Non-Controlled Medication Discrepancy Management - The Pyxis ...

Table 1: Types of Physical Counts
Physical Counts Advantages Disadvantages
Blind Count
Requires the end user to
enter the quantity instead of
showing the expected
beginning count and asking
for confirmation or correction
Verify Count
Provides the end user with
the expected beginning count
and asks for confirmation or
correction
Accurate medication counts upon
access of pocket
If count IS performed, accurate
medication counts upon access of
pocket
Increased time required during
medication removal process
Difficult to drive compliance
IF COMPLIANT, requires same
amount of time as BLIND COUNT
Discrepancy Resolution
When a discrepancy is created, depending on the software configuration, resolution will either be manual or
automatic.
Resolution-required discrepancies: The user is notified immediately and is required to resolve the
discrepancy at the Pyxis MedStation. A discrepancy is documented as resolved when the reason or
explanation statement is entered at the device.
Auto-resolved discrepancies: The user is not notified of the discrepancy. A discrepancy is documented as
resolved and no resolution is required.
Common Reasons for Discrepancies
There are many causes of non-controlled medication discrepancies:
A user removed a quantity greater or less than the quantity requested
A user cancelled the removal, but removed the medication
A user did not remove the medication requested
A user made a typographical error (for example, 11 instead of 1)
A user accessed the wrong pocket during remove, return, refill or load
A user indicated incorrect quantity during refill or load
A user diverted or pilfered a medication.
Basic Elements for Non-Controlled Substance Management
An essential element to initially consider is the development of policies and procedures. Policies should be
developed to address the prevention, identification, and monitoring of non-controlled discrepancies. A second
essential element required is that of education. Multidisciplinary involvement is recommended to design an
educational curriculum for ongoing staff education for pharmacy, nursing, respiratory and other providers (i.e.
anesthesia department.) Lastly, a third area for consideration is that of accountability. Processes that drive
accountability and compliance should be evaluated. Table 2 summarizes basic elements.