FOR HOSPITAL PHARMACY USE ONLY

Transcription

1 V.A.C.ULTA NEGATIVE PRESSURE WOUND THERAPY SYSTEM FOR HOSPITAL PHARMACY USE ONLY Use of Topical Wound Solutions with the V.A.C.ULTA Negative Pressure Wound Therapy System This information should be used in conjunction with the product labeling, including Instructions for Use, provided by the solution manufacturer and KCI for the V.A.C.ULTA Therapy System. This document provides information to assist hospital pharmacies in preparation and fulfillment of treating physician orders involving use of topical wound solutions using the V.A.C. VeraFlo Instillation Therapy available with the V.A.C.ULTA Therapy System. This information should be used in conjunction with (not as a replacement for) hospital policies and protocols related to preparation, labeling, and administration of pharmaceuticals in the hospital. Components of the V.A.C.Ulta Therapy System Solution Container Arm Solution Canister Arm Label For Irrigation Only Solution Bottle Instillation Cassette (V.A.C. VeraLink Cassette) Canister Filling Orders for V.A.C. VeraFlo Therapy Although physician orders will vary based on physician preference and facility protocols, there are certain prescription elements the pharmacy should consider when filling orders for topical solutions to be used with V.A.C. VeraFlo Therapy. Illustrations 1 and 2 provide examples of how a physician s order might appear, highlighting the essential elements that will allow the pharmacist to calculate the volume of instillation solution needed per day. Formula to calculate the Total Solution Required per Day of V.A.C. VeraFlo Therapy: [Number of Instillation Cycles per Day] X [Instillation Volume per Cycle] = Total Daily Instillation Volume

2 Illustration 1. Prescriber orders V.A.C. VeraFlo Therapy by identifying the V.A.C. Therapy time. Physician writes to pharmacist that s/he will instill 100mL of the prescribed solution at a soak time of 10 minutes and then will set the V.A.C. Therapy cycle time for 3 hours. 1. Use Table 1 to identify Number of Instillation Cycles per Day associated with prescribed Soak Time and V.A.C. Therapy Time. 2. Multiply the Number of Instillation Cycles per Day from the table by the Instillation Volume per Cycle. Answer: [8 Cycles per Day] X [100mL] = 800mL per Day Illustration 2. Prescriber orders V.A.C. VeraFlo Therapy, identifying the Number of Instillation Cycles per day Physician writes to pharmacist that s/he will instill 100mL of the prescribed solution 8 times per day at a soak time of 10 minutes per cycle. 1. Multiply the Number of Instillation Cycles per Day from the physician s order by the Instillation Volume per Cycle. Answer: [8 Cycles per Day] X [100mL] = 800mL per Day 2. To calculate the V.A.C. Therapy time for this physician order, use Table 1 by following the Soak Time column down to the prescribed Number of Instillation Cycles per Day, then follow row left to identify the associated V.A.C. Therapy time. Table 1. Answer: [8 Cycles per Day] and [10 min Soak Time] = 3 hours of V.A.C. Therapy Converts Approximate Number of Instillation Cycles by V.A.C. Therapy Time V.A.C. Therapy Time (hours) Approximate Number of Instillation Cycles per Day 10-minute Soak Time 15-minute Soak Time 20-minute Soak Time Table 2 illustrates the two techniques outlined above with additional order elements to consider for a complete V.A.C. VeraFlo Therapy physician order. Table 2. Potential V.A.C. VeraFlo Therapy Physician Order Order Item Illustration 1 Illustration 2 Solution Name Solution A Solution A Solution Concentration #.# % #.# % Instillation Volume per Cycle 100mL 100mL Soak Time 10 minutes 10 minutes V.A.C. Therapy Time 3 hours N/A Number of Instillation Cycles per Day N/A 8 cycles per day V.A.C. Therapy Negative Pressure Setting ###mmhg ###mmhg Wound Location Location X Location X

3 Most hospital pharmacies have established policies and protocols covering the mixing, labeling, and delivery of instillation/ irrigation solutions, including appropriate labeling and training. The following sections provide some information for pharmacies to consider as a part of their policies and protocols to the extent not already established. Differentiate the Solution Container Consider differentiating wound irrigation solution from systemic solutions (eg, intravenous fluids) by mixing and/or transferring physician-ordered irrigation into an irrigation bottle and using an irrigation screw cap adapter/spike adapter. Most pharmacies already stock an irrigation bottle, but some examples, with the appropriate irrigation cap adapter, include the B.Braun, Baxter irrigation and Thermo Scientific Nalgene irrigation bottles listed in Table 3. Table 3. Irrigation Bottles and Cap Adapters Note: The listing of certain products below is for illustrative purposes only and is not intended as an endorsement by KCI. There may be other suitable choices. Manufacturer Product Description Part Number B. Braun 0.9% Sodium Chloride 38mm Irrigation Bottle PIC Plastic Irrigation Containers 1,000mL (case of 16 bottles) Sterile Water 38 mm Irrigation Bottle PIC Plastic Irrigation Containers 1,000mL (case of 16 bottles) R R PIC Irrigation Container Spike Adaptor (case of 50 eaches) N2150 Baxter 0.9% Sodium Chloride 38 mm Irrigation Bottle 1,000mL (case of 12 bottles) 2F7124 Sterile Water 38mm Irrigation Bottle 1,000mL (case of 12 bottles) 2F7114 Hospira 1,000mL bottle with septum closure from Thermo Scientific Nalgene mm Screw Cap Adapter.* For use with Aqualite semi-rigid pour bottle system and other 38mm bottles (case of 20 eaches) *Cap adapter can be used for any 38mm irrigation bottle from any supplier Twistit White Rubber Stopper, size 6 from Cole Palmer EW

4 Label the Container Most hospital pharmacies have protocols in place for use of labels to distinguish irrigation solutions from systemic solutions. Consider covering the irrigation bottle with conspicuously colored labels with a note, such as the example in Figure 1. Figure 1. Auxiliary Label For Irrigation Only FOR IRRIGATION ONLY Your hospital may already have appropriate labels in pharmacy. The label pictured above may be ordered in quantities of 1,000 at the website Require Trained Clinicians to Check Out A final recommendation would be to require only V.A.C. VeraFlo Therapy-trained clinicians to sign for the topical wound solution, either at the pharmacy or with the pharmacy runner. Upon request, the KCI sales representative can provide a list of the trained clinicians at your facility.

5 Examples of V.A.C. VeraFlo Therapy Physician Order Templates Following are several examples of physician orders showing the time for V.A.C. Therapy and the Number of Instillation Cycles per Day. These are provided as examples only. Example 1: V.A.C. VeraFlo Therapy Physician Order (with V.A.C. Therapy time indicated) Solution Name Solution Concentration Instillation Volume per Cycle Soak Time V.A.C. Therapy Time V.A.C. Therapy Negative Pressure Setting Wound Location Example 2: V.A.C. VeraFlo Therapy Physician Order (with Number of Instillation Cycles per Day indicated) Solution Name Solution Concentration Instillation Volume per Cycle Soak Time Number of Instillation Cycles per Day V.A.C. Therapy Negative Pressure Setting Wound Location Note: Specific indications, contraindications, warnings, precautions, and safety information exist for KCI products and therapies. Please consult a physician and product instructions for use prior to application. Rx only KCI Licensing, Inc. All rights reserved. Aqualite is a trademark of Hospira, Inc. PIC is a trademark of B.Braun. Twistit is a trademark of Cole-Parmer. All other trademarks designated herein are proprietary to KCI Licensing, Inc., its affiliates and/or licensors. DSL# US (Rev.11/14)