PCA and Health Link Updates
November 1, 2016 is the go-live date for the PCA discrete field functionality. This functionality will improve safety when ordering PCA. New orders placed will apply this functionality; current patients receiving previously ordered PCA will be unaffected with no change in workflow.
- PCA Loading Dose: As part of this upgrade, prescribers will have the option of ordering a PCA loading dose. This is a one-time bolus that can be given at the initiation of PCA therapy. This is a new feature for all adult profiles on the Alaris pump. Once programmed, the PCA pump will deliver the full Loading Dose immediately upon pump start. RNs may access instructions for programming a PCA loading dose using this link:
- Editing Bolus Dose Flowsheet Row: A potential for incorrect documentation of PCA bolus dosing exists if:
- PCA syringe is scanned on Rover,
- A Bolus dose is entered and then,
- Administration is discarded before completion
- Although no bolus was actually administered, the flowsheet row is documented automatically from Rover
- RNs must edit the bolus dose flowsheet row if cancelled/discarded administration. RNs may access instructions for editing bolus dose flowsheet row using this link: Editing PCA Bolus Flowsheet Row
Alaris Drug Library
- Name Change: Medication entries previously listed in the drug library as High Concentration selections for morphine, fentanyl, and hydromorphone are now listed as “Opioid Tolerant”. The selection for Standard morphine, fentanyl, and hydromorphone has not changed. See these changes in the document.
- New Drug Library Download: The Alaris pumps must download associated library changes to accept the activation of the Loading Dose feature and the renamed PCA entries. This is a process that often takes several days to complete throughout UWH. Pumps that are currently running take priority status with the Alaris server and will download the new drug library before pumps not currently in use. Use this link to download and activate the new drug library:
Does scanning with Auto ID take the place of scanning with Mobile Meds?
No, all medications must be scanned using Mobile Meds barcode scanner as currently practiced.
Will pump infusions be recorded in Health Link?
No, scanning with Auto ID does not populate patient’s medical record in Health Link.
Does scanning with Auto ID ensure that medications are delivered to patients at the right time?
No, Auto ID does not indicate if medication is programmed at the correct time. It does support other rights of medication administration such as: right drug, right dose, right patient, and right route.
What types of barcodes can I scan with Auto ID?
Alaris Auto ID is able to scan both NDC bar codes (linear – e.g. fluid bag) and 2- dimensional barcodes (pharmacy drug labels).
Which barcode should I scan?
When scanning barcodes, always scan the patient-specific barcode if available rather than the NDC (linear factory printed) barcode. Scan NCD barcodes only when patient-specific barcode labels are not attached.
08/03/2013 Dawn Berndt MS, RN, CRNI, Clinical Nurse Specialist ‐ Infusion
Am I required to scan the patient ID band in an emergency? What if I do not have a patient ID band?
When setting up the pump, press “CONFIRM” to bypass this prompt if unable to scan patient ID band during initial startup.
Patient ID can be added later by scanning ID band (or)
By pressing OPTIONS, selecting PATIENT ID, and using the numeric keypad to enter PATIENT ID (MR) from ID band.
How will I know if the patient’s ID has been scanned into the pump?
When entered, the patient’s MR number is shown on the Alaris Programming Unit just above the prompt bar. Scanning patient’s wristband once associates specific IV pump with the patient.
After entering patient ID, the patient’s wristband does not need to be scanned again.
Can I still attach four modules to the Alaris programming unit with the Auto ID module attached?
Yes, you may still attach four modules to the Alaris® programming unit when the Auto ID module is attached.
Does it matter which handheld scanner I use when I have several Alaris Programming Units for one patient?
When using multiple Programming Units on one patient, the handheld scanners must be used only with the programming unit to which it is connected. Each programming unit has its own Auto ID scanner.
Why do I need my employee ID badge when using Auto ID?
Before programming any medications or fluids the pump will require the clinician to either scan his/her badge or manually enter the employee number to unlock the pump.
How soon will the pump lock after I have finished programming an infusion?
The pump locks five minutes after the last key press requiring the clinician to scan his or her badge or enter employee ID number before operating the pump.
What if I would like to have my pump lock immediately without waiting for five minutes?
If you would like to have the pump lock earlier than 5 minutes, you may press and hold the tamper resist button on the back of the pump for three seconds. This action will lock the pump.
What if I need to unlock the pump in an emergency?
Press and hold the Tamper Resist button on back of pump for 3 seconds. This action will unlock the pump.
What if my patient is in isolation and my badge is under my isolation gown?
Enter Employee ID manually by pressing OPTIONS, selecting Clinician ID, and using numeric keypad to enter employee ID number.
If I program an infusion for my patient, am I the only one who can use the pump or unlock it now?
No, any nurse can scan his/her badge to operate a pump.
Can I do anything on the pump without unlocking it first?
All actions on the pump require the pump to be unlocked. The silence key can be used to silence an alert, but the pump must be unlocked to solve the issue.
Will I use the Alaris Auto ID scanner for programming blood infusions?
No, blood products will not have a scannable barcode and will not be recognized by the pump. When programming blood products, press Channel Select on the module, select Guardrails Fluid Library, and then manually select the blood product from the list for programming.
Will the exact name of my patient’s IV fluid scroll on the module?
Not always. Many fluids when scanned will populate and scroll as Maintenance IV Fluid or Maintenance IV Fluid with 10, 20, 30, 40 KCL. Other fluids with higher concentrations of constituents such as 3% sodium chloride will populate and scroll the specific name of the fluid.
Do I need to order an Auto ID module when obtaining a pump from Central Services:
No, the Auto ID module is permanently attached to the Alaris programming unit and does not need to be ordered separately.
What if the Auto ID barcode scanner is broken or doesn’t work?
Alaris® System can be used manually by pressing Channel Select, then Guardrail Drugs to select from the library if the Auto ID scanner does not function.
Alaris Auto ID Resouces
Intravenous Administration of Formulary Medications - Pediatric - Inpatient/Ambulatory
Hospital Administrative Policy:
High Alert Medication Administration
Nursing Patient Care Policies:
1.24 Alaris System
1.19 Needle Free IV System
1.17 Patient Controlled Analgesia