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

Table 4: Preventing Non-Controlled Discrepancies
Store non-controlled
medications in secure,
single drug access pockets
(CUBIE ® s, Mini-drawers,
Carousels)
Store non-controlled
medications in single dose
medication storage (minidrawers)
Activate notice: removal
amount does not match
ordered amount
notification
Do not allow return to
pocket
Advantages
• User has access to one
medication line item:
decrease error in removal,
refill, load or return.
• Decrease incidence of
discrepancies related to
pilferage
• User has access to one
medication DOSE
• Decrease incidence of
discrepancies related to
pilferage
• Notifies end user if
amount to remove
different than ordered
amount
• Reduces potential for the
user to place medication in
wrong location and return
a medication that is not
intact or has been altered
• Reduces potential for user
to use the return function
to access medications not
on a patient profile
Disadvantages
• Increase cost of CUBIEs and Mini-
Drawers versus matrix drawer or
carousel
• User may still remove more or less
than the quantity indicated at station
• Single dose storage requires larger
footprint to hold the same number of
medications (decreased capacity)
• Increased pharmacy workload to refill
• Increased cost versus matrix drawer
or carousel.
• Not offered on all versions of Pyxis
MedStation
• If an internal return bin is used,
challenges may occur with large items
Options to Assist in Identifying Non-Controlled Discrepancies
Secondly, options to assist in identifying non-controlled substances should be determined.
Table 5 displays options to assist in identifying discrepancies.
Table 5: Identifying Non-Controlled Discrepancies
Activate blind count and
disable auto resolve for
non-controlled medications
Activate verify count for
non-controlled medications
Implement daily/weekly
inventory of non-controlled
substances
Advantages
• Accurate medication
counts upon access of
pocket
• If count IS performed,
accurate medication
counts upon access of
pocket
• Accurate inventory counts
• Non-controlled medication
discrepancies are
identified by nursing daily
Disadvantages
• Increased time required for nursing
during medication removal process
(decreased efficiency)
• Potential to create lines at Pyxis
MedStation
• Potential delay in medication
administration
• Increased time to resolve
discrepancies
• Difficult to drive compliance
• If compliant, same disadvantages as
blind count
• Increased time/workload