1. Use of the Pneumatic Tube System

2. What is the Pneumatic Tube System • The tube system is a computer-controlled, sophisticated pipe structure used to efficiently transport carriers which may contain medications, lab samples, paperwork, etc, to locations around Duke Hospital and Clinics. • Appropriate use of the tube system is critical to avoid malfunctions.

3. Statistics of Present Tube System (2012) • 107 Stations located in different buildings across campus • 196 Blowers, transfer Units and other associated equipment • Over 6 miles of pipe documented in 2010 • 8500-9500 transaction per week day • 98%-99% Successful Completion Rate

4. Pneumatic Tube Expansion with DMP and Cancer Center • 33 More Stations (Total 137) • 27 More Associated Equip. (223 Total) • 9.1 miles of pipe in total • Estimated additional 5K transactions per week day.

5. Picture of a typical tube station. You will see these in your work area.

6. Sections of the tube station: Control Panel Dispatcher Receiving Bin

7. Control Panel • The left side in the picture is the display and keypad used for general functions. • The right side in the picture is for speed dial selection if the station is programmed to do so. Left Right

8. Control Panel • Use EMPTY SEND when the system alerts that the station has more carriers than allowed. Using EMPTY SEND allows the system to determine the area of greatest need to route the carrier to. • SEND is used to dispatch all carriers, whether for EMTY SEND or when a desired location is specified. • STATION DIRECTORY has information about the tube identification number for each location • MENU provides the user with a listing of functions that can be performed • The directional arrows can be used to scroll up and down when using the MENU function. Directional Arrows Display Keypad Cancel Station Directory Send Button Empty Send Menu

9. Speed Dials • If the station is programmed and labeled for speed dialing, the user only needs to press the appropriate selection button. • Speed dials save staff time. Selection Buttons

10. Station Directory • In addition to the station directory on the station keypad, each station will also have posted a hardcopy of the directory. • The copy also indicates the tube station number and the maximum number of carriers allowed at a given time for the station. Tube Station Number Number of Carriers allowed

11. Display Screen • It is critical to pay attention to the messages on the display screen before and after a tubing transaction. The screenshot below shows the station number and the last location a tube was dispatched. It also indicates station ready to receive transactions.

12. Entering a Dispatch Location • After you enter a location to dispatch a carrier to, make certain the tube indications “Selection Accepted”. If not, there may a problem requiring attention.

13. Warning Messages • The tube station has sensors located on walls of the station. If the sensor is blocked by a carrier, the system will no longer receive carriers. Take action and remove or send out carriers as the message indicates. Sensor

14. Other Warning Messages That Will Cause Your Station to Beep and not Function Properly • Return Surplus – This means you have more carriers than allowed. Use EMPTY SEND to send out carriers. • Selection Not in Service – This means that a specific location which you are trying to send a carrier to is not in service. • Station Signed Off – This means that a location you are trying to send a carrier to is turned off. This is typically done when an area closes for business and wants to avoid receiving tubes as no one will be available to respond to them. • Path Not Available – The path to your desired location is not available. Often, wait a few minutes and try again, but if there is a serious issue, the downtime could be longer.

15. Proper Use of the Tube System • Make sure contents are in the carrier completely • Make sure both latches close completely • Make sure zip Lock bags are sealed completely • Test for leaks by turning upside down • Do Not staple paperwork to zip lock bags • NO Food or Drinks are to be sent in the system • Do Not send Ice in system • Don’t force the carrier closed

16. The next few slides with pictures will highlight real findings which have led to hours of tube system downtime. Please take them seriously and help us avoid malfunctions, as it adversely impacts our ability to care for our patients.

17. Bad Packaging : Open Carrier Contents crushed to be able to force-close carrier, and latch was broken, hence, reason for open carrier

18. Bad Packaging: Items Hanging Out

19. Bad Packaging: Items Hanging Out

20. Bad Packaging: Liner Hanging Out or Being Cut OFF

21. Bad Packaging: Top Was Cross Threaded and Likely to Leak

22. Bad Packaging: Leaking & Bag Not Sealed

23. Bad Packaging: Object Larger Than Carrier

24. Bad Packaging: Do Not Block Post and Pin

25. Bad Practice: Do Not Send Blood Cultures Via The Tube

26. Bad Practice: Do Not Send Back A Leaking Item Via the Tube. The Item Below Arrived Leaking Then Sent Back To Pharmacy.

27. Bad Practice: Do Not Use Broken Carriers in the System. Call the Maintenance line (684-3232) for Pick Up

28. Bad Practice: Do Not Tape The Carrier

29. In Case Of Spill If you have a spill at your station and it is Body Fluids or Medication that is sticky, follow the Emergency Shutdown procedure posted at every station.

30. Emergency Shutdown Procedure Posted at the Stations

31. To Report Problems Call 684-3232

32. Quiz 1) If you receive a carrier with sticky material that has leaked out of carrier, you should continue using the tube, but call 684-3232 to pick up the carrier? • True • False • It is acceptable to cut a corner off the carrier liner to allow your item to fit properly • True • False • A RETURN SURPLUS message on the control panel lets you know that the station will soon be receiving extra carriers from other areas • True • False • The tube system is made up of over 6 miles of pipes used for material transport across different locations • True • False • The tube station directory can be found by accessing the MENU on the display screen. • True • False