SMART Infusion PumpSMART Infusion PumpAdministration of Intravenous Therapy however, a change to time will automatically recalculate VTBI. DO NOT CHANGE THE TIME FIELD after initial programming. This alters the original value that was entered in VTBI. Therefore, only change the rate if needed.3.Press Next A.4.Review confirmation screen for accuracy and press Start Basic A.5.Confirm the green channel LED light is lit, and the primary line icon is visible.Touch the screen to display split channels and the Larger Font Size (“Far View Screen”), or it will automatically default to Far View Screen in 20 seconds. 17Piggyback InfusionPiggyback Infusion1.Do NOT stop Basic Infusion.2.Tap screen to move to near view screen.3.Press Piggyback button.4.Press Select Infusion field select drug and concentration.Note: If required, press Weight field and enter the patients weight.1.Press VTBI field, program volume and press Enter.2.Press Time field, program time and press Enter.3.Rate will automatically be calculated; however, a change to time will alter the VTBI. DO NOT CHANGE THE TIME FIELD after initial programming. This alters the original value that was entered in VTBI and medication delivery. Therefore, only change the rate if needed.1.Press Next A and press OK to confirm Clinical Note.2.Press Start Piggyback A.3.Confirm the green channel LED light is lit, and the piggyback icon is visible.18Piggyback InfusionPiggyback Infusion“Piggyback” and “Secondary” are interchangeable terms.Piggyback option is only available if a primary infusion has been programmed and confirmed.The maximum rate a piggyback infusion can be programmed is 500 ml/hr.A pop-up screen will appear as a reminder before the start of every piggyback infusion.When a piggyback infusion is completed, the infuser automatically switches back to the primary infusion at the pre-programmed rate.Rate is automatically calculated when VTBI and time are entered; however, a change to time will alter VTBI. DO NOT change the time field after initially programming. Only change the rate if needed.19Outside LimitsOutside LimitsIf the dose or rate entered is higher or lower than the predefined parameters, an Outside Limit Message will appear. The RHCP must first ensure that it is not a key stroke error.Note:Doses/rates within the green zone are safe. Only doses/rates within the soft limits can be overridden. Hard limits cannot be overridden.An icon will be displayed indicating the delivery is outside the predefined parameters. 20Soft/Hard LimitsSoft/Hard LimitsSoft Limit Alert:Review the medication order and IV Manuals to determine whether an override of the limit is warranted.Consult the most responsible physician if required. Pharmacy is available as a resource.Press Edit to re-enter a value or press Override to accept the dose and begin infusion.Rationale must be documented as per unit standards.Hard Limit Alert:Review the medication order with the physician. Pharmacy is available as a resource.Upon physician approval, deliver the medication using the “Other Drug” option.Independent double check on the MAR/eMAR must be performed before delivering the medication as “Other Drug”.Rationale must be documented as per unit standards.21“Other Drug” Option“Other Drug” OptionCaution: The use of “Other Drug” option does not provide any drug dosing limits as a safety feature. Therefore, “Other Drug” option should only be used in the following 3 situations:1.“Hard Limit Alert” with physician approval.2.Medications that are NOT listed in both the IV manuals or the current CCAs drug library.3.Medications that are listed in the IV manuals but NOT listed in current CCAs drug library.Every time the “Other Drug” option is used, the following steps must be done:Review IV manuals and physician orders.Consult the most responsible physician for approval before proceeding.Pharmacy is available as resource. An independent double check must be performed.The rationale for using this option must be documented as per unit standards.Pharmacy must be notified by paper/electronic reporting tool.22“Other Drug” Option“Other Drug” Option1.Select Other Drug.2.Select _ _/_mL concentration.3.Press Select and press the appropriate medication unit.4.Press Total Drug Amount in Container field, program drug amount and press Enter.5.Press Total Volume in Container field, program volume and press Enter.6.Press Enter again.7.Press Select, choose unit from list, program dose and press Enter.8.Press VTBI field, program volume and press Enter.9.Press Time field, program time and press Enter.10. Rate will be calculated automatically; however, a change to time will alter VTBI.DO NOT CHANGE THE TIME FIELD after initial programming. This alters the original value that was entered in VT