Chapters Transcript 1 Sensica™ Urine Output System Overview The large box displayed on the home screen shows the current hour's urine output and core bladder temperature if the patient has a temperature sensing Foley catheter. The current hour urine output is recording in real time. This number will go up as the urine collects in the bag and is continuously recorded. This will always be a partial hour volume. Upon completion of the current hour, this volume will move to the left and a new hour volume will begin to be measured. Historical temperature can also be seen in these boxes to the left. The highest and lowest temperatures of that hour will be shown. All the hours are time and date stamped. These numbers are the urine output of the past 3 hours, so you can easily see a trend by glancing at the screen. You can scroll back to see previous hours too. If you need more frequent monitoring, just tap the yellow circle above the current urine output volume box, and a quarter hour clock will appear. Any past hour can be reviewed this way as well. You can remove the quarter clocks by tapping the yellow circle again. This percentage number indicates the total bag volume. Double tapping on this number will show the bag volume in milliliters for a few seconds. This toggle button lets you dim the screen at night and then return it to the day view. These two buttons allow you to access data reports and perform other actions. The status bar shows the patient ID, EMR connectivity status, current date and time, catheter use time, the add subtract volume calculator shortcut, and an inactive instant update button. It's possible to manually add or subtract urine output from the current hour recording. Currently, the volume in the bag is 49 mL. Let's say, for example, you just took an IAP measurement which required adding volume to the drainage system. To change the current hour urine output volume, simply touch the calculator icon on the status bar, which will cause the add subtract urine output calculator to appear. There are 3 icons used for subtracting volume infusing slash IAP, irrigation, and other slash subtract urine output. Press the appropriate icon, type in amount of volume to be subtracted, then hit enter. Now the current hour volume shows 29 mL. Now, for example, say you took a urine sample of 10 mL which required removing urine from the drainage system before it was counted by the system. To add volume, just like when subtracting, there are 3 icons to choose from unrecorded urine output, urine sample, and other slash add urine output. Press the appropriate icon. Type in amount of volume to be added, then hit enter. Now the volume shows 39 mL. The instant update button is located in the status bar. It is normally inactive. When it turns yellow, it is active. This happens during episodes of continuous large urine output, such as when a diuretic is administered, and there is no pause between bolus of urine output. In these cases, a notification will be shown instructing the clinician to touch the instant update button. This will override the short built-in delay time and record the volume immediately. Entering the patient's weight when beginning a monitoring session enables the sensicca urine output system to automatically calculate the weight normalized urine output data. This is one early parameter used by clinicians to help identify acute kidney injury, or AKI based on internationally recognized guidelines. To enter the patient's weight, simply touch the Shutdown and actions button and select Edit Patient weight. Use the arrows to enter the weight in kilograms. To enter the weight in pounds, touch the toggle button. To enter and save, then confirm to return to the monitoring screen. The patient's catheter use time can also be adjusted. This is important if the patient has been catheterized prior to being monitored by the device, or if the patient's Foley catheter needs to be replaced. To adjust the catheter use time, simply touch the shutdown and actions button and select edit catheter use time. Use the arrows to enter the proper duration and select new time. The updated catheter use time can be seen on the status bar. There are several types of data screen built into the Sensaurine output system. To access historical data, touch the data button and select data screen. Information is available as table by shift, table by date, and bar graph. Here, the data is sectioned by shift. The hourly urine output and temperature data can be seen in these columns. If the patient's weight has been entered, the weight normalized urine output will be seen here. This information is one early parameter clinicians can use to identify AKI based on international guidelines. The system has a clinical decision support tool which aligns with these guidelines. Any value that falls below 0.5 mL per kilogram per hour will be highlighted yellow, which aligns with the internationally accepted AKI identification guidelines like rifle, Aiken, and Codigo. The clinicians will be notified if this continues for 6 or more hours to consult the guidelines for AKI identification, unless the default setting is changed by the user. The status column provides additional information about the UO monitoring. To learn more about what each term means, simply click the terms button. For instance, partial means the patient was not monitored for more than 15 minutes during that hour. Away means that patient was not monitored for that entire hour, like when that patient was transported to another location. You can also get a quick reminder of what each status means here. The table by date screen is very similar to the table by shift screen. You can add or edit the patient weight on either of these screens. The bar graph screen shows a graphical view of the previous 24 or 48 hours. Another report that can be handy is the snapshot screen. This report shows the past 6 hours of urine output and temperature data updated every 15 minutes, along with an average and a trend line. The snapshot will include weight normalized urine output data if the patient weight is entered. The other report is called the summary report. This report gives a top line look at the urine output monitoring, including total volumes in the current shift, previous shift, and total volume since monitoring began. The Sensicca urine output system has built in notifications to inform clinicians of any abnormal urine output or temperature measurements. These notifications can be adjusted for an individual patient. The urine output notifications show up in blue boxes and are silent. The system has a clinical decision support tool which defaults to notifying the clinician any time the patient's weight normalized urine output falls below 0.5 mL per kilogram per hour, which is consistent with the internationally recognized guidelines. The temperature will be displayed in a red box if the patient's temperature exceeds the set threshold. Similarly, the temperature will be displayed in a blue box if the patient's temperature falls below the set threshold. The Sensaca urine output system also has system notifications that require action to ensure accurate urine output monitoring. These alerts show up in yellow and have a chirping sound. Touch the sound off icon to turn off the chirping. You can change the patient notifications by touching the shutdown and actions button and choosing settings. To change the low and high urine output thresholds, touch the arrow and select the output and time range desired. In this case, a silent notification will occur if there has been less than 30 mL of urine output recorded each hour over 4 hours. The high urine output default setting is greater than 1000 mL for over 1 hour, while the default low urine output setting is less than 30 mL for over 1 hour. The weight normalized urine output threshold can also be changed here. The temperature notifications defaults to 36 °C for low and 38.3 °C for high thresholds. To change a setting, touch the edit button. This will activate a calculator to type in the desired number. Once the patient no longer requires monitoring, the patient data should be cleared from the sensicca urine output system. To ensure no loss of data, make sure to record all patient data per your hospital policy prior to ending the session. Simply touch the shutdown and actions button and select End monitoring. A screen will appear to confirm. Touch and monitoring to end the session and erase all the patient information. Touch cancel if you want to go back to the home screen and continue monitoring. To shut down the system, touch shut down system. Remove the Sensca ring from the Sensicca urine output system. Clean and dispose of according to hospital procedure. The Sensicca urine output system is indicated to monitor urine output and core bladder temperature when connected to a temperature sensing Foley catheter. Temperature sensing Foley catheters are intended for use in conjunction with the sensica urine output system and other compatible 400 series temperature sensing monitors to provide a measure of core bladder temperature. Please consult product label, inserts and instructions for use for any indications, contraindications, hazards, warnings, cautions, and directions for use. Warnings. The BD Sensica urine output system is designed to be used with any barred Foley catheter and urological disposables connected to any standard urine drainage bag 2000 or 2500 mL with or without a urine meter. Ensure that the urine drainage bag hanging on the BD sensica ring is always below the level of the patient's bladder to maintain continuous gravity flow of urine into the collection bag. Precaution. During system startup and in general practice, plug the BD sensicaurine output system into a wall power supply whenever possible. The system screen will dim when the system is unplugged to maximize battery life. After using the system on battery backup, plug it back into the wall power supply for recharging and to avoid system shut down due to a drained battery. This information pertains to SCCS 1002. If using SCCS 1001, please refer to the instructions for use for more information. For more information on product training and education programs, contact bard.edu@bD.com. Created by
