Codonics SLS Total Dose/Total Volume
Contents
1. es el Technical Support If problems occur when using the SLS system contact Codonics Technical Support Phone 1 440 243 1198 Email support codonics com Website www codonics com 4 CODONICS We bring the future into focus 17991 Englewood Drive Codonics Limited KK Middleburg Heights OH 44130 New Shibaura Bldg F1 USA 1 3 11 Shibaura 1 440 243 1198 1 440 243 1334 Fax JAPAN Email info codonics com Phone 81 3 5730 2297 www codonics com Fax 81 3 5730 2295 Minato ku Tokyo 105 00232. The JP L1 Label Template Pack supports printing of TD TV on the label The JP S1 and STD 1 Label Template Packs will show TD TV on the 500i user interface but not print TD TV on the label For more information about the Label Template Packs refer to the Codonics SLS Administration Tool Localization Enhancements Technical Brief part number 901 261 001 2 With the formulary drug list displayed click the drug record s Edit icon Edit icon Administrator Log Out Template Message Actions Miscellaneous White U x a e Miscellaneous White L e x iin EPINEPH Miscellaneous White 4 x I The Editing Formulary Drug s dialog box displays 3 In the Dilution Status list select the dilution status Allowed Not Allowed or Required Editing Formulary Drug s Ephedrine ePHEDrine fede 40 mg mL i ie st it Expires 09 08 2012 08 42 By kama reprae mours Dilution Status Allowed vi Preparation 7 f 1 f a Method Total Dose Total Volume Dilutions Total Dose Total Volume Edit M Sterilized Water Custom 1 e MV Normal Saline Custom 2 e Diluents Dsw Custom 3 e l Ringers Lactate Custom 4 e l Other Miscellaneous v X Cancel Vv Save Dilution Status list 4 Inthe Preparation Method list select Total Dose Total Volume Editing Formulary Drug s Ephedrine ePHEDrine KERA 40 mg mL KERS Expires 09 08 2012 08 42 By ka
3. Behavior The following examples show the TD TV prompt behavior on 500i during the label printing procedure The examples are based on the drug s Dilution setting and TD TV entries as specified in the AT These are examples only they do not represent an actual drug situation The examples are intended to represent how the TD TV works and its behavior in the AT and 500i NOTE If the TD TV equivalent concentration is within 1 of the original container concentration the system considers the TD TV to be equivalent to the original concentration Otherwise the system considers the TD TV to be a dilution For example if the original container concentration is 0 3 g but the TD TV entry is 0 333 then they are considered different and 0 333 is considered a dilution A warning will be displayed for the relevant AT and 500i use cases Example 1 For this example The drug is Morphine The Always Show TD TV configuration option on the Safety tab of the AT s Configuration Manager section was selected The original drug container concentration is 10 mg mL The dilution status is set to Allowed The available diluents are Normal Saline Sterile Water and Other The TD TV entries include multiples of the original container concentration and dilutions of the original concentration 10 mg 1 mL 10 mg 10 mL 10 mg 20 mL 10 mg 100 mL 20 mg 2 mL Other mg mL oO o The formulary settings for this drug on t
4. Total Dose Total Volume Dose Volume Concentration Diluent 10 mg 1 mL 10mg mL Other mg mL Other mg mL O Only TD TV entries whose concentration is equivalent to the original container concentration are displayed and no diluents are displayed gt O CODONICS Ifthe Dilute switch is set to On the following prompt that indicates that dilutions are allowed is displayed Morphine Choose a Total Dose Total Volume Dose Volume Concentration Diluent 10 mg 10 mL 1mg mL 10 mg 100 mL 0 1mg mL Sterilized Water 10 mg 20 mL 0 5mg mL Normal Saline Example 6 For this example The drug is Morphine The Always Show TD TV configuration option on the Safety tab of the AT s Configuration Manager section was not selected NOTE The Always Show TD TV configuration option applies to all drugs in the formulary The original drug container concentration is 10 mg mL The dilution status is set to Allowed The available diluents are Normal Saline Sterile Water and Other The TD TV entries include a concentration that is equivalent to the original container concentration and a dilution e 10mg 1mL e 10mg 10 mL The formulary settings for this drug on the Editing Formulary Drug s dialog box in the AT are shown in the screen at the top of the next column Editing Formulary Drug s Morphine ee ee Dilution Status Allowed a Preparation Mahad Tot
5. example The drug is Heparin The Always Show TD TV configuration option on the Safety tab of the AT s Configuration Manager section was selected The original drug container concentration is 10 000 Units mL The dilution status is set to Not Allowed There are no available diluents The TD TV entries include multiples of the original concentration dilutions of the original concentration and an Other entry 10 000 Units 1 mL 10 000 Units 2 mL 20 000 Units 2 mL 20 000 Units 4 mL 40 000 Units 4 mL Other Units mL 6M The initial formulary settings for this drug on the Editing Formulary Drug s dialog box in the AT are shown below Editing Formulary Drug s Heparin Heparin 10 000 units mL Expires 09 05 2012 16 30 By gt eri Not Allowed w Status Not Allowed Preparation Method Total Dose Total Volume Dilutions 10 000 Units 1 mL 10 000 Units 2 mL 20 000 Units 2 mL 20 000 Units 4 mL Edit 40 000 Units 4 mL Other Units mL Total Dose Total Volume Sterilized Water Custom 1 e Normal Saline Custom 2 e Diluents M DSW l Custom 3 e Ringers Lactate l Custom 4 e l Other Miscellaneous Mi X Cancel vV Save However because dilutions are not allowed the following prompt would be displayed after selecting TD TV entries that represent dilutions of the original container concentration Warning following entries have conc
6. Codonics SLS Technical Brief Total Dose Total Volume Overview This document describes how to setup and use the Total Dose Total Volume TD TV drug preparation method with the Codonics Safe Label System SLS This document explains e How Administration Tool AT users can enter TD TV information for drugs in a formulary e How SLS 500i users can select TD TV entries on 500i to provide printed syringe labels with TD TV information SLS Drug Preparation Methods There are two preparation methods for managing how drugs are labeled Normal Dilution and TD TV The Normal Dilution method is commonly used in OR environments where the amount and frequency of drug administration can vary Since the total dose being administered might not be known ahead of time the primary information required on the syringe label is the drug name and prepared concentration TD TV is commonly used when an order or prescription for a drug is issued and the drug is prepared according to the instructions in the order TD TV is also used in applications involving infusion pumps Drugs prepared in this manner include the drug name the total dose to be administered and the total volume of the drug and diluent in the final preparation 500i also includes the equivalent concentration of the preparation on the label for regulatory compliance SLS allows multiple TD TV preparations to be associated with each drug The preparations are set up using t
7. ODONICS Formulary Devices Buiki formulary for SLS Manage SLS Devices g Create Package Security Media Enable Test Prints M System Test Print on Every Login Vv Test Print on First Login Custom Labels Test Print Every 24 Hours General Verify On SLS xI xI Confirm Before Print x Confirm After Print xI Speak Drug Name xI Speak Concentration Always Show TD TV a lt I Disable Wired Hand Scanner Always Show TD TV option gt O CODONICS Ifthe Always Show TD TV option is selected the default the TD TV prompt will always display during the label printing procedure on 500i Ifthe Always Show TD TV option is deselected then the TD TV prompt will not display if there is only one TD TV entry and one diluent In that case the procedure will go directly to displaying or printing the label To disable the Always Show TD TV option you must deselect the option create a configuration package and deploy the configuration to each 500i On the AT Specifying TD TV Entries for a Drug in fhe Formulary The following procedure covers only the drug formulary settings that are specific to TD TV For more information about other drug formulary settings refer to the SLS Administration Tool User s Manual 1 Select the Label Template Pack that you want to create for the specific formulary All Label Template Packs support TD TV if the drug s preparation method is set to TD TV
8. al Dose Total Volume gt Dilutions Total Dose 10 M9 1 mL 10 mg 10 mL Total Volume Edit M Sterilized Water Custom 1 e M Normal Saline Custom 2 e Diluents M DSW l Custom 3 e 7 Ringers Lactate Custom 4 e M Other Miscellaneous Ml X Cancel vV Save On 500i Ifthe Dilute switch is set to Off the TD TV entry whose concentration is equivalent to the original container concentration will be automatically selected because it is the only non diluted concentration defined for the drug A TD TV prompt is not displayed Ifthe Dilute switch is set to On the TD TV prompt will display as follows Q Morphine Choose a Total Dose Total Volume Dose Volume Concentration Diluent Sterilized Water 10 mg 10 mL 1mg mL Normal Saline Other SD The prompt is displayed because even though there is only one dilution value multiple diluents have been selected for the drug If only one diluent had been selected then the dilution and diluent would have been automatically selected by the system and no prompt would have been displayed gt O CODONICS Example 7 For this example The drug is Morphine The Always Show TD TV configuration option on the Safety tab of the AT s Configuration Manager section was selected The original drug container concentration is 10 mg mL e The dilution status is set to Allowed The available diluents are Normal Sa
9. eate an Other TD TV entry An Other TD TV entry allows you to specify only the combination of TD TV units For an Other entry a 500i user will enter the values for the TD TV unit combination when creating the label b Toallow TD TV and equivalent concentrations to be highlighted in cases for which there is a non standard equivalent concentration that should be alerted on the 500i user interface and on printed labels select the Highlight check box c Click the Add Total Dose Total Volume button The new entry is added to the list Set Total Dose Total Volume Choose Total Dose Total Volume f 0 04 mg 0 08 mL 0 5 mg mL 40 mg 10 mL 4 mg mL Total Dose Total Volume Select Number v Select Units v Select Number Select Units Highlight xX Cancel vy Set Total Dose Total Volume d Create additional entries as needed 7 Select the check boxes for the TD TV entries that apply to the drug 8 To save your selections click the Save Total Dose Total Volume button The selected TD TV entries are displayed in the Editing Formulary Drug s dialog box Editing Formulary Drug s Ephedrine ePHEDrine seit 40 mg mL st St ed Expires 09 08 2012 08 53 By kam ee mours A Dilution Status Required Mi Preparation Method Total Dose Total Volume v Dilutions Total Dose 10 mg 10 mL 20 mg 10 mL 40 mg 10 Edit Total Volume mL 40 m
10. entrations that may be dilutions of the original drug e 10 000 Units 2 mL 5 000 Units mL e 20 000 Units 4 mL 5 000 Units mL Original container concentration 10000 Units mL i The Dilution Status of this drug is Dilution Not Allowed The To correct this problem consider changing the Dilution Status of this drug or changing the entries shown Cancel If dilutions are not intended to be included the entries listed in the Warning message should be removed If dilutions are intended to be included then the Dilution Status should be changed to Allowed The following example shows the dilution entries removed to resolve the problem gt O CODONICS Editing Formulary Drug s Heparin Heparin 10 000 units mL Expires 09 05 2012 16 30 By ari en ae nuurs gt Dilution Status Not Allowed Preparation A 7 Method Total Dose Total Volume Dilutions Total Dose 10 000 Units 1 mL 20 000 Units 2 mL Total Volume 40 000 Units 4 mL Other Units mL Edit Sterilized Water FT Custom 1 e Normal Saline Custom 2 e Diluents M Dsw l Custom 3 e Ringers Lactate Custom 4 e Other Miscellaneous sj X Cancel vV Save If no changes were made to the original TD TV entries or dilution status on 500i Ifthe Dilute switch is set to Off the TD TV prompt will display as follows Heparin Choose a Total Dose Total Volume Dose Volume Concentration Di
11. g 20 mL 40 mg 40 mL Sterilized Water Customi xI 2 M Normal Saline Custom 2 Diluents DSW E Custom 3 Ringers Lactate E Custom 4 4 Other Miscellaneous Ms X Cancel vV Save 9 Enter the other formulary information required for the drug 10 Click the Save button to save the formulary drug information The TD TV information is displayed in the Total Dose Total Volume column in the drug list gt O CODONICS Bats Pachage Create fevort Morphine Choose a Total Dose Total Volume x Dose Volume Concentration Diluent tions 10 mg 10 mL 1mg mL Sterilized Water 10 mg 100 mL 0 1mg mL Normal Saline 10 mg 20 mL 0 5mg mL Other P _ a 3 Press and or drag the Dose Volume list until the 11 When you have finished entering information for the appropriate TD TV entry and equivalent concentration drugs in the formulary create a formulary package and is selected that is it is displayed under the blue deploy it to 500i For more information refer to the SLS highlighted bars Administration Tool User s Manual 4 Press and or drag the Diluent list until the appropriate diluent is selected On 500i Ifthe dilution status for the drug is Not Allowed the Entering TD TV Values for a Syringe only option in the Diluent list will be None Label Ifthe dilution status for the drug is Allowed a None option is included at the bottom of the Diluent list For d
12. he AT and included as part of the SLS formulary When a drug container is scanned on 500i the user can select from the TD TV preparations associated with that drug Notes About the TD TV Preparation Method Note the following about the TD TV preparation method The TD TV information will be printed on labels that support it for example 30 x 80 mm Japan labels JP L1_vxx and shown on any applicable previews However if the selected drug classification template does not support TD TV information the TD TV dialog boxes described in this Technical Brief will still appear on 500i but the label will not have any TD TV information printed on it e TD TV information is not encoded in the syringe barcode The TD TV function is only supported for single drugs in the formulary It is not supported for combination drugs e Administer Mode will only announce the drug name and equivalent concentration but not the TD TV values On the AT Setting the Always Show TD TV Option The Always Show TD TV option which is located on the Safety tab of the AT s Configuration Manager section controls when the TD TV prompt displays during the label printing procedure on 500i NOTE The Always Show TD TV option applies only to drugs that are assigned the TD TV preparation method For drugs that are assigned the Normal Dilution preparation method the prompt for dilutions and diluents works as described in the SLS User s Manual C
13. he Editing Formulary Drug s dialog box in the AT are shown below Editing Formulary Drug s Morphine ry gt Dilution ee Allowed v Preparation Ei Total Dose Total Volume Dilutions 10 mg 1 mL 10 mg 10 mL 10 mg 20 Total Dose mL 10 mg i00 mL 20 mg 2 mL Other Edit ma Total Volume M Sterilized Water Custom 1 e MV Normal Saline Custom 2 e Custom 3 e Ringers Lactate l Custom 4 e M Other Diluents M Dsw Miscellaneous lt X Cancel Vv Save On 500i Ifthe Dilute switch is set to Off the TD TV prompt will display as follows Morphine Choose a Total Dose Total Volume Dose Volume Concentration Diluent 10 mg 1 mL 10mg mL 20 mg 2 mL 10mg mL Other mg mL Other mg mL No diluted TD TV entries or diluents will be shown because the Dilute switch is set to off Only TD TV entries with concentrations that are equivalent to the original concentration for example 10 mg mL are displayed and no diluents are displayed If the Dilute switch is set to On the TD TV prompt will display as follows gt i O CODONICS Q Morphine Choose a Total Dose Total Volume Dose Volume Concentration Diluent 10 mg 10 mL 1mg mL Sterilized Water 10 mg 100 mL 0 1mg mL Normal Saline 10 mg 20 mL 0 5mg mL Other Only TD TV entries that are dilutions of 10 mg mL are displayed and the diluents are displayed Example 2 For this
14. line and Sterile Water The only TD TV entry is Other mg mL The formulary settings for this drug on the Editing Formulary Drug s dialog box in the AT are shown below Editing Formulary Drug s Morphine a nuurs gt Dilution Status Allowed v Preparation Method Total Dose Total Volume Dilutions Total Dose Other mg mL P Total Volume Edit M Sterilized Water Custom 1 e MV Normal Saline l Custom 2 e Diluents M Dsw l Custom 3 4 7 Ringers Lactate Custom 4 e l Other Miscellaneous v X Cancel Vv Save Get it all with just one call 800 444 1198 All registered and unregistered trademarks are the property of their respective owners Specifications subject to change without notice Patents pending Copyright 2012 Codonics Inc Printed in the U S A Part No 901 259 001 02 On 500i if the Dilute switch is set to Off only the Other entry will be displayed in the TD TV prompt Morphine Choose a Total Dose Total Volume Concentration Diluent a aa Dose Volume Other mg mL Other mg mL TD If the Dilute switch is set to On and the user selects a TD TV entry whose concentration is equivalent to the original container concentration for example 20 mg 2 mL the system will display the following message to indicate that the entered TD TV might not be a dilution This may not be a diluted value Are you sure you want to continue
15. luent 10 000 Units 1 mL 10 000U 20 000 Units 2 mL 10 000U 40 000 Units 4 mL 10 000U ee ae ce No dilution values of 10 000 Units mL will be shown Only TD TV entries that are equivalent to the original container concentration of 10 000 Units mL are displayed for example 20 000 Units 2 mL and no diluents are displayed Ifthe Dilute switch is set to On the following prompt that indicates that dilutions are not allowed is displayed Dilution not allowed Example 3 If the Warning shown in example 2 is ignored and a TD TV entry is a dilution but the Dilution setting is Not Allowed then the 500i user will be able to choose a dilution but no diluents will be displayed You should be aware that this configuration overrides the intention of not allowing dilutions Example 4 For this example The drug is Atropine The Always Show TD TV configuration option on the Safety tab of the AT s Configuration Manager section was selected The original drug container concentration is 0 5 mg mL The dilution status is set to Required The available diluents are Normal Saline and Sterile Water The TD TV entries include multiples of the original container concentration dilutions of the original concentration and an Other entry 0 25 mg 10 mL 0 5 mg 1 mL 0 5 mg 5 mL 0 5 mg 10 mL 0 5 mg 50 mL 1 mg 2 mL Other mg mL 0 0 o o The initial formulary settings for this drug o
16. m TENS O A a mours Dilution Satun Required v Preparation Method Total Dose Total Volume Dilutions Total Dose Total Volume Edit M Sterilized Water Custom 1 e M Normal Saline Custom 2 e Custom 3 e Ringers Lactate Custom 4 e Diluents DSW l Other Miscellaneous X Cancel vV Save Total Dose Total Volume selected in the Preparation Method list 5 Click the Total Dose Total Volume Edit button The Set Total Dose Total Volume dialog box displays gt O CODONICS Set Total Dose Total Volume Choose Total Dose Total Volume 9 04 mg 0 08 mL 0 5 mg mL Total Dose Total Volume Select Number vi Select Units v Select Number v Select Units v Highlight X Cancel VY Set Total Dose Total Volume If the TD TV entries that you want to use are listed go to step 7 If the TD TV entries that you want to use are not listed you can add them Go to step 6 6 ToaddaTD TV entry a Select the values and units for the new entry in the Total Dose and Total Volume number and units lists Values and units selected in lists Set Total Dose Total Volume Choose Total Dose Total Volume f 0 04 mg 0 08 mL 0 5 mg mL Total Dose Total Volume v f mL E Highlight Add Total Dose Total Volume XX Cancel v Set Total Dose Total Volume The number lists include an Other option to cr
17. n the Editing Formulary Drug s dialog box in the AT are shown below gt i O CODONICS Editing Formulary Drug s Atropine peers mours a Satie Required v ahi Total Dose Total Volume Dilutions 0 25 mg 10 mL 0 5 mg 1 mL 0 5 mg 5 Total Dose mL 0 5 mg 10 mL 0 5 mg 50 mL 1 Edit mg 2 mL Other mg mL M Sterilized Water J Custom 1 e M Normal Saline I Custom 2 e Diluents T psw IT Custom 3 e Ringers Lactate Custom 4 e l Other Miscellaneous w However because dilutions are required the following prompt would be displayed after selecting TD TV entries that are equivalent to the original container concentration entries have concentrations that may not be dilutions of the original drug 0 5 mg l mL 0 5 mg mL e 1 mg 2 mL 0 5 mg mL Original container concentration 0 5 mg mL 1 The Dilution Status of this drug is Dilution Required The following To correct this problem consider changing the Dilution Status of this drug or changing the entries shown To correct this condition the values listed in the Warning message should be removed so that the final settings are as shown below Editing Formulary Drug s Atropine apenre mours a noen Required b reparation Dilutions Total Dose 0 25 mg 10 mL 0 5 mg 5 mL 0 5 mg 10 Edit Total Volume mL 0 5 mg 50 mL Other mg mL M Sterilized Water Custom 1 MV Normal Saline l Cust
18. om 2 e Diluents M psw Custom 3 4 i Ringers Lactate J Custom 4 e Other Miscellaneous al X Cancel vV Save Based on the final settings shown above on 500i the following TD TV prompt displays regardless of whether the Dilute switch is set to Off or On Atropine Choose a Total Dose Total Volume Dose Volume Concentration Diluent 0 25 mg 10 mL 0 025mg mL Sterilized Water 0 5 mg 10 mL 0 05mg mL Normal Saline Cancel Only TD TV entries that are dilutions are displayed and the diluents are displayed S O CODONICS Example 5 For this example The drug is Morphine The Always Show TD TV configuration option on the Safety tab of the AT s Configuration Manager section was selected e The original drug container concentration is 10 mg mL The dilution status is set to Allowed The available diluents are Normal Saline and Sterile Water The TD TV entries include multiples of the original container concentration a concentration that is higher than the original concentration dilutions of the original concentration and an Other entry 10 mg 1 mL 10 mg 10 mL 10 mg 20 mL 10 mg 100 mL 20 mg 1 mL Other mg mL o o The initial formulary settings for this drug on the Editing Formulary Drug s dialog box in the AT are shown below Editing Formulary Drug s Morphine Dilution Status Allowed be Preparation Method Total Dose Total Volume
19. rugs in the formulary whose preparation method was specified as TD TV you will automatically be prompted to enter the TD TV values when printing a syringe label Ifthe dilution status for the drug is Required a None option is not included in the Diluent list 1 Before scanning the drug container barcode if the intent 5 To save your selections press the OK button is to dilute the drug set the Dilute switch to on If you did not select an Other TD TV option then continue in the label printing workflow as described in the SLS User s Manual If you selected an Other TD TV option you are prompted to enter the dose and volume values Morphine Enter Other Total Dose Total Volume Total Dose Total Volume mL Equivalent Concentration 10 mg mL Dilute switch on position 09 17 2012 14 06 6 Enter the TD TV values in the Total Dose and Total 2 Scan the drug container barcode Volume fields NOTE The drug will follow the verification steps as As you enter the values the system computes the described in the SLS User s Manual equivalent concentration and displays it in the Equivalent as m Concentration field After the drug is identified the prompt for the TD TV entries displays 7 To save the value entries click the OK button S O CODONICS You can continue in the label printing workflow as described in the SLS User s Manual Examples of TD TV Prompt
20. v Dilutions 10 mg 1 mL 10 mg 10 mL 10 mg 20 Total Dose as Pree mL 10 mg 100 mL 20 mg 1 mL Other Edit mg mL M Sterilized Water Custom 1 4 MV Normal Saline l Custom 2 e Diluents M Dsw l Custom 3 4 z Ringers Lactate I Custom 4 e l Other Miscellaneous v xX Cancel vV Save However because the 20 mg 1 mL entry has a concentration that is higher than the original container concentration the following prompt would be displayed after selecting the TD TV entries Warning Verify concentration values The following entries have a A concentration that is higher than the original drug concentration 20 mg i mL 20 mg mL Original container concentration 10 mg mL Cancel To correct this condition the higher concentration entry listed in the Warning message should be removed so that the final settings are as shown below Editing Formulary Drug s Morphine a mours gt Dilution Status Allowed a Preparation Method Total Dose Total Volume Dilutions Total Dose 10 mg 1 mL 10 mg 10 mL 10 mg 20 Edit Total Volume mL 10 mg 100 mL Other mg mL M Sterilized Water Custom 1 e MV Normal Saline Custom 2 e Diluents M D5W l Custom 3 4 a Ringers Lactate Custom 4 e l Other Miscellaneous v X Cancel Vv Save On 500i Ifthe Dilute switch is set to Off the TD TV prompt will display as follows Q Morphine Choose a
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