You’re flushing, but are you checking for a positive blood return?

Always aspirate for a positive blood return prior toadministering medications and solutions1

Promptly addressing catheter occlusion is a goal ofcatheter management3

“ The ability to...salvage a dysfunctional CVC is critical in minimizing delays in therapies and avoiding catheter replacement. Unnecessary CVC replacements decreases the number of sites available for future venous access and subjects the patient to additional painful, invasive procedures.”4

— PediSIG Best Practice Guidelines 2nd Edition, Darcy Doellman, 2015, page 15, para 4

“ Central vascular access devices (CVADs) [should be] regularly assessed for patency and proper function as defined by the ability to flush the catheter without resistance and the ability to yield a blood return.”1

— INS Infusion Therapy Standards of Practice, 2016, page S104, standard 48.1

“ During the initial flush, slowly aspirate the VAD for blood return that is the color and consistency of whole blood, which is an important component of assessing catheter function prior to administration of medications and solutions.”1

— INS Infusion Therapy Standards of Practice, 2016, page S77, standard 40, practice criterion D1

“ Ensure brisk blood return. Ensure consistent verification of blood return prior to, during, and after infusion.”2

— ONS Access Device Standards of Practice, 2017, page 94, standard H3, b

References: 1. Infusion Nurses Society. Infusion therapy standards of practice. J Infus Nurs. 2016;39(suppl 1):S1-S159. 2. Camp-Sorrell D, Matey L, eds. Access Device Standards of Practice for Oncology Nursing. Pittsburgh, PA: Oncology Nursing Society;2017. 3. Haire WD, Herbst SF. J Vasc Access Dev. Summer 2000:1-8. 4. AVA Pediatric Special Interest Group. Best Practice Guidelines in the Care and Maintenance of Pediatric Central Venous Catheters. 2nd ed. Association for Vascular Access;2015:1-70.

© 2017 Genentech USA, Inc. All rights reserved. CAT/081815/0050(2) Printed in USA.

Flushes easily, without resistance

Aspirates easily, with brisk, free-flowing blood return

Patency is confirmed when the line:

Are you documenting patency?

Key societies recommend documenting catheter patency

Documentation should indicate whether patency wasconfirmed prior to administration of medications and solutions

“ Documentation includes, but is not limited to: results of CVAD functionality assessment including patency, absence of signs and symptoms of complications, lack of resistance when flushing, and presence of a blood return upon aspiration.”1

— INS Infusion Therapy Standards of Practice, 2016, page S29, standard 10, practice criterion A10

Documentation includes presence of blood return.2

— ONS Access Device Standards of Practice, 2017, page 154, Section III, C, 2 (7)

PDF: CAT-68063_M5_Ptncy_Gdlns_FC_FOF_RGB.pdf - printed on Tuesday, May 9, 2017

Page 1

File Info

Version: 1.5Creation Date: 5/9/17 1:50 PM

Modification Date: 5/9/17 1:50 PMFile Size: 284753Creator: -

Producer: -ICC Profile: sRGB IEC61966-2.1

# of revisions: 2Title: -

Author: -Internal Creation Date: 2017/05/09 14:49:52 -04'00'

Internal Mod. Date: 2017/05/09 14:50:22 -04'00'Flatness (min-max): -

Font Sizes (min-max): 6 - 30Allow Changing: Y

Allow Changing Notes: YAllow Copying: YAllow Printing: Y

Password(Encrypted): NASCII Encodings: N

Trapping: -Number of Pages: 2

Separated: NLinearized: Y

Articles: NBookmarks: Y

PDF/X Version: -PDF/X Conformance: -

Uses Rendering Intent: N# of Spot Colors: 0

Uses Page Scaling: YAll Page Sizes Equal: Y

All Pages S...Orientation: YUnknown Operators: N

PDF Compliance: 1.2PDF/X-1a c... trapping: N

Output Intent

Type ICC Profile Registry Name Identifier Condition Info

Page List

Page# Is Empty? #Colors #Fonts #Images Width Height MediaBox TrimBox ArtBox CropBox BleedBox Nested Boxes2 N 8 7 - 8.5" 11" √ √ √ √ √ Y1 N 7 4 1 8.5" 11" √ √ √ √ √ Y

Color Space

NameICCBasedPattern

Color

Name Color Space C M Y KBlue DeviceRGB 100 100 0 0Green DeviceRGB 100 0 100 0Red DeviceRGB 0 100 100 0C1=0 C2=0 C3=0 ICCBased 0 0 0 0C1=0 C2=0.335 C3=0.59 ICCBased 0 0 0 0C1=0 C2=0.482 C3=0.766 ICCBased 0 0 0 0C1=0 C2=0.538 C3=0.813 ICCBased 0 0 0 0C1=0.301 C2=0.565 C3=0.804 ICCBased 0 0 0 0C1=0.496 C2=0.503 C3=0.513 ICCBased 0 0 0 0C1=0.701 C2=0.786 C3=0.91 ICCBased 0 0 0 0C1=0.955 C2=0.454 C3=0.195 ICCBased 0 0 0 0C1=1 C2=1 C3=1 ICCBased 0 0 0 0

Fonts

Name Type Subtype Subtype Tag Style First chr. Last chr.ITCAvantGardeStd-BkObl Postscript Type1 Plain " " (32) "v" (118)ITCAvantGardeStd-Bk Postscript Type1 Plain " " (31) "y" (121)ITCAvantGardeStd-Bold Postscript Type1 Plain " " (32) "�" (146)ITCAvantGardeStd-Demi Postscript Type1 Plain " " (31) "y" (121)AvenirLTStd-Book Postscript Type1 Plain " " (32) "�" (151)ITCAvantGardeStd-Md Postscript Type1 Plain " " (31) "©" (169)AvenirLTStd-BookOblique Postscript Type1 Plain " " (30) "�" (148)

Images

Name Page Color Space Compression Res. Height Width Bits/ChannelIm0 1 ICCBased Flate(ZIP) 300 0.48 2 8

DO NOT BEGIN WITHOUTSigned Color Break or Pick Up Previous CB Signed Spec Sheet (by PD and AD)

Previous round is signed off by entire team. (If missing, contact PC to attain) Review backup and Color Break for notes from ES Manager and/or the AD

Review Document Specifications Review Spec Sheet for Mechanical Construction (see drawing) Review Spec Sheet for Color Usage (2 color, 4 color, 6 color, etc.) Review Spec Sheet for Image Resolution Requirements

File Management & Artwork Usage In Portal, archive Color Break or "_To Archive" folder (if applicable). In Portal, move entire Layout folder to Mechanical Server. Locate the most current round and make sure it matches the backup before saving it to your desktop. Alert ES Manager if it does not match. Open this file and package the file to your desktop. Inside new collected folder, create a “Previous” folder.

Copy this folder to the Mechanical Server and place previous files, current round, and Layout folder into the Previous folder.

From your “WorkOnHD”, re-link art to the collected Links folder, and if applicable, link art to the appropriate client folder on the Logos And Reusable Art Server.

Inspect Picture Usage for ”OK” status in Preflight. (DPI is OK, colors match specs, etc.) If artwork is below dpi spec requirements, check Color Break for callouts or reach out to the AD for location of High-Res Art. If marked as FPO, place “FPO” (set in FPO spot color) on each image. Add comment, directed to PD/AD indicating effective resolution needed for artwork.

Any new art such as charts, specific images, dies, etc. should be renamed (ex: 12345_graph_4C, 12345_image, etc.) And placed in the Links folder. Any Logos or Reusable Art that exist on the server should link to Logos & Reusable Art Server and be deleted from your collect. NOTHING should EVER be linked to Creative Layout Server or your desktop.

Document Construction Set the Trim, live area, and bleed Crops as well as the Slug using Triple Triangle

to match the provided Spec Sheet. Make sure to use the correct slug if building a scaled document or if the document has folds. (See F1)

Construct any dies/non-print elements where needed (folder, tabs, folds, pockets, perfs, etc.) In Illustrator. Please use correct spot colors when creating your dies. Make sure all dies are set to OVERPRINT.

From the Layout, copy and paste the live files into your new document. Make sure to delete any stray picture or text boxes. Please construct your file with the appropriate layer structure. If an ”FPO” stamp is needed, place on its own layer. (See F2)

Image Usage All linked High-Resolution Art should be linked to the Logos And Reusable Art Server. If the image is new and job specific, please label according to the current job.

If any Illustrator image is job specific, it must be cleaned up (no loose layers, unnecessary elements, or unused colors) and saved as .eps file with no fonts embedded, unless noted by a manager for specific brands.

Font Usage❑ ONLY USE OPEN TYPE FONTS. (Alert manager if other font types or issues appear)Color Usage

Job should match Color Break and Spec Sheet. If not, change accordingly. Make sure illustrator colors appear in InDesign palette (spot colors only). Add all unnamed colors, and DELETE ALL UNUSED COLORS. PMS naming convention driven by logos. Select all content and TURN OVERPRINT OFF first to make sure nothing is overprinting (Unless indicated by PD or manager).

All DIES MUST BE SET to “OVERPRINT.” ALL CMYK colors should be labeled by their values (ex: cXXXmXXXyXXXkXXX).

Preflight Once Layout has been set, run the internal H&S Preflight to check for any errors.

Prelim Separations, Comp Printout & Upload Run report from “PACKAGE” function in InDesign and upload PDF to HandsOn:

Confirm colors to color breakdowns (spot and CMYK values). Delete/consolidate duplicate colors. No fonts are embedded, unless indicated for brand-specific or file issues. All mage resolution (300 DPI print & 100/150 DPI panels). No embedded images in Illustrator files (unless otherwise indicated); links only.

Create a screen PDF of the Separations named "job #_pSeps.pdf" (for the Preliminary Seps), review plates, and save on HandsOn, in the "Color Break and Seps" folder of that job.

Confirm Color Plates match Spec Sheet and Color Break. Confirm Dies appear on their own plates and are set to overprint. For every job, print 100% copy of the file for a comp to be created. (Panels, billboards, and PDF releases are exempt.) If necessary you may have to tile print the mechanical to get 100% of the file.

Along with the printed comp, each job should have a virtual comp PDF version created. This will be the flat final size setup in spreads. Please label the file ”_Shell” (ex: Job1234 _Shell) and place in its own folder on the Mechanical Server within the specific job folder. (This will be used for review purposes as well as account submissions on later rounds.) Create PDF with slugs and crops of the live file. Use the "HandS Print-Opt PDF" setting when exporting. Add eRouting coversheet as the first page of the PDF and place appropriate ES_Stamp on it. Indicate any queries, comments, or VOS's using the appropriate comment tool. If any art elements have shifted or type was keyed in, CALL IT OUT. Make sure to address query/comment to appropriate person (eg, ED or AD).

Back Up to Server Place the current M1 in the appropriate job folder on the Mechanical Server. Double check all art links to the server NOT to your hard drive or the Layout server.

Quality Control Place the folder in the QC rack to be checked. Share link with ES managers. Do not sign out until told to do so. Email eRouting link to PC after job has been checked and then sign out of the job.

MECHANICAL CHECKLIST JOB NUMBER ________________________________________FILE NAME___________________________________________________________________________________________________

CLIENT/PRODUCT___________________________________ BUILD FROM ____________

FIRST MECHANICAL DATE __________________COMPUTER ARTIST _____________________________ ES MANAGER _______________________

PRE-MECH DATE _____________________ES MANAGER _______________________M01 Due Date__________________Approx Time _______________________

Signed Spec Sheet Revisions to Spec Sheet Signed CB Pick Up CB

Comp: Y N Qnty __

Layout Built to size Scaled at____%

❑ Changes at M1 Include FSC logo N/A Archive Layout Files Color Break

Release Release Date ________ Disk/Full Collect FTP ❑ Confirm Time line PO PDF w/o Crops w/o Slug RGB PDF AI/EPS Outline Fonts Other_________

ArtworkDPI @ 100%_____ ❑ All Art High ResWhen will high res art be complete? ____Dielines: Vendor supplied ES to create

NOTES:_____________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________________

I CHECKED ALL OF THIS

F1

F2

PREPRESS: For PDF Release PRINT-OPT PDF: (For RGB PDF releases, please refer to the correct output process sheet on HandsOn)

Disconnect all servers, re-link art, and create Print Opt PDF from InDesign using Adobe PDF Presets drop-down menu (HandS Print-Opt PDF...)

Create PDF with slugs and crops of the live file. Use the "HandS Print-Opt PDF" setting when exporting. Add “_PO” to the end of the saved PDF file name. (When creating the PDF, make sure the slug/crops are activated unless indicated to PDF without them.) Add eRouting coversheet as the first page of the PDF and place appropriate ES_Stamp on it. Indicate any queries, comments, or VOS's using the appropriate comment tool. If any art elements have shifted or type was keyed in, CALL IT OUT. Make sure to address query/comment to appropriate person (eg, ED or AD).

Create a PDF of the Flight check for the PrintOpt PDF and place on HandsOn. Place Print-Optimized PDF in your Collected folder with full Prepress. Once Print-Opt PDF routes clean, PC will sign job back into the studio to have PDF released.

Backing Up to the Server Copy the Collected folder back onto the Mechanical Server and contents of the disk back to the appropriate location on the server and move the LINKS folder into the PREVIOUS folder.

Change the folder icon of the collected folder and the outside folder to a CD icon. (See F3)

Create a SCREEN PDF of the released job and upload onto HandsON as well as include in the released folder on the Mechanical Server. (PDF should not include crops or slug but, if needed, should be in the job-specific shell format for review).

Email the HandsON URL to the PC and Studio Manager.Quality Control

Place the folder in the QC rack to be checked. Share link with ES managers. Do not sign out until told to do so. Email eRouting link to PC after job has been checked, then sign out of the job.

FTP ReleaseComputer Artist:____________ Date:______

For Box.com Uploads: Click and copy path to uploaded file and send to PC/PD/AE For other FTP uploads: Create screenshot of successful upload and Send to PC/PD/AE Once file is uploaded successfully, archive the folder through PORTAL.

Do Not Begin WithoutThe latest Mech round on HandsOn matches the latest round on the serverSigned Color Break, or Pick Up Previous CB Signed Spec Sheet (by PD and AD)

SIGNED COMP/DUMMY (if not, alert the PC) Disconnect Creative Server❑ Confirm sign-off on previous round has all signatures (if missing, contact PC to attain)

Font Usage❑ ONLY USE OPEN TYPE FONTS. (Alert manager if other font types or issues appear.)Color Usage

Elements of job should match Color Break and Spec Sheet. If not, change accordingly. Make sure Illustrator colors appear in InDesign palette (spot colors only). DELETE ALL UNUSED COLORS. All black and dies “OVERPRINT” unless otherwise specified.

Artwork Usage Inspect Picture Usage for ”OK” status and NOT linking to Concept/Layout Server. All linked High-Resolution Art should be linked to the Logos and Reusable Art Server. If the image is new and job specific, please label according to the current job.

If any Illustrator image is job specific, it must be cleaned up (no loose layers, unnecessary elements, or unused colors and saved as .eps file with no fonts embedded, unless noted by a manager for specific brands.

Run report from “PACKAGE” function in InDesign and upload to HandsON. Replace any previous reports for the job if they exist.

Confirm colors to color breakdown and match Color Break. (spot and CMYK values). No fonts are embedded in document or any artwork (True Type or Microsoft). All image resolution (300 DPI print and 100/150 DPI panels-Check Spec Sheet). No embedded images in Illustrator files (Unless otherwise indicated); links only.

Preflight Once Layout has been set, please run the internal H&S Preflight to check for any errors.

Separations, Color Break and Composite Printout Create a screen PDF named “job #_fSeps.pdf” (for the Final Seps), review plates, and save on HandsON, in the "Color Break and Seps" folder of that job.

Confirm SEPARATIONS match Color Break and Spec Sheet. All dies appear on their own plates. (Folder, tabs, folds, pockets, perfs, etc.). All art prints & fonts load correctly. Using Color Spec Cubed, generate a Color Break Save a Screen PDF of the Color break with 4" margins all around. Name the Color Break file with an “_CB” at the end of the file name and delete the round #. (ex.: CLNT-54321_Sales_Aid_CB)

Back up the Color Break PDF to the “Color Break and Seps” folder of the job on HandsON and to the job folder on the HS Mechanical Server. Replace any previous Seps for the job if they exist. DO NOT PUT IN “PREVIOUS” FOLDER.

Create PDF with slugs and crops of the live file. Use the “HandS Print-Opt PDF” setting when exporting. Add eRouting coversheet as the first page of the PDF and place appropriate ES_Stamp on it. Indicate any queries, comments, or VOS's using the appropriate comment tool. If any art elements have shifted or type was keyed in, CALL IT OUT. Make sure to address query/comment to appropriate person (eg, ED or AD).

Back up files to server.Quality Control

Place the folder in the QC rack to be checked. Share link with ES managers. Do not sign out until told to do so. Email eRouting link to PC after job has been checked and, then sign out of the job.

FINAL MECHANICAL & SEPARATIONSDATE ________________________________ COMPUTER ARTIST ____________________________________ ES MANAGER _______________________

Do Not Begin WithoutThe latest Mech round on HandsOn matches the latest round on the serverSigned Color Break or Pick Up Previous CB Signed Spec Sheet (by PD and AD)

SIGNED COMP/DUMMY (if not, alert the PC) Disconnect Creative Server❑ Confirm sign-off on Final Mech round has all signatures (If missing, contact PC to attain)

Run Report and Package Run report from “PACKAGE” function in InDesign and upload to HandsON. Delete any previous reports for the job if they exist.

Delete/Consolidate duplicate colors. No fonts are embedded (True Type or Microsoft). All Image resolution (300 DPI print and 100/150 DPI panels). All images should be linked, not embedded in Illustrator.

Collect job using PACKAGE function in InDesign or "ArtFiles" for Illustrator files.

Give collected JOB FOLDER the same name as Job Number but add "_rlsdXX_XX". Make sure naming convention is 31 characters or under. Please DELETE round number from Prepress folder (ex.: CLNT-54321_Sales_Aid_rlsd12_8).

Include the Color Break PDF with the full collect.PREPRESS: For Full File Collection Release BURN DISK:

Burn job onto disk. Disk label should be legible. Take disk to BURN STATION and load fonts into temporary suitcase from disk. Open file from DISK and LINK all artwork to disk. Create a PDF of the contents of the disk from the "PRINT WINDOW" application and upload to HandsON.

Compare the InDesign package report to the printout contents of the disk. Create PDF with slugs and crops of the live file. Use the "HandS Print-Opt PDF" setting when exporting. Add “_PP” to the end of the saved PDF file name. Add eRouting coversheet as the first page of the PDF and place appropriate ES_Stamp on it. Indicate any queries, comments, or VOS's using the appropriate comment tool. If any art elements have shifted or type was keyed in, CALL IT OUT. Make sure to address query/comment to appropriate person (eg, ED or AD).

Delete fonts from temporary suitcase window and LOG OUT of Burn Station.

PREPRESSDATE ________________________________ COMPUTER ARTIST ____________________________________ ES MANAGER _______________________

I CHECKED ALL OF THIS

I CHECKED ALL OF THIS

Disk FTP Illustrator (.ai /.eps) PrintOpt PDF PrintOpt PDF (no Slug/Crops) RGB PDF Outlined Fonts

CLNT-54321_Sales_AidCLNT-54321_Sales_Aid_Rlsd06_08

CLNT-54321_M8_Sales_Aid.indd

CLNT-54321_M8_Sales_Aid.pdf

CLNT-54321_Sales_Aid._CB.pdf

LinksFonts

PREVIOUS

CLNT-54321_M8_SalesAid_PO.pdf (If applicable)

F3