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I've never heard of the Accudose. It's my understanding that the difference between the Pyxis and the Omnicell is the Pyxis will not only dispense your med but document the administration whereas the Omnicell simply dispenses. I could be wrong, though. We use Omnicells at my facility and we still have to scan the patient's ID and the med to verify pt/document administration.
Now that I think about, if the Pyxis documents administration, how does it ensure it got to the right patient? Hopefully someone who knows what they're talking about will come along and enlighten us all!
I have never used a pyxis or an omnicell, I have a lot of experience with McKesson's Acudose. About 2 years ago I was on a comity at my hospital implimenting medication automation. We ended up spending about 2 million dollars on software and equipment to work towards being fully automated and integrated. We are still in the process as we introduce new items on a schedule. One of the first things we got was the Acudose. I was sent to McKesson's office in PA and I trained for a week on how to use the machine and software then came back and taught others.
My hospital choose Acuddose for two major reasons- 1) we already have McKesson software for almost every aspect of care and hope to achieve a fully integrated system. 2) McKesson has been a leader in implimenting automation, and specifically in the development and use of robots in pharmacies.
We also bought the robot, really the central part of automation. It's pretty cool because it is connected to the Acudose cabinets and the e-mars, so when a drug is used the robot will pull it for replacement with the next pt cart fill.
We are slowly moving to physician order entry, which will mean the doc enters the order in the computer, the pharmacist verifies the order on the computer, and the robot pulls the meds off the shelf automatically. The final product we are planning on getting in the future is a hand held scanner with the e-mar on it where the nurse can scan barcodes and have it document automatically at the bedside in real time.
We use the Pyxis. I like it the ID system because we verify with our soc and then a fingerprint. No chance someone can use my ID to get in, which is a huge relief for me.
The patient's meds are listed for each patient and we just touch the screen for the ones we want and the time and the name of the person who took that med is documented.
I also like that I can check to see when meds were pulled last on a transferred patient. That way I don't have to guess about what time a patient got a pain med or what time the last Lasix was given, even if someone forgot to sign the MAR.
It's not perfect, but I like it for those reasons.
At one place that I worked we had an OmniCell (I think) that allowed us to return in pop up sleeve the narcotic waste so a second nurse didn't have to witness the waste-I really liked that but haven't seen it any other place.
I like Omnicell because it's got a draw where it dispenses all of the controlled substances into and then the drawer pops out. No counting of narcotics each time you pull morphine, dliaudid, versed, ativan, etc. You just punch in all of your controlled substances and it will dispense them all in the same drawer to you.
I like omnicell for 2 reasons:
You don't have to count your narcotics
The omni machines are bigger so more meds can be stored in them.
We just switched from pyxis to omni. We used to have 2 pyxis on the unit and we were constantly running between the 2 machines to pull meds (large med/surg, ortho, oncology unit). Now the 2 omnis have the exact same meds stocked so I don't have to walk to 2 machines and wait in line to pull meds for each pt.
I do have to say that I don't like that our omnis don't prompt for a waste co-sign so we have to remember to waste. The pyxis would prompt us and show a cosign screen for waste without additional steps.
The bottom line is, having no dispensing machine at all on a med surg unit is hell.
I remember the time before them and it was tedious, time consuming and there were always missing meds that pharmacy took hours to deliver.