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03/15/19 BS -- Cerner TPN tips

From: Berkley Sykes

Sent: Friday, March 15, 2019 4:35:53 PM

Subject: Cerner TPN tips

Here are some tips that may be helpful to you and a few that are also helpful to PSP... 

1) Osmolarity calculated in the powernote is based on goal and not necessarily accurate.  If you are unsure of the osmolarity of your TPN, Abacus and Global RPh can be helpful.  For a PPN, Gregg suggests using the old concentrations in the QRG based on the rate, and then calculate the protein and CHO, then fill out the powerform goal to match those numbers.  

2) Cyclic TPNs : Please type "cyclic" in the top line of the comments in the verification comments box. Remember that the first line in the comments cannot be blank... be cautious when copying and pasting. 

3) If you modify a TPN order , it will not print a label. Either enter a new one, or add "1" to the initial dose field.  T he initial dose field is a default of zero so that in the event a physician changes the rate on a TPN, it will not auto print a label to PSP.  

4) Do not alter the route to read  " peripheral or central " . Choose the route that best reflects what is happening at the time of entry (or what will be happening when the TPN hangs). Abacus does math to determine the appropriateness of TPN contents based on the route. If you need to make a comment to the explain that the bag may hang either peripherally or centrally, that is fine, but Abacus (and the TPN technician) needs to know which way the bag needs to be prepared. I hope this makes sense.  

Please let me or Gregg know if you have questions or other suggestions.

Thanks,

Berkley

Berkley Sykes, Pharm.D.

Pharmacy Manager - Sterile Products Services