Section 4 - Program demonstrations

Section 5 - Program demonstrations

Introduction

TPNassist© is a clinical tool for pharmaceutical care which combines comprehensive data-base functions and nutritional assessment into a single user-friendly package.

TPNassist© has context sensitive help, so please take advantage of this feature by pressing the F1 key.
All program icons have tool tips, hold your mouse pointer over a button and after a few seconds a description of the button will appear.

Program "How-to's"

The film-strip icon indicates a link from this page to a "video" which demonstrates a TPNassist© function. You do not need to interact with the demo, however, there is a "VCR-style" control at the top of the demo window which will allow you to pause, rewind, fast-forward, and exit the animated sequence.

System requirements for viewing Program How-to's

Please be patient, these applets make take a few minutes to load, it all depends on the speed of your internet connection. One last note, the demo's were created with an advertiser-supported program, I apologize for the banner ads which appear at the top of the demo window, I have no control over them.

Login

When you first start the program you will be asked to log-in. Enter your intials (up to 3 letters). The first time you enter your initials the program will ask you for your name, title and contact numbers. Thereafter you may log in with just your initials.

How to Log in and Add new user

Setup

Next, you will want to enter the Setup and customize the settings to your needs. Setup is accessed via the menubar and is password protected. The program ships without a password, so choose one that you will remember.

Database maintenance

Database maintenance functions are accessed via the menubar. All of these functions except the physician data entry are password protected.

Function Description
Repair database Compress and repair db tables
Amino acid data Maintain db of AA brands
Enteral formula data Maintain db of formula brands
Fax cover notes Maintain default notes for fax cover sheets
Physician data Maintan physician db
TPN pathway data Maintain TPN "templates"
User data Maintain program user db

Function	Description
Repair database	Compress and repair db tables
Amino acid data	Maintain db of AA brands
Enteral formula data	Maintain db of formula brands
Fax cover notes	Maintain default notes for fax cover sheets
Physician data	Maintan physician db
TPN pathway data	Maintain TPN "templates"
User data	Maintain program user db

Setup and database maintenance

Patient data

To enter a new patient, click the [+] icon on the patient databar. You may enter peds (age 1 year) to adults. Out of range patient data is flagged in red. This does not mean that the data is wrong, it is only meant to alert you to any potential data entry error,

To retrieve a previously entered patient, click on the "Patient name" list box, then select the patient from the list.

Retrieve and edit an existing patient

Assessment

After entering basic patient data, the next thing you must do is assess the patient. The nutritional assessment is the basis of all the calculations. There are only 2 things needed for an assessment, current weight and stress/activity level. The latter is a judgement call, you should get out and see the patient, review the labs, gather as much information as you can.

Examples of stress levels:

Stress or activity level Descriptor Factor
Bed rest None 1.1
Minor surgery None to slight 1.1 - 1.3
Ambulatory Slight 1.3
Infection Slight 1.3
Fracture Slight 1.3
Major surgery Mild 1.5
Major trauma Moderate 1.7
Sepsis Moderate to severe 1.7 - 1.9
Burns Severe 1.9 - 2.1

Stress or activity level	Descriptor	Factor
Bed rest	None	1.1
Minor surgery	None to slight	1.1 - 1.3
Ambulatory	Slight	1.3
Infection	Slight	1.3
Fracture	Slight	1.3
Major surgery	Mild	1.5
Major trauma	Moderate	1.7
Sepsis	Moderate to severe	1.7 - 1.9
Burns	Severe	1.9 - 2.1

Labs/anthropometrics

You may also enter Labs and Anthropometrics, note that these are not required, but are optional parameters for monitoring the patient, the labs have context sensitive help with some data relevent to nutritional assessment.

Enter a new patient, assessment, and labs

Enteral Rx entry

To enter an enteral tube feeding, click on the Enteral Rx icon, select a formula from the list, strength and rate. The program will calculate the nutritional content supplied to the patient, you can then compare this to the patient's nutritional needs assessment.

Enter a new Enteral Rx

TPN entry

TPN entry is via a wizard which takes you through each step in the TPN entry process:

Type
You may select a pathway, these are standard TPN's which are created and maintained *by you* via the Database maintenance menu. Other choices are self explanatory.
Base
This is the most important step. Read this like you would a printed page, start at the top left and read across and down. Note that you start with the patient's needs. Enter target kcal and protein grams and the program will calculate how much dextrose and amino acid.
Lytes
You may enter electrolytes by salts or by their constituent anions/cations. If the later you must "balance" the cations. Select the anion you wish to use, Cl, Ac, or both, then click balance.
Other
If a homecare patient you can select some of these adds to be "Patient adds".
Order notes
A free form text entry for recording progress notes, etc. related to the TPN.
Summary
An evaluation of the TPN you have just entered. You must view the summary before you can save the TPN. Click the Finish button to save the TPN.
Summary values outside of normal flag in red. This does not mean that the TPN is wrong, it is only meant to alert you to any potential order entry error!

Enter a new TPN Rx

Retrieve and edit an existing TPN

Reports

To print a report without screen preivew, click the print icon on the toolbar.To preview reports on the screen, click Print on the menubar, then select a report. There are also keyboard shortcuts to these previewed reports.

Reports include:

TPN worksheet
TPN and Enteral labels
TPN and Enteral assessment
TPN and Enteral Rx
Lab trends
Fax cover sheet

Print a TPN Assessment and TPN worksheet

Baxa compounder link

Click the link icon to create a file for import into the Baxa MM23 Compounding Sofware. MM23 is specialty software designed to operate the Baxa Macro/Micro 23 TPN compounder.

Section 5 - Program demonstrations