On the TPN entry, the 24 hour rate is calculated from the base solution volume (for continuous infusion over 24 hours). Would it not be appropriate to divide the TOTAL volume (electrolytes, etc.) by 24 hours?
That is a point of contention for some pharmacists. Some are from the school that uses the electrolytes as "overfill", to account for tube/pump priming, and to give a little cushion between bags, so you're not rushed to mixed a new bag if it runs in a little too fast, etc. Basically it's the same thing as using a pre-mixed IV, as manufacturers routinely overfill IV bags by 5 to 10%.
The system requires patient height/weight before a new patient can be entered, in home care/LTC this info is not initially available.
TPNassist© is a clinically-oriented program. You enter the patient data first, then create a nutrition Rx specifically for that patient, based on their estimated nutritional requirements. It's analogous to dosing drugs without knowing ht/wt, and giving every patient the same dose of gentamicin (80mg Q 8 hours).
My patient is bedridden and I cannot obtain his/her height, what should I do?
Good question. A patient may also have scoliosis or severe contractions that prevent a true height measurement. There are (at least) three methods that may be used to estimate height when actual measurement is not possible: knee height, forearm length and demi-span.
Does TPNassist© interface with our Pharmacy Information System?
TPNassist© may be interfaced with a PIS, using our open interface specification. Please contact your PIS vendor to request implementation.
What size label does TPNassist© require?
The default TPNassist© label is 5" wide by 5" high (perf to perf).
New to version 2.4.13 is the ability to change the label width.
The TPN label is cut off on the left and/or right side on our new printer. How do we adjust the print position?
You have the ability to set the left margin and the label width on the setup window (see below).
The default settings are 0.35 inch left margin and 5.0 inch width. Experiment with these settings to fit the text output to your new printer.
How and where do I download and install the update?
TPNassist© has had a built-in update checker since version 2.3.10, it is accessed via the Help menu:
There are three steps to the web update process, and there are three buttons on the web update dialog which correspond to the three steps.
- Click Check for updates to access the RxKinetics web site to check for available updates. If an update is available, the "Download" button will be activated.
- Select an update from the list by clicking on the check box next to the description, then click the Download updates button to proceed. If the download was successful, the "Install" button will be activated.
- A running program cannot be replaced.
Therefore, you must exit TPNassist before installing an update. Web update will not proceed with the install step until you close TPNassist.
After you have closed the TPNassist program, click the Install updates button to begin the update process.
Where do I find what functions have changed in the latest version?
We need to reinstall TPNassist© on our new computer, how do we transfer our current patient from our old computer?
Step-by-step instructions for re-installing TPNassist©:
- Copy these data files from your current install folder (usually c:\program files\tpn)
to a temporary folder, a floppy disk or any other removable media:
- Install TPNassist© onto your new computer from the original installation CD.
- Copy the data files saved in step 1 to the install folder in your new computer.
- Download and install the latest update patch from the website.
I use Windows XP, some of the fields are missing, or difficult to read.
Windows XP introduced the theme concept to Windows. Unfortunately the default theme in XP is the "Fisher Price" desktop with cartoon-like icons and a large Arial font. This font is too large for the TPNassist© screens. Change to the "Classic" theme, this uses a smaller font, and it also gives your screen a more professional look and feel. To select a different theme:
- Click Start
- Point to Settings
- Click Control Panel
- Double-click Display.
- On the Themes tab, under Theme, Select "Windows Classic"
- Click "OK"
When we print reports, the preview window is blank. The reports print out okay, the only problem is we are unable to preview them before printing.
There is a known issue with dDoc on some video cards (driver problem) where the card is set to 24-bit or 32-bit color. This issue causes a *blank* preview window to display initially. Clicking on the window to resize the preview will display the previewed document. Also, clicking the print button will print the report just fine (it's a video-only problem).
One work around for this is to set the color depth in the video display settings down to 16-bit color (this is a faster mode anyway, with very little difference in video quality).
Otherwise, you may download the updated dDoc print engine here:
On Windows 7 (or 8, or 10) the F1 key for help is not working. Also we cannot access TPNassist© help via the Help button.
When attempting to access the product help, you may see a message similar to this one:
Beginning with Windows Vista, the Windows Help program (WinHlp32.exe) is no longer distributed with Windows. The question is, WHY? Microsoft will let us run the older programs, but does not want us to use HELP for these programs? A little silly, eh? So, Microsoft maintains, currently, SIX different installs for winhlp32.exe:
It serves no purpose for Microsoft to continually create install files for winhlp32.exe with each new version of Windows because it is THE EXACT SAME PROGRAM, nothing has changed!
Microsoft asks developers to use a different help format. What they can't seem to comprehend is, there are multiple problems with all of the suggested replacements (CHM, HTML, XML). And none of these formats is as user-friendly as WinHelp.
Now, Microsoft wants us to wait until they decide to make an installer for Windows 10. Well, I am tired of waiting and found a way to create my own WinHelp installer for Windows 10. Although it is technically "illegal" to distribute winhlp32.exe, here it is. Download, right click on the file, and select Run as administrator.
If you can't use this fix, you may view the help file online here:
Does TPNassist© run on 64-bit Windows 7 (or 8, or 10)?
All versions of 64-bit Windows (XP, Vista, 7, 8, 10) are able to run 32-bit programs seamlessly through WOW64 which is provided with the operating system and does not have to be explicitly enabled. In other words, it's 100% automatic. (Ref: Microsoft)
According to Microsoft, 32-bit software running under WOW64 has a similar performance when executing under 32-bit Windows. (Ref: Microsoft)
Troubleshooting TPNassist© error messages
Error 0 "Unable to initialize the print/preview engine"
This is caused by missing or improperly installed dDoc print preview engine. Please reinstall from the CD, or download from the web site.
Error 20 "Unanticipated error in the object ddoc.bas"
This error too is caused by missing or improperly installed dDoc print preview engine. As above, please reinstall from the CD, or download from the web site.
Error 48 "File not found: ddoc32.dll"
Again, this error is caused by missing or improperly installed dDoc print preview engine. As above, please reinstall from the CD, or download from the web site.
Error 91 "Object variable or with block variable not set"
Error 91 is caused by a missing or incorrectly installed component required by TPNassist©.
- If this is a new install, then there was an error during the installation. Please reinstall from the CD.
- If this is a new problem on a previously working PC, then another software application you recently installed may have corrupted the Windows registry. To fix this problem: first re-install TPNassist© from the original install disks or CD, then download and install the latest update.
If the error persists, please download the TPNassist component checker program. Clicking the "Register" button on the component checker usually fixes the problem.
Error 339 "Component 'DXDBGRID.DLL' or one of its dependencies is not correctly registered."
DXDBGRID.DLL is a "helper" program used by TPNassist©. As stated in the error message, it is either missing or the Windows registry has "misplaced" it.
You may download the missing file here:
Installation fails with error message "msdart32.dll is missing" when trying to install the program on my Windows XP system.
We have found that some Windows XP Home systems were shipped without the latest data access components from Microsoft. The quickest solution is to copy the file yourself. You will need to be logged in with admin privileges. Next, get the DOS window on screen (you will find the DOS prompt shortcut in your Start menu). Then type the following lines at the DOS prompt, pressing enter after each line:
- cd \windows\system32
- copy msdart.dll msdart32.dll
TPNassist crashes intermittently on Windows Vista with the message "program has stopped".
This problem is caused by third-party components which are not fully Vista-compatible.
On most Vista PC's, turning off Data Execution Prevention on TPNassist will fix this problem.
FYI, this issue does not appear with Windows 7 or 10.