User Guide Influenza Pneumococcal Immunization Form for WRHA PCH by yoursovain

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									                                                 User Guide

          Influenza/Pneumococcal
Immunization Form for WRHA PCH Residents
                     &
           Creatinine Clearance
       Amantadine/Tamiflu Dosage
                Calculation


                                              Revised October 1, 2007
                                                   (see Page 8)




Developed By WRHA-PCH Program:

Penny Murray, Manager, LTC Pharmacy Program
Betty Taylor, Manager, PCH Infection Prevention and Control
Caroline Crawford, Application Administrator – MDS (eHealth)
                                      Table of Contents



             Glossary of Terms……………………………………………………                Page 3

             Overview of Workbook….…………………………………………..             Page 4

             Freezing Panes……………………………………………………...                Page 5

             Maneuvering through Worksheet……………………………………. Page 5

             Getting Started……………………………………………………….. Page 6

             Usage of Cells………………………………………………………                  Page 6,7

             Amantadine and Tamiflu Dosage Tables                 Page 8




WRHA PCH Program                                    Page 2 of 8
July 2006
                                          Glossary of Terms




Year: Immunization Year (i.e. 2006/07)
Surname: Surname of Resident
First Name: First name of Resident
PHIN: PHIN # of Resident (9 digits)
Date of Birth: Date of Birth of Resident (i.e. YYYY/MM/DD, same as year/month/day)
Current Age: Automatic calculation using Date of Birth to Current Date (Cannot input into this field)
Room No.: Room number of Resident at time of immunization.
Gender: Select either “Male” or “Female”
Influenza: Date of Immunization (i.e. YYYY/MM/DD)
Pneumo: Date of Pneumococcal (i.e. YYYY/MM/DD)
Reason for Immunization (A/B/C)*: *A - High Risk < 65 Years B - > 65 Years C - Household Contact
Informed Consent Obtained: Select either “Written” or “Verbal”.
Weight: Input weight (MUST be in kilograms)
Serum Creatinine Date: The date of the Serum Creatinine test.
Serum Creatinine Result (umo/L): The result of the Serum Creatinine test from the lab report.
Calculated Creatinine Clearance: An automatic calculation using Gender/Current Age/Weight and Serum
Result fields. (Cannot input into this field)
Amantadine Dosage: An automatic calculation using the Calculated Creatinine Clearance calculation. (Cannot
input into this field)
Tamiflu Dosage: An automatic calculation using the Calculated Creatinine Clearance calculation. (Cannot
input into this field)


If using this form for completing all immunization data collection, please print* the form and
send to:

                     Attention:    Influenza Clerk
                                   WRHA Communicable Diseases Program
                                   490 Hargrave St.
                                   Winnipeg, Manitoba
                                   R3A 0X7

This information should be provided by December 31st, 2007.


WRHA PCH Program                                      Page 3 of 8
July 2006
                                          Overview of Workbook
*To print a copy of the workbook, select File, Print, and Page(s)   From____ to ____. If this process is not
followed, the entire workbook of 15 pages will print.

Sample Page:

View a sample of 3 test residents and how the row should be completed. This page includes the Amantadine
and Tamiflu Dosage table.




Creatinine Clearance/Amantadine/Tamiflu Dosage Calculator Page:
(CrCl_Amantadine_Tamiflu_Calc)

This page/worksheet provides for a data collection for the Influenza/Pneumococcal Immunization Form for
PCH Residents. The worksheet includes automatic calculations for Creatinine Clearance, Amantadine and
Tamiflu dosing and can be used in preparing for an outbreak.

By completing the fields of Gender, Date of Birth, Weight and Serum Creatinine Result, the Creatinine
Clearance, Amantadine and the Tamiflu Dosage fields are automatically calculated. All of the fore-mentioned
fields must be completed to get the calculations.




WRHA PCH Program                                         Page 4 of 8
July 2006
                                                Freezing Panes

Freezing panes allows you to select data that remains visible when scrolling in a worksheet. It will keep row and
column labels visible as you scroll. This is for your convenience. The workbook has only the top headings
frozen.

When starting your data entry, it is very important to ensure that all rows are visible by selecting the scroll bar
at the right side of the screen, and moving it to the top. You can check that all rows are visible by noting the
numbered lines at the left, which should be consecutive starting from row 10 down. If not, then some rows are
hidden.

You may “unfreeze” the worksheet by selecting “Window” then “Unfreeze Panes”.

You may also choose to freeze the worksheet in a manner that will allow left hand columns, such as Surname
and First Name to remain visible, when using the bottom scroll bar to aid in reading the calculated creatinine
clearance and dosages. To do this, select cell “C11” which is immediately under the header row, and to the right
of the columns you wish to remain visible. Select “Window” and “Freeze Panes”.

On the Window menu, click Freeze Panes. To Unfreeze Pane, click on Window menu, click Unfreeze Pane.

                                    Maneuvering through Worksheet

•   Use the “Tab” key to move around within the row. It will skip the “Automatic Calculated” (light grey) fields
    and when the row is complete, will start you in the next row under “Surname”.
•   When you come across a drop-down list (Gender, Reason for Immunization and Informed Consent
    Obtained), click on the black arrow and select the appropriate choice. When the mouse moves into the drop-
    down cells, you will see an information box explaining what is expected in the field.
•   All Grey areas are locked fields and will not accept input.
•   When placing in the dates, ensure that when you tab to the next field, the date field shows the proper date
    format. You should see a date formatted such as:

                                       Type in: 2006/10/31
                                       Visual: 31-Oct-2006

•   If you still see the “2006/10/31”, you have made a mistake. Check for year, month, day positioning. If the
    date is correct you will see the “Visual” as displayed above.
•   The worksheet has 500 usable rows in which to list your residents. If you need more, please let Betty Taylor
    or Penny Murray know and a 2nd workbook can be created for you.
            o Contact: Penny Murray Email: pmurray@wrha.mb.ca Telephone: 831-2967
            o Contact: Betty Taylor Email: btaylor@wrha.mb.ca Telephone: 831-2964




WRHA PCH Program                                           Page 5 of 8
July 2006
                                               Getting Started
Type in the Immunization Year i.e.: 2006. The Date that is shown on the left of the worksheet is the current
date. It is used for calculations and is not an input field. It is locked and disabled.




                                                Usage of Cells
Surname: (Required) Input surname of resident.

First Name: (Required) Input first name of resident.

PHIN: (Required) This is the Personal Health Insurance Number for the resident. It must contain 9 digits.

Date of Birth: (Required) This field is formatted to take in the following: YYYY/MM/DD (year/month/day)
(i.e. 2005/12/31). When you tab out of the field, you should see 31-Dec-2005. See “Maneuvering through
worksheet” page 5. This field is used for calculation, so it MUST be completed as year/month/day.

Current Age: (Locked Field) This is a calculated field derived from the Current (Today) Date minus DOB/365
days. You cannot input into this field. By using the “Tab” key, this field will be skipped, but the calculation
will automatically appear in the cell.

Room No. Enter the Resident’s room number.

Gender: (Required) Use the drop-down list to make selection of Male or Female. This is used in the
calculation for the Creatinine Clearance calculation, which in turn, also effects the dosage calculations for both
Amantadine and Tamiflu. For the calculation, the field MUST read “Male” or “Female” NOT “M” or “F”.




WRHA PCH Program                                          Page 6 of 8
July 2006
Influenza Date: (Required) This field is formatted to take in the following: YYYY/MM/DD (i.e. 2005/12/31).
When you tab out of the field, you should see 31-Dec-2005. See “Maneuvering through worksheet” page 5.

Pneumo Date: (Only required if Pneumovax is given) This field is formatted to take in the following:
YYYY/MM/DD (i.e. 2005/12/31). When you tab out of the field, you should see 31-Dec-2005.
See “Maneuvering through worksheet” page 5.

Reason for Immunization (A/B/C)*: (Required) *A - High Risk < 65 Years B - > 65 Years C - Household
Contact. Use the drop-down list to select the appropriate choice. You will also notice that when the mouse is in the field,
you will receive an explanation of what is expected in the field, in the black box.




Informed Consent Obtained: (Required) Must either be “Written” or “Verbal”. Use the drop-down list to select
the appropriate choice. You will also notice that when the mouse is in the field, you will receive an explanation of what is
expected in the field, in the black box.




Weight: (Required) This field is used in the calculations for the “Calculated Creatinine Clearance”. This field
must be completed to calculate the correct Amantadine & Tamiflu Dosage, and MUST be entered in kilograms.

Serum Creatinine Date: (Required) Enter the date of the Serum Creatinine Test. This field is formatted to
take in the following YYYY/MM/DD (i.e. 2006/12/31). When you tab out of the field, you should see 31-Dec-
2006. See “Maneuvering through worksheet” page 5.

Serum Creatinine Result (umo/L): The result of the Serum Creatinine test from the lab. Enter as a whole
number: i.e. 75 or 110, etc.

Calculated Creatinine Clearance: (Locked Field) An automatic calculation using Gender/Current
Age/Weight and Serum Result fields. NO INPUT REQUIRED.
Calculation: Male – 140 - Current Age * Weight / (0.81 * Serum Clearance Result)
            Female – 0.85 * (140 – Current Age) * Weight / (0.81 * Serum Clearance Result)
WRHA PCH Program                                                Page 7 of 8
July 2006
                                               Dosage Tables
**PLEASE NOTE: Amantadine doses are calculated but information is hidden unless needed. Contact
Betty Taylor if necessary.

Amantadine Dosage: (Locked Field)

An automatic calculation using the Calculated Creatinine Clearance calculation. NO INPUT REQUIRED.


                        Amantadine Dosage Table:
                        Creatinine Clearance (mL/min)         Dosage
                        LOADING DOSE                          100 mg
                        More than or equal to 80 mL/min       100 mg Daily
                        60-79 mL/min                          75 mg (7.5 mL) Daily
                        40-59 mL/min                          50 mg (5 mL) Daily
                        20-39 mL/min*                         25 mg (2.5 mL) Daily
                        10-19 mL/min*                         100 mg weekly
                                                              No dosing
                                                              recommendation is
                                                              available.
                        Less than 10 mL/min*                  Contact Physician




Tamiflu Dosage: (Locked Field)

An automatic calculation using the Calculated Creatinine Clearance calculation. NO INPUT REQUIRED.


                          Tamiflu Dosage Table:
                          Creatinine Clearance (mL/min)        Dosage
                          More than 30 mL/min                  75 mg Daily
                          10-30 mL/min                         75mg every other day
                                                               No dosing
                                                               recommendation is
                                                               available.
                          Less than 10 mL/min*                 Contact Physician




WRHA PCH Program                                          Page 8 of 8
July 2006

								
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