CADD Pump Performance Checklist - UC Davis Health System
CADD Pump Performance Checklist - UC Davis Health System
CADD Pump Performance Checklist - UC Davis Health System
Create successful ePaper yourself
Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.
Section 1<br />
Skill Ferformance Documentation<br />
for <strong>Health</strong> Care Personnel<br />
Page 1 of4<br />
The <strong>CADD</strong>@-Solis <strong>Pump</strong> Skill <strong>Performance</strong> Form is intended to be used by health care personnel<br />
who are instructed in initial pump programming, pump operations, and program changes.<br />
Participant Name Date<br />
<strong>CADD</strong>@-Solis ambulatory infusion pump<br />
<strong>CADD</strong>- medication cassette reservoir with <strong>CADD</strong>@ extension set<br />
<strong>CADD</strong>@ administration set<br />
<strong>CADD</strong>o disposables to be used with epidural infusions, if applicable<br />
Remote dose cord<br />
Polemount bracket adapter<br />
lnstallthe batteries or a rechargeable battery pack<br />
Press the power button to turn the pump on<br />
ldentify the following:<br />
tr Function of the green and amber indicator lights<br />
D Function of each key on the keypad<br />
I Power button<br />
I Cassette latch<br />
tr Cassette/keypad lock<br />
D USB port<br />
0 Remote dose cord jack<br />
SAMPLE: NOT FOR USE WITHOUT INSTITUTIONAL APPROVAL.<br />
<strong>CADD</strong>. <strong>CADD</strong>-Solis, and the <strong>CADD</strong> and Smiths Medi€l deslgn marks are trademarks of Smiths Medical. The<br />
symbol @ indicates the trademark is registered in the U. S. Patent and Trademark Office and certain other countries.<br />
O200SSmithslMedical. All RightsReseryed. PrintedinU.S.A. RevisedlC/09 C1609A<br />
Met<br />
tr<br />
D<br />
D<br />
tr<br />
tr<br />
tr<br />
DD<br />
trtr<br />
Unmet<br />
D<br />
Q<br />
tr<br />
a<br />
a<br />
n<br />
smlths rr':edlcal<br />
bi.ging bdnoLoey to lite<br />
Smiths lvledical North America<br />
St. Paul, MN 55112<br />
1-800-258-5361<br />
ww.smiths-medical.mm
B User interface (LCD screen)<br />
D Status bar<br />
tr Describe what the different colors indicaie<br />
tr Protocoltitle bar<br />
fl Screen title bar<br />
tr Help bar<br />
D Work area<br />
O Soft key bar<br />
Start a new patient<br />
Unlock keypad using the code or key<br />
Select the appropriate Therapy, Qualifier and Drug<br />
Verify Therapy, Qualifier and Drug<br />
Page 2 of 4<br />
Met Unmet<br />
Review the pump settings<br />
tr Adjust the patient specific parameters per the Physician Orders<br />
n Describe what happens when a parameter is adjusted outside of the soft limit range<br />
Accept the values<br />
Demonstrate attaching, latching, and locking the cassette to the pump<br />
State the importance of free flow protection and identify how that is accomplished<br />
using the <strong>CADD</strong>@ disposables<br />
ldentify <strong>CADD</strong>@ pump disposables used in the epidural mode, if appropriate<br />
Demonstrate priming the tubing<br />
Position the pump, tubing, and attach the pump<br />
to the lockable pole mount bracket<br />
Demonstrate attaching the remote dose cord<br />
SAMPLE: NOT FOR USE WITHOUT TNSTITUTIONAL APPROVAL.<br />
<strong>CADD</strong>, <strong>CADD</strong>-Solis, and the <strong>CADD</strong> and Smiths Medi€l design marks are trademarks of Smiths Medical. The<br />
symbol @ indi€tes the trademark is registered in the U. S- Patent and Trademark Office and certain other countries.<br />
@ 2008 Smiths Medi€|. All Rights Reserued. Printed in U.S.A. Revised 10/09 C1609A<br />
tr<br />
tr<br />
tr<br />
e<br />
n<br />
D<br />
n<br />
trtr<br />
trf,<br />
DA<br />
tr<br />
D<br />
D<br />
tr<br />
o<br />
tr<br />
D<br />
tr<br />
B<br />
D<br />
B<br />
smtths mPdr.el<br />
hnging bchnrlleyicUfe<br />
Smiths Medical NorthAmeriG<br />
St. Paul, MN 55112<br />
1-800,258-536'1<br />
ww.smiths-medi€l com
Demonstrate starting the pump<br />
Demonstrate delivering a ctinician bolus<br />
Demonstrate delivering a PCA dose<br />
Demonstrate making program changes with the pump running<br />
tr Continuous rate<br />
fl PCAdose<br />
n PCA lockout<br />
Demonstrate stopping the pump<br />
Demonstrate changing the reservoir volume<br />
Describe the difference between lnformation, Low Medium and High PriorityAlarms<br />
ldentify and resolve alarm conditions:<br />
tr Low battery<br />
tr Reservoir volume low<br />
tr Reservoir volume is zero<br />
tl Downstreamocclusion<br />
n<br />
B<br />
tr<br />
Battery depreted<br />
Other<br />
Other<br />
SAMPLE: NOT FOR IJSE WTHOUT INSTITUTIONAL APPROVAL.<br />
<strong>CADD</strong>. <strong>CADD</strong>-Sotis, and the <strong>CADD</strong> and Smiths Medi€l design marks are trademarks ot Smiths lvledicals. The<br />
symbot €) indi€tes the trademaft is registered in the U- S. Patent and Trademark Office and certain other couniries<br />
O 2008 Smilhs Medical. All Rights ReseNed. Printed in U.S.A. Revised 10/Cg C1609A<br />
Met<br />
B<br />
tr<br />
D<br />
tr<br />
D<br />
tr<br />
tr<br />
D<br />
Page 3 of 4<br />
Unmet<br />
a<br />
tr<br />
tr<br />
D<br />
tr<br />
D<br />
tr<br />
B<br />
smtths i-r:eCrral.<br />
Mnqina lechmbeytoufe<br />
Smiths Medical Norlh America<br />
St. Paul, NIN 55112<br />
1-800-258-5361<br />
ww.smiths-medicl.@m
Demonstrate going to the Tasks Menu and demonstrate:<br />
tr Starting a nelv patient<br />
tr Start new protocol, same patient<br />
tr Prime tubing<br />
D Set time and date<br />
tr Adjusting the backlight intensity<br />
tr Adjusting alarm volume<br />
Demonstrate viewing and/or clearing pump reports:<br />
D Given and PCA dose counters<br />
U PCA dose graph<br />
tr Delivery history and pie chart<br />
tr Delivery log<br />
tr Event log<br />
The participant has received instruction in the operation of the <strong>CADD</strong>@-So|is pump and has demonstrated<br />
adequate performance of the skills listed above.<br />
Validator<br />
Facility Personnel<br />
SAMPLE: NOT FOR USE WITHOUT INSTITUTIONAL APPROVAL.<br />
Date<br />
<strong>CADD</strong>, <strong>CADD</strong>-Solis, and the <strong>CADD</strong> and Smiths Iredi€l design marks are trademarks oi Smiths [4edical. The<br />
symbol @ indi€tes the trademark is registered in the U. S- Patent and Trademark Ofiice and cerlain other countries.<br />
O2008 Smiths Medical. All Rights Reserued. Printed in U.S.A. Revised 10/09 C16094<br />
Met<br />
tr<br />
E<br />
Page 4 of 4<br />
Unmet<br />
a<br />
tr<br />
srnrths $,rrril,ca|<br />
Mnginq t.chnoL.ey to Ute<br />
Smiths MediBl NorthAmerica<br />
St. Paul, MN 55'112<br />
1-800-258-5361<br />
ww.smiths-medi€l.mm
Change language