hold information Menu A set of options or functions available to users for editing formatting generating reports etc Menu Manager A part of the Kernel that allows each site to manage the various options or functions available to individual users April 1997 Intake and Output V 4 0 GL 3 User Manual Glossary ML Milliliters a unit of volume used in the Intake and Output application Modem An electronic device which converts computer signals to enable transmission through a telephone Namespace A naming convention followed in the VA to identify various applications and to avoid duplication It is used as a prefix for all routines and globals used by the application The Intake and Output Package uses GMRY as its namesp
62. dditional solutions 2 Pleas nter a new DATE TIME n FEB 14 1997 15 06 56 Select one of the IV types listed below admixture blood blood product hyperal intralipid piggyback L locks ports Please enter a character b blood blood product No pharmacy active IV order for this patient Hmtu i Select a n blood blood product from the following Nursing Solution file listing 1 OTHER 0 mls 4 PACKED RBC 350 mls 2 CRYOPRECIPITATE 150 mls 5 PLATLETS 100 mls 3 FRESH FROZEN PLASMA 100 mls 6 WHOLE BLOOD 450 mls Note Only solutions designated as blood blood products will display If you are required to document the blood control select 1 for Other and enter the type of blood product with the control Enter a number name for your selection Enter additional vitamins electrolytes using a to separate for example 4 multivits 4 Amount of solution in mls in the container 350 lt RET gt Enter a number for infusion rate Example 125 125 ml hr 100 PACKED RBC blood blood product 350 mls 100 ml hr Is it correct Yes lt RET gt Yes NS A 500 mls 02 14 97 15 05 PACKED RBC B 350 mls 02 14 97 15 06 Do you want to add another solution to this line No lt RET gt No If you entered YES you can enter more solutions to the same IV site Start IV Solution Replace DC Convert Finish Solution Replac
63. e Same Solution DC IV Lock Port and Site Care Maintenance Flush Add Additional Solution s Restart DC d IV Adjust Infusion Rate Flush Oo O0 1 OY O1 4 C0 P2 ES 2a Discontinuing converting an IV solution using Solution Replace DC Convert Finish Solution Select from 1 to 9 enter 1 3 5 etc or RET to exit 2 SOLUTION REPLACE DC CONVERT FINISH SOLUTION 4 20 Intake and Output V 4 0 April 1997 User Manual Enter Edit Patient Intake and Output All running IV s are listed 1 LEFT SUBCLAVIAN TRIPLE LUMEN 1 MEDIAL D5W 29 NS 500 A 30 ml hr Added on 02 14 97 14 53 2 LEFT SUBCLAVIAN TRIPLE LUMEN 1 DISTAL DEXTROSE HEPARIN 1 000 U ML 05 UNITS AMPHOTERICIN B 50MG A 100 ml hr Started on 02 14 97 14 44 3 LEFT SUBCLAVIAN TRIPLE LUMEN 1 PROXIMAL DEXTROSE AMINOSYN 7 SODIUM CHLORIDE 2 5 MEQ ML 40 MEQ H 100 ml hr Added on 02 14 97 14 44 Select a number to be discontinued 2 Discontinued 5 DEXTROSE HEPARIN 1 000 U ML 05 UNITS AMPHOTERICIN B 50MG 1000 mls A LEFT SUBCLAVIAN started on FEB 14 1997 14 44 Select one of the following reasons for DCing or to exit RDER EXPIRE EMOVED BY RDER CHANGED D 1 ACCIDENTLY DC ED 2 CLOTTED 3 DATA ENTRY ERROR 4 INF
64. ed the user must validate the information displayed Amount of solution in mls in the container 900 RET Enter a number for infusion rate Example 125 125 ml hr 50 RET D5W 2 NS 1000 admixture 900 mls 50 ml hr Is it correct Yes lt RET gt Yes The software then prompts for IV site and catheter information to complete the restart cycle Pleas nter a new DATE TIME n FEB 14 1997 15 15 47 Select from the following IV sites 1 HAND 7 JUGULAR 2 WRIST 8 ANKLE FOOT 3 LOWER ARM 9 LEG 4 UPPER ARM 10 FEMORAL 5 ANTECUBITTAL 11 UMBILICAL 6 SUBCLAVIAN 12 PEDAL Enter a number with a qualifier L for LEFT R for RIGHT default L eft e g 2R for RIGHT WRIST 2 or 2L for LEFT WRIST 5 LEFT ANTECUBITTAL The ADP coordinator can add entries to the display list through the Configure I O Files option specifically the IV Site option Select from the following IV CATHs 1 ANGIO CATH 14 12 TRIPLE LUMEN CVP 2 ANGIO CATH 16 13 RA PA CATH 3 ANGIO CATH 18 14 VENOUS INTRODUCER 4 ANGIO CATH 20 15 HICKMAN LOCK 5 ANGIO CATH 22 16 DOUBLE LUMEN PERIPHERAL 6 BUTTERFLY 16 17 SUBCLAVIAN 7 BUTTERFLY 18 18 DOUBLE LUMEN SUBCLAVIAN 8 NEEDLE 1 1 4 IN 14 19 DOUBLE LUMEN 1 9 NEEDLE 1 1 4 IN 16 20 T
65. er 1000 RET Enter a number for infusion rate Example 125 125 ml hr 100 RET DEXTROSE AMINOSYN 7 SODIUM CHLORIDE 2 5 MEQ ML 40 MEQ hyperal 1000 mls 100 ml hr Is it correct Yes RET Yes DISTAL DEXTROSE HEPARIN 1 000 U ML 05 UNITS AMPHOTERICIN B 50MG A 1000 mls 02 14 97 14 44 PROXIMAL DEXTROSE AMINOSYN 7 SODIUM CHLORIDE 2 5 MEQ ML 40 MEQ H 1000 mls 02 14 97 14 44 Do you want to add another solution to PROXIMAL port No lt RET gt No 1 DISTAL 2 MEDIAL 3 PROXIMAL Select the port number used for medication infusion or to quit Note The users must to exit otherwise an ERROR ENTRY prompt displays Start IV Solution Replace DC Convert Finish Solution Replace Same Solution DC IV Lock Port and Site Care Maintenance Flush Add Additional Solution s Restart DC d IV Adjust Infusion Rate Flush 000 10 01 CO PO S 1c Hanging a unit of blood or blood products Select from 1 to 9 enter 1 3 5 etc or RET to exit 1 AA START INM AES The IV line supporting blood transfusions can be supported by starting an IV using normal saline NS and adding the blood blood product to the main line Current IV s April 1997 Intake and Output V 4 0 User Manual Enter Edit Patient Intake and Output
66. ersions to meet the needs of the medical facilities A link with Health Summary is planned April 1997 Intake and Output V 4 0 1 5 User Manual Package Management 1 6 Intake and Output V 4 0 April 1997 User Manual Chapter 2 Maintenance of Site Files GMRYMGR Patient Intake Output Menu Description This is the main menu for the Intake and Output I amp O application It contains options for 1 documenting patient intake and output 2 starting and discontinuing IV lines and fluids 3 documenting IV care and 4 printing various intake and output reports Additional Information This is the primary menu for the Intake and Output application and is assigned to the package s application coordinator Options 1 2 and 4 8 may be assigned to clinical staff Option 3 should be assigned to registered nurses and members of the IV team The package application coordinator should be assigned option 9 Menu Display Select OPTION NAME GMRYMGR Patient Intake Output Menu 1 Enter Edit Patient Intake 2 Enter Edit Patient Output 3 Start Add DC IV and Maintenance 4 Print I O Summary by Patient by Shift amp Day s 5 Print I O Summary Midnight to Present 6 Print I O Summary 48 Hrs 7 24 Hours Itemized Shift Report 8 Intravenous Infusion Flow Sheet 9 Configure I O Files ADP Coordinator Only Menu Access The Patient Intake Output Menu is the main menu April 1997 Intake and Output V 4 0 2 1 User Man
67. es GMRY IV SITE IV Site Description This option allows the ADP coordinator to enter IV sites into the GMRY IV Site 1126 7 file The entries are names of anatomical sites such as right wrist and left hand Additional Information This information is used to track the IV insertion site and assist with documen tation of the site s status and surrounding skin integrity Deletion of file data does not affect existing patient I amp O information Menu Display Select Patient Intake Output Menu Option 9 Configure I O Files ADP Coordinator Only Intake Type Output Type Output Subtype Intake Items IV Site IV Solution Shift Starting Hour and Other Parameters IV Site Description IV Catheter 0 IV DC ed Reason F2 0 00 1 OY O1 4 CO PO ES Screen Prints Select Configure I O Files ADP Coordinator Only Option 5 IV Site Select GMRY IV SITE WRIST RT Are you adding WRIST RT as a new GMRY IV SITE the 12TH No Y Yes Enter appropriate IV site IV SITE WRIST RT RET Select GMRY IV SITE lt RET gt Menu Access The IV Site option is accessed through the Configure I O Files ADP Coordinator Only option of the Patient Intake Output Menu 2 12 Intake and Output V 4 0 April 1997 User Manual Maintenance of Site Files GMRY IV SOL IV Solution Description This option allows the ADP coordinator to enter IV solutions into the GMRY NUR IV Solution 7126 9 file There are three fie
68. hange and flushing of lines 4 27 April 1997 Intake and Output V 4 0 iii User Manual Table of Contents Add Additional Solutions see reri ei trc xe dPepreti esto pra e et ed vds vx ed res des b ETATS 4 27 Restart DO d IV aso et RR etai ep EAEE EERE etat cele NNN MO 4 29 Adj stanfusion FOTO nrbe breite i matin bnulbe deir D rs a TEL Stud me vod M 4 31 Flushing the IV line lock or port eeeeeeeeeereeen 4 32 Chapter 5 Intake and Output Reports eeeeesssseeeeeeeeeeene eene enne nnn 5 1 Print I O Summary by Patient by Shift amp Day s eeeeeeeees 5 1 Print I O Summary Midnight to Present eeeeessseeeenn 5 3 Print V O Summary 48 HIPS cepta ect vis eva M Nas prs o Dec ape Ae M olea e 5 5 24 Hours Itemized Shift Report eeeeeseeeeeseseeeseeeen nnne eene enne 5 7 Intravenous Infusion Flow Sheet eeeeeesssseeesseeeeeeeneee eee 5 9 BI CIAR RR LT Em GL 1 Lh Osea PTE TM RE IN 1 iv Intake and Output V 4 0 April 1997 User Manual Introduction The Intake and Output I amp O application is designed to store in the patient s electronic medical record all patient intake and output information associated with a hospital stay or outpatient visit This application is not service specific and currently is interfaced with the PIMS MAS Nursing and Pharmacy applications Functionality Users may elec
69. ient Intake Output Menu Option 9 Configure I O Files ADP Coordinator Only Intake Type Output Type Output Subtype Intake Items IV Site IV Solution Shift Starting Hour and Other Parameters 1oY01 5 00 P525 rp 2 2 Intake and Output V 4 0 April 1997 User Manual Maintenance of Site Files 8 IV Site Description 9 IV Catheter 10 IV DC ed Reason Menu Access The Configure I O Files ADP Coordinator Only option is accessed through the Patient Intake Output Menu April 1997 Intake and Output V 4 0 2 3 User Manual Maintenance of Site Files GMRY INPUT FILE1 Intake Type Description This option is used by the ADP coordinator to configure the NON IV intake type entries for the GMRY Input Type 126 56 file For example PO TUBE FEEDING and OTHER are input types Additional Information This information is used in the following options Enter Edit Patient Intake Print I O Summary by Patient by Shift amp Day s Print I O Summary Midnight to Present Print I O Summary 48 Hrs 24 Hours Itemized Shift Report The entries of the GMRY Input Type Name prompt cannot be deleted except by IRMS staff A user may change the entry name by editing the information When entering and editing the intake type the coordinator needs to be aware that only the first 5 characters print in the header of the following reports Print I O Summary by Patient by Shift amp Day s Print I O Summary Midnight to Present
70. lds associated with this option that store information on the IV solution solution name the type of solution hyperal piggyback admixture blood blood products and intralipids and the volume of the solution Additional Information The IV solutions added to this file include admixtures hyperals intralipids piggybacks and blood blood products This data is used only when the Pharmacy IV module interface is not available when patient IV orders have not been entered into OE RR and processed by pharmacy or if an API application programmer interface has not been written for a specific package e g Blood Bank Deletion of file data does not affect existing patient I amp O information Menu Display Select Patient Intake Output Menu Option 9 Configure I O Files ADP Coordinator Only Intake Type Output Type Output Subtype Intake Items IV Site IV Solution Shift Starting Hour and Other Parameters IV Site Description IV Catheter 0 IV DC ed Reason r4000 10y01 5 C 0 ES Screen Prints Select Configure I O Files ADP Coordinator Only Option 6 IV Solution Select GMRY NUR IV SOLUTION NAME D10W 1000 Are you adding D10W 1000 as a new GMRY NUR IV SOLUTION the 31ST No Y Yes Enter the name of an appropriate IV solution GMRY NUR IV SOLUTION TYPE A ADMIXTURE April 1997 Intake and Output V 4 0 2 18 User Manual Maintenance of Site Files Enter appropriate IV solution type The f
71. level by typing a or April 1997 Intake and Output V 4 0 3 1 User Manual Package Operation 3 2 Intake and Output V 4 0 April 1997 User Manual Chapter 4 Enter Edit Patient Intake and Output GMRY EDIT INTAKE Enter Edit Patient Intake Description This option allows the user to enter or edit patient intake records e g oral IV and nasogastric Data is stored in the GMRY Patient I O 126 file Refer to Chapter 2 Maintenance of Site Files for editing associated files Additional Information Enter Edit Patient Intake is the primary option used to enter patient intake You will note that two 2 columns display after the patient s hospital location or patient s name is entered Detailed input from 6 to 9 1 PO 6 PO 2 IV Access 7 Tube Feeding 3 Tube Feeding 8 Irrigation 4 Irrigation 9 Other 5 Other The column on the left side of the screen permits a user to document only the total intake in milliliters associated with a specific intake type PO IV etc The column on the right allows users to document the names of specific liquids fluids solutions etc associated with an intake type The documenting of specific IV fluids is accomplished through the Start Add DC IV and Maintenance option explained later in this chapter If a user does not document that an IV has been started on a patient through the Start Add DC IV and Maintenance option the software will not allow the user to chart an IV intake amount
72. ltivits 13 to separate The ADP coordinator can add entries to the display list through the Configure I O Files option specifically the IV Solution option Amount of solution in mls in the container 1000 RET Enter a number for infusion rate Example 125 125 ml hr 50 D5W 23NS 1000 admixture 1000 mls 50 ml hr Is it correct Yes lt RET gt Yes D5W 23NS 1000 A 1000 mls 02 14 97 14 39 Do you want to add another solution to this line No Y Yes Select one of the IV types listed below A admixture B blood blood product H hyperal I intralipid P piggyback L locks ports Please enter a character P piggyback No pharmacy active IV order for this patient Select a n piggyback from the following Nursing Solution file listing Es 255 OTHER 0 mls D5W 50 50 mls 3 4 MANNITOL 500 mls NS 9 100 100 mls If you select 1 for OTHER you are asked to enter the name of an IV solution For example Enter a number name for your selection Enter additional vitamins electrolytes using a for example 4 multivits 1 to separate Please SP maximu ECIFY the name of the solution m 75 characters AMPICILLIN 1GM in NS 9 The user may type in the name of any solution or blood blood product that is not longer than 75 characters AMPICILLIN 1GM in NS 9 Yes RET Yes Amount of solution in mls in the container 0 50 En
73. ne s for a selected infusion site The software supports documentation of intravenous intake via both single and multi lumen catheters The software is interfaced with the IV module of the Pharmacy software The following reports are included April 1997 Intake and Output V 4 0 1 User Manual Introduction Print I O Summary by Patient by Shift and Day s Print I O Summary Midnight to Present Print I O Summary 48 Hrs 24 Hours Itemized Shift Report Intravenous Infusion Flow Sheet The last four reports can be printed for all patients on a ward for patients in selected rooms on a ward and for an individual patient Patient Intake and Output information is printed on the following Nursing application reports End of Shift Report Vital Signs Record Expanded SF511 Report Itemized I O This version of Intake and Output is not interfaced with the Health Summary or the Order Entry Results Reporting applications 2 Intake and Output V 4 0 April 1997 User Manual Section 1 Package Management April 1997 Intake and Output V 4 0 User Manual Package Management ii Intake and Output V 4 0 April 1997 User Manual Chapter 1 Implementation and Maintenance Description This chapter provides guidelines for implementing the Intake and Output I amp O application It is important to complete all of the steps contained in this chapter before assigning menu options to clinical staff Virgin Installation of Soft
74. night to Present Print I O Summary 48 Hrs 24 Hours Itemized Shift Report A report of a patient s detailed output is found on the 24 Hours Itemized Shift Report Restrictions Data can only be edited for the previous 48 hour period Future data cannot be entered Menu Display Select OPTION NAME GMRYMGR Patient Intake Output Menu 1 Enter Edit Patient Intake 2 Enter Edit Patient Output 3 Start Add DC IV and Maintenance 4 Print I O Summary by Patient by Shift amp Day s 5 Print I O Summary Midnight to Present 6 Print I O Summary 48 Hrs 7 24 Hours Itemized Shift Report 8 Intravenous Infusion Flow Sheet 9 Configure I O Files ADP Coordinator Only Screen Prints Select Patient Intake Output Menu Option 2 Enter Edit Patient Output by A ll patients on a unit S elected Rooms on unit or P atient P 4 8 Intake and Output V 4 0 April 1997 User Manual Enter Edit Patient Intake and Output Select PATIENT NAME MOUSE MICKEY 04 25 38 123222111 If the patient is an outpatient and or placed on a ward for 23 hour observation the hospital location prompt displays Select HOSPITAL LOCATION 1 EAST T URINE 2 N G 3 EMESIS 4 DRAINAGE 5 FECES 6 OTHER Select from 1 to 6 enter 1 3 5 etc or to quit URINE RET Enter output URINE T FEB 2 1996 08 00 245 mls VOIDED 2 FEB 1 1996 14 24 455 mls F
75. nt by Shift amp Day s Print I O Summary Midnight to Present Print I O Summary 48 Hrs 24 Hours Itemized Shift Report Intravenous Infusion Flow Sheet Configure I O Files ADP Coordinator Only 000 1001 CO SNB ES Clinical staff should be assigned options 1 8 Option 9 is assigned to the Intake and Output application coordinator You will note that options 4 through 8 are print options We suggest that options 4 through 7 be given to physicians dietitians and others who may have an interest in viewing a patient s or group of patient s Intake and Output The following table is a reference for print sort parameters for the reports using menu option numbers OPTION DATE RANGE WARD SELECTED RM PATIENT SCREEN PRT TEMIZED 4 YES NO NO YES YES NO 5 NO YES YES YES YES NO 6 NO YES YES YES YES NO 7 YES YES YES YES YES YES 8 YES YES YES YES YES YES IV April 1997 Intake and Output V 4 0 1 3 User Manual Package Management NOTE For intake to be itemized DETAILED INPUT in the Enter Edit Patient Intake option must be used IV solutions will display names from the Start ADD DC IV and Maintenance protocol 7 Printer related issues Reports can be printed on a dot matrix printer or a laser printer Non Virgin Installation of Software Follow steps 1 through 8 above when preparing the Intake and Output software for use in an
76. nual Maintenance of Site Files Answer with IV catheter name The following is a representative list of choices displayed by the software when a user queries the application for a list of IV catheter types sizes ANGIO CATH 14 Note In this file when you configure ANGIO CATH 16 the entries FileMan will order ANGIO CATH 18 either numerically or alphabeti ANGIO CATH 20 cally depending on your entries ANGIO CATH 22 For instance if you enter BUTTERFLY 16 catheter size first such as 18 BUTTERFLY 18 and the user selects 18 then NEEDLE 1 1 4 IN 14 all the 18 catheters will be NEEDLE 1 1 4 IN 16 displayed for the user to select NEEDLE 1 1 4 IN 18 from Select PORT RET A single lumen port does not need an entry at this prompt Example 2 Enter the name of a multi lumen catheter and names of associated ports Select GMRY IV CATHETER IV CATHETER TYPE SIZE DOUBLE LUMEN Are you adding DOUBLE LUMEN as a new GMRY IV CATHETER the 19TH No X Yes IV CATHETER TYPE SIZE DOUBLE LUMEN 1 RET The following PORT prompts allow the package coordinator to associate the name of a port with the catheter Since this is a double lumen port the port names of PROXIMAL and DISTAL are entered If this was a triple lumen port the MEDIAL port would have been added Select PORT PROXIMAL Are you adding PROXIMAL as a new PORT the 1ST for this GMRY IV CATHETER No
77. ollowing is a list of choices distributed in the software HYPERAL P PIGGYBACK A ADMIXTURE B BLOOD BLOOD PRODUCT I INTRALIPIDS NAME D10W 1000 RET TYPE ADMIXTURE RET VOLUME 1000 Enter amount of IV solution Select GMRY NUR IV SOLUTION NAME RET Menu Access The IV Solution option is accessed through the Configure I O Files ADP Coordinator Only option of the Patient Intake Output Menu 2 14 Intake and Output V 4 0 April 1997 User Manual Maintenance of Site Files GMRY NURSHIFT Shift Starting Hour and Other Parameters Description This option allows the application coordinator to edit specific Intake and Output parameters that are stored in the GMRY NUR Shift Other 4126 95 file These parameters include the starting hours for the night day and evening shift tour of duty which are used to calculate a patient s total intake and output for a specific time span Additional Information In this version of Intake and Output the application can only assign shift start times for the entire hospital In a future version the application s functionality will be modified to accommodate unique shift times for specific wards or units Also the displaying of data for units with two tours of duty i e two 12 hour shifts within a 24 hour time frame will be explored The data type for the shift start hours is entered in military time e g 0800 1600 and 2400 Menu Display Select Patient
78. option and associated with this IV No intake records for this IV line within the last 48 hours If no IV intake was entered the display appears on the screen Pleas nter a new DATE TIME 1500 FEB 11 1996 15 00 00 Enter ADMIXTURE intake dated FEB 11 1996 15 00 Enter for AMOUNT LEFT if amount of solution absorbed is unknown Unit mls is not required AMOUNT LEFT 600 This is the amount of the IV solution left at 1500 hours or 3pm Intake for this period 400 mls Yes lt RET gt Yes This is the amount of IV fluid absorbed from the 1000 ml bag from the time it was started at 10 39am this morning Do you want to enter OUTPUT Yes N No Menu Access The Enter Edit Patient Intake option is accessed through the Patient Intake Output Menu option April 1997 Intake and Output V 4 0 4 7 User Manual Enter Edit Patient Intake and Output GMRY EDIT OUTPUT Enter Edit Patient Output Description This option allows user to enter or edit patient output records only Patient data is stored in the GMRY Patient I O 126 file Additional Information This option only permits entry of OUTPUT URINE and DRAINAGE are the only output types with associated output subtypes e g foley voided but entering data for these subtypes is optional Patient output information is printed in the following options Print I O Summary by Patient by Shift amp Day s Print I O Summary Mid
79. rieves data in a system usually utilizing a CRT Utility An M program that assists in the development and or maintenance of a computer system VDT Video Display Terminal Also called a Cathode Ray Tube CRT Verify Code A unique security code which serves as a second level of security access Use of this code is site specific sometimes used interchangeably with a password VISTA Veterans Health Information Systems and Technology Architecture GL 6 Intake and Output V 4 0 April 1997 User Manual Index 24 Hours Itemized Shift Report s sseeeeeeesesseeeeseeenn nennen eene 5 8 Assignins menie eere nectiaiiet ena dedic i a dd scan bua dud i tu e Pur 1 3 Configure I O Files ADP Coordinator Only eeeeeeseseeeeeeeee 2 2 Data Entry and Printer Devices eeeeeeeeeeseeseeeseeen nnne eene 1 4 Disk Storage 4r rr p e ei OD n e OD E Va v ER aaa 1 4 Editing site configurable files eei deret av deccdedsdeded sivgeatd ode dadedodsdecsdededesedeasdeusd 1 2 Enter Edit Patient Intake i eo vent ees eoe aLi REEERE EEEE ER 4 1 Enter Edit Patient Intake and Output sseeeseseeeeeeeeeeeene nnne 4 1 Enter Edit Patient Output esses eene eene nnne nene senes tnn nnns 4 8 F nctionality szeruen psi bnt cob a aduana ivitndeiad settle ui exei utis 1 1 GMB Y and NUR I amp O options 2 ern o Peer ete tod eoe DER Y tn s Peso Mte ees dV 1 3 GMRYMNQGKG steven ce eren
80. rt Restrictions Data can only be edited for the previous 48 hour period Future data cannot be entered Menu Display Select OPTION NAME GMRYMGR Patient Intake Output Menu 1 Enter Edit Patient Intake 2 Enter Edit Patient Output 3 Start Add DC IV and Maintenance 4 Print I O Summary by Patient by Shift amp Day s 5 Print I O Summary Midnight to Present 6 Print I O Summary 48 Hrs 7 24 Hours Itemized Shift Report 8 Intravenous Infusion Flow Sheet 9 Configure I O Files ADP Coordinator Only Screen Prints Select Patient Intake Output Menu Option 1 Enter Edit Patient Intake by A ll patients on a unit S elected Rooms on unit or P atient P Select PATIENT NAME STARK ANTHONY L 01 19 25 589632111 NSC VETERAN Enter patient name Select HOSPITAL LOCATION Ifthe patient is an outpatient the hospital location prompt displays 4 2 Intake and Output V 4 0 April 1997 User Manual Enter Edit Patient Intake and Output The following example demonstrates the use of the left column for documenting ingested items More than one 1 entry can be entered by separating numbers by a comma or a hyphen for a range of numbers Note The following screen display can be edited through the Intake Type option refer to Chapter 2 Detailed input from 6 to 9 1 PO 6 PO 2 IV ACCESS 7 TUBE FEEDING 3 TUBE FEEDING 8 IRRIGATION 4 IRRIGATION 9
81. skin around the insertion site of the IV catheter or needle Additional Information The following descriptions are distributed with the software DRAINAGE NO REDNESS PAIN SWELLING This description is the default NON TENDER RED SLOUGH SWOLLEN TENDER Information is printed on the 24 Hours Itemized Shift Report the Intravenous Infusion Flow Sheet and the Nursing application s End of Shift Report Deleting information from the file does not affect existing patient I amp O information Menu Display Select Patient Intake Output Menu Option 9 Configure I O Files ADP Coordinator Only Intake Type Output Type Output Subtype Intake Items IV Site IV Solution Shift Starting Hour and Other Parameters IV Site Description IV Catheter 0 IV DC ed Reason H 4000 10Yy01 5 QC 0 ES Screen Prints Select Configure I O Files ADP Coordinator Only Option 8 IV Site Description April 1997 Intake and Output V 4 0 2 17 User Manual Maintenance of Site Files Select GMRY IV SITE DESCRIPTION WARM Are you adding WARM as a new GMRY IV SITE Yes c ESCRIPTION the 8TH No X Answer with IV site description DESCRIPTION WARM lt RET gt Select GMRY IV SITE DESCRIPTION RET Menu Access The IV Site Description option is accessed through the Configure I O Files ADP Coordinator Only option of the Patient Intake Output Menu 2 18 Intake and Output V 4 0
82. tart Add DC IV and Maintenance module of the Intake and Output package 2 Name spacing and file listing Intake and Output is found in the GMRY namespace All routines templates and options begin with GMRY File numbers are in the range of 126 to 126 95 and are stored in the GMR and GMRD globals April 1997 Intake and Output V 4 0 1 1 User Manual Package Management 3 Editing site configurable files a The Intake Type option edits the GMRY Input Type 7126 56 file b The Output Type option edits the GMRY Output Type 4126 58 file c The Output Subtype option edits the GMRY Output Subtype 126 6 file d The Intake Items option edits the GMRY Intake Items 126 8 file e The IV Site option edits the GMRY IV Site 7126 7 file f The IV Solution option edits the GMRY NUR IV Solution 7126 9 file g The Shift Starting Hour and Other Parameters option edits the GMRY NUR Shift Other 4126 95 file h The IV Site Description option edits the GMRY IV Site Description 126 72 file i The IV Catheter option edits the GMRY IV Catheter 1126 74 file j The IV DC ed Reason option edits the GMRY IV DC ed Reason 4126 76 file A primary concern for the ADP Coordinator is the Configure I O Files Option 9 in the GMRYMGR menu option that contains the options listed in a j above This option allows you to enter a various IV or oral fluids and the amount in milliliters associated with containers b names of IV sites that m
83. ter Edit Patient Output Start Add DC IV and Maintenance Print I O Summary by Patient by Shift amp Day s Print I O Summary Midnight to Present Print I O Summary 48 Hrs 24 Hours Itemized Shift Report Intravenous Infusion Flow Sheet Configure I O Files ADP Coordinator Only Oo 00 10Y O1 iS CO PD ES Screen Prints Select Patient Intake Output Menu Option 4 Print I O Summary by Patient by Shift amp Day s Enter start DATE for report T 3 12 11 DEC 11 1996 Enter appropriate start date Go to DATE NOW lt RET gt DEC 12 1996 12 09 Enter appropriate end date April 1997 Intake and Output V 4 0 5 1 User Manual Intake and Output Reports Select PATIENT NAME PARKER PETER P 08 04 18 931848807 SC VETERAN Enter patient name DEVICE Enter appropriate response PATIENT INTAKE OUTPUT SUMMARY DEC 11 1996 DEC 12 1996 12 09 PAGE INPUT OUTPUT IV BLOOD PARNT FLUID PRDCT NUTRI PO TUBE IRRIG OTHER URINE N G EMESI DRAI ES OTHER 12 11 96 400 0 100 250 0 0 0 500 0 0 0 0 0 D _ 500 0 100 300 0 0 0 400 0 0 0 0 0 400 0 100 200 0 0 0 400 0 0 0 0 0 TOTAL 1300 OI 300 750 0 0 0 1300 0 0 0 0 0 OTAL INTAKE MEASURED 2350 OTAL OUTPUT ME
84. ter a number for infusion rate Example 125 125 ml hr 100 AMPICILLIN 1GM in NS 9 piggyback 50 mls 100 ml hr Is it correct Yes RET Yes D5W 2 NS 1000 A 1000 mls 02 14 97 14 39 AMPICILLIN 1GM in NS 9 P 50 mls 02 14 97 14 39 Do you want to add another soluti 4 14 Intake and Output V 4 0 on to this line No lt RET gt No April 1997 User Manual Enter Edit Patient Intake and Output If you entered YES you can enter more solutions to the same IV site Start IV Solution Replace DC Convert Finish Solution Replace Same Solution DC IV Lock Port and Site Care Maintenance Flush Add Additional Solution s Restart DC d IV Adjust Infusion Rate Flush 000 10Y 01 CO SO ES 1b Start IV using a multi lumen catheter Select from 1 to 9 enter 1 3 5 etc or RET to exit 1 START IV Current IV s 1 LEFT LOWER ARM ANGIO CATH 18 D5W 2 3NS 1000 A 50 ml hr Started on 02 14 97 14 39 2 LEFT LOWER ARM ANGIO CATH 18 AMPICILLIN 1GM in NS 9 P 100 ml hr Added on 02 14 97 14 39 Start new IV Pleas nter a new DATE TIME n FEB 14 1997 14 44 35 Select from the following IV sites 1 HAND 7 JUGULAR 2 WRIST 8 ANKLE FOOT 3 LOWER ARM 9 LEG 4 UPPER ARM 10 FEMORAL 5 ANTECUBITTAL 11 UMBILICAL 6 SUBCLAVIAN 12 PEDAL Enter a number with a qualifier L for LEFT R for RIGHT default L eft
85. through this option The Intake and Output application does NOT automatically calculate the IV intake totals this data must be manually entered Although the intake amount could be calculated based on the date time the IV solution was hung the variables adversely affecting the flow rate and producing an erroneous IV intake counter indicate the automatic calculation of the intravenous intake The Enter Edit Patient Intake option prompts you after you have entered the intake to enter the patient s output This was done to simplify the I amp O process and save time The prompt s response is defaulted to YES but you can answer N for NO if there is no output at this time April 1997 Intake and Output V 4 0 4 1 User Manual Enter Edit Patient Intake and Output This software does not prevent intake and output measurements from being entered for patients on leave status e g authorized unauthorized or those that are deceased When the date and time the data was collected is later than the date time the patient died or was placed on leave the software displays a reminder Following this message the user may continue entering data A patient s I amp O information is printed on the following reports Print I O Summary by Patient by Shift amp Day s Print I O Summary Midnight to Present Print I O Summary 48 Hrs 24 Hours Itemized Shift Report Information on a patient s detailed intake is printed on the 24 Hours Itemized Shift Repo
86. tion absorbed is unknown Unit mls is not required AMOUNT LEFT 300 Enter the amount left in the IV bag bottle Intake for this period 200 mls Yes RET Yes The user validates the amount of the IV fluid absorbed Do you wish to Convert to lock port Hang At the next prompt the user may enter RET to document removal of the IV a new solution line catheter Pleas nter the FIRST character for your selection or press return to continue RET The IV site has no more solutions hanging Do you want to DC IV SITI RET Yes 1 NO REDNESS PAIN SWELLING 2 NON TENDER 3 TENDER 4 RED 5 SWOLLEN 6 DRAINAGE 7 SLOUGH 8 FRANK PUS Select from 1 to 8 enter 1 3 5 etc to describe the infusion site NO REDNESS PAIN SWELLING 1 Start IV 2 Solution Replace DC Convert Finish Solution 3 Replace Same Solution 4 DC IV Lock Port and Site 5 Care Maintenance Flush 6 Add Additional Solution s 7 Restart DC d IV 8 Adjust Infusion Rate 9 Flush 3 Replace same solution Select fro m 1 to 9 enter 1 3 5 etc or RET to exit 3 REPLAC E SAME SOLUTION 1 RIGHT W NS A 2 LEFT SU LOCK P April 1997 RIST ANGIO CATH 14 30 ml hr Started on 02 14 97 15 05 BCLAVIAN TRIPLE LUMEN 1 DISTAL ORT Converted on 02 14 97 15 03 Intake and Output V 4 0 User Manual E Yes
87. tronically document patient intake e g oral fluids tube feedings intravenous fluids irrigations and other types of intake defined by the facility and patient output e g excreted patient material such as urine nasogastric secretions emesis drainage liquid feces stool and other types of output defined by the facility ntake data can be entered through either a quick or detailed route The quick route documents the total fluid consumed Detailed information requests the user to enter specific type of fluid intake e g orange juice water soup along with the quantity absorbed The Start Add DC IV and Maintenance option contains nine protocols associated with intravenous therapy 1 Start IV Start a new IV line or heparin saline lock port 2 Solution Replace DC Convert Finish Solution DC current solution then replace a new solution to the selected IV line or convert the IV according to the user s choice 3 Replace Same Solution Replace the same solution to a selected IV 4 D C IV Lock Port and Site Remove IV lock port from a selected IV site 5 Care Maintenance Flush Check site condition dressing change tube change and flush 6 Add Additional Solutions s Add additional solution s without discontinuing an existing one 7 Restart DC d IV Restart an IV which was DC d due to infiltration or other reasons 8 Adjust Infusion Rate Adjust infusion rate for a selected IV 9 Flush Flush all IV li
88. ual Maintenance of Site Files GMRY FILE EDIT Configure I O Files ADP Coordinator Only Description This menu is provided for the ADP Coordinator to configure the following file entries GMRY INPUT TYPE 4126 56 GMRY OUTPUT TYPE 2126 58 GMRY OUTPUT SUBTYPE 2126 6 GMRY IV SITE 2126 7 GMRY INTAKE ITEMS 4126 8 GMRY NUR IV SOLUTION 4126 9 GMRY NUR SHIFT OTHER 4126 95 GMRY IV SITE DESCRIPTION 2126 72 GMRY IV CATHETER 4126 74 and GMRY IV DC ED REASON 4126 76 Additional Information The first area of concern is to ensure that you have the appropriate entries in the site specific files to use the software at your hospital ambulatory care facility or other VHA facility When the application is installed all files have a few entries to assist you with initially running the software but you will have to enter appropriate facility related data in the site configurable files You may always edit file data if that data does not apply to a specific site deleting data is not always permitted Menu Display Select OPTION NAME GMRYMGR Patient Intake Output Menu 1 Enter Edit Patient Intake 2 Enter Edit Patient Output 3 Start Add DC IV and Maintenance 4 Print I O Summary by Patient by Shift amp Day s 5 Print I O Summary Midnight to Present 6 Print I O Summary 48 Hrs 7 24 Hours Itemized Shift Report 8 Intravenous Infusion Flow Sheet 9 Configure I O Files ADP Coordinator Only Select Pat
89. ware The following steps should be followed when the Intake and Output software is installed in an environment where no previous installation of the Intake and Output application has taken place 1 Setting up the software environment Information Resource Management Services IRMS staff must install the software using the Installation Guide in either a test environment or the production VAH directory The following VISTA Veterans Health Information Systems and Technology Architecture packages should reside in the environment where the Intake and Output application is to be installed Kernel V 8 0 or greater Kernel Toolkit V 7 3 or greater VA FileMan V 21 or greater PIMS MAS V 5 3 or greater Inpatient Medications V 4 5 or greater optional iS a eru The Intake and Output software must be installed before the Nursing V 4 0 application can be installed because specific Nursing V 4 0 options are dependent upon the Intake and Output routines Data entered into the test environment CANNOT be transferred into the production environment It is recommended that a limited amount of data be entered into the test directory in order for the user to become familiar with the application and to establish an acceptable training data base The Intake and Output application displays ordered IV solutions for a patient from the Inpatient Medications software Without Inpatient Medications loaded users may still implement the S
90. y INTAKE AND OUTPUT USER MANUAL Version 4 0 April 1997 Department of Veterans Affairs Software Service Clinical Support Product Line Preface This manual has been developed for clinical IRMS Information Resource Management Service and CIOFO Chief Information Office Field Office staff for the purpose of describing the implementation and use of the Intake and Output application The content covers software implementation site configurable file maintenance on line documentation functional use of each option menu access and prototype screen displays The content of this manual was prepared under the auspices of the multi disciplinary Nursing Focus Group that provided the application s developers with functional specifications April 1997 Intake and Output V 4 0 User Manual Preface ii Intake and Output V 4 0 April 1997 User Manual Table of Contents Section 1 Package Management Introduction izan aean cities e dada b inpe dan Pep Double aq Pra uod dlpe add Pepe ad dad QUO adu Did dau a dd 1 Chapter 1 Implementation and Maintenance cccccccessssssesseeeeceeeeceeeeeeeeeeceeeeeeaes 1 1 BIBIT T ITE TT DR TUS LET EH D 1 1 Virgin Installation of software eeeeeeeseseseeeseeeeseeee nennen eene 1 1 Setting up the software environment seeeeeeeeeeennneeneeenen 1 1 Name spacing and file listing eseeeseeeeeeeeeeeeeeeeeennne mene 1 1 Editing site configur

INTAKE AND OUTPUT USER MANUAL Version 4.0 April 1997

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