Hospira Sapphire PCA/Epidural Pump Handout

Transcription

1 Important Information You Need to Know 1. Order Sets Have been updated to reflect the new device terminology 2. Terminology: Crosswalk Current (Gemstar) New (Sapphire) Continuous Dose Continuous Rate Bolus Dose/Loading Dose Loading Dose Demand Dose Demand Bolus Demand Lockout Bolus Lockout 1 hr. Limit Total Dose per 1 hr. Total Dose Received Total Dose Received (Bolus + Continuous) 3. Priming 4. New Dose Delivery Methods Added Prime volume is displayed on the pump in milliliters (ml) To view the prime volume amount: Pause the infusion Enter security code: 1300 Click View/Edit option Select the View Systems option Click on next to navigate to the next page until you see the Prime Volume Document the prime volume in COMPASS on the PCA/Epidural/Peripheral Nerve Ad Hoc form Mg/kg Mcg/kg 5. Cleaning Instructions Wipe down pump with Seton approved bleach wipes Sani-Cloth (orange top container) For specific cleaning instructions go to: Intranet>Clinical Resources>Clinical Practice>Clinical Education>Resources A- Z>Under letter H look for Hospira Sapphire PCA and Epidural Pump Training Resources> Sapphire Infusion Devices: Steps to Device Cleaning 1

2 6. Basic Conversion from Total Volume (ml) Infused to Total Dose Received (mg/mcg) Formula Example: Concentration x Total Volume Received = Total Dose Received A patient on HYDROmorphone with a concentration of 0.2mg/ml and a total volume infused of 9.5 ml Total Dose Received = (0.2 mg X 9.5 ml) = 1.9 mg. The patient received a total dose of 1.9 mg of HYDROmorphone. 7. Documentation. Use the Ad Hoc form PCA/Epidural/Peripheral Nerve to document in COMPASS. See scenario handouts and document on the screenshots below (for practice) Screenshots from COMPASS Activity Medication Dose Delivery Method Continuous Rate Demand Bolus Bolus Lockout (min) Total dose per 1 hour Loading Dose Example Verified morphine mg Prime Amount PCA IV 1 PCA IV 2 Number of Pt. Boluses Given Number of Bolus Attempts Total Dose Received (Bolus + Continuous) Remaining Volume (ml) Waste (ml) Comment Example mg 0 4 hour check PCA IV 1 PCA IV 2 NOTE: To document activity, you can select more than one option. To document type of medication and the dose delivery method, you can only select one option. See screen shots below. Activity Medication Delivery Dose Method 2

3 Additional Documentation Elements Needed In addition to documenting the total dose received, you will need to document the following on the COMPASS Ad Hoc form PCA/Epidural/Peripheral Nerve (see screenshot above). Number of patient boluses given Number of patient bolus attempts To document number of patient boluses given and number of patient bolus attempts follow these steps: 1. Go to Bolus History option on the pump 2. Change Bolus History to 4 hrs 3. Then look for the elements (# of pt. boluses given and # of attempts) mentioned above 4. Document in COMPASS on the Ad Hoc form Change this to 4 hours Note # of bolus given and # of attempts On this screenshot the # of bolus given is 1 # of bolus attempts is 4 Document on the Ad Hoc form. Go to Bolus History 8. Trouble Shooting Process If you have issues or need assistance with the Hospira Sapphire pump (PCA or Epidural) after the go live, please follow these guidelines: 3

4 Frequently Asked Questions (FAQs) 1. Why can t I administer a clinician dose using the Sapphire PCA in the PCA mode? The clinician dose will be counted towards the total dose per hour thereby limiting the demand boluses per one hour. Therefore if an extra dose is needed, obtain a physician order and then administer that dose as an intravenous (IV) push and document on the emar. The clinician bolus should not be used for PCAs 2. Do I have to prime the tubing or remove air via the PCA/epidural pump or can I do that manually? Priming of PCA/Epidural tubing should be done using the pump to ensure accurate monitoring of controlled substances. The prime value (ml) should be documented in the PCA/Epidural/Peripheral Nerve Ad Hoc form because the prime volume is not added to the volume infused. 3. How do I use the PCA keys that are in the Omnicell medication dispensing cabinet? Please check out narcotic keys in the Omnicell medication dispensing cabinet using the patient s account. Return the narcotic keys to the Omnicell under the same patient account. This will ensure proper tracking of narcotic keys. 4. How often do we document in COMPASS? This practice has not changed. Document every 4 hours or per doctors orders 5. When do we use the continuous non PCA mode on the new Hospira Sapphire PCA pumps? The Hospira Sapphire PCA pump can be used for non PCA infusion like Ketamine infusion usually given in EDs and ICUs 6. What is the difference between the 500 ml and 250 ml lock box keys? See below, the 500ml lock box key is smaller than the 250 ml lock box key 4

5 Hospira Sapphire Pump Scenarios for ED Ketamine Use Scenario One ED The nurse receives an order to give a healthy 35 yr old, 70 kg patient 21 mg of ketamine by infusion for pain. Which Clinical Care Area (CCA) is the nurse supposed to select for ketamine dosages? Select Adult non- PCA CCA Which one of the medication dictionary listings should the nurse select? Select the Ketamine Low Dose (middle choice) Where is the ketamine documented? Document in the MAR Scenario Two The Nurse in the ED receives an order for Ketamine 10 mcg/kg/min infusion. Which library setting should the nurse select? Select Ketamine continuous infusion Adult Which parameters are entered? Dose rate (10mcg/kg/ min) 5

6 Notes: Write Your Notes Here 6