UnBELEEEEVABLE

[Joules]

At my hospital, Pitt County Memorial Hospital in Greenville, North Carolina (on the eastern side of the state), the administrators have just installed the new Pyxis System (all this without even consulting the nurses OF COURSE). To say this new system is a disaster, is putting it very mildly. Now, if you even want ONE alcohol swipe or a small tube of doppler jelly, you have to select the patient's name and then punch in for EACH one you take!!!! In one of the machines, there are even individual disposable cups!!! While up on the unit, there was a code. Literally, supplies could not be found. As we all know, seconds count in a code and you don't have time to be scurrying around hunting down scarce supplies and typing in information into a tempermental machine. Suddenly, it seems as bad as a third world country around the hospital. I keep my OWN vacutainer and my OWN tourniquet for drawing labs on my person at all times.... because new ones simply CANNOT be found!!! Infection control has been a BIG issue at this hospital... 43% post-surgery infection rate!!! Been in the news and in the newspaper, and the administration is trying to "educate" staff about proper infection control. Now, if you can't find proper supplies for asepsis (not EVEN an alcohol pad to wipe off your stethoscope after each patient visit) and have to keep reusing supplies that are supposed to be used once... how is this going to help the infection problem??? Our hospital is also having a TERRIBLE time retaining nurses... Units are having to close down beds to sick patients simply because there are not enough nurses. Some units are 50% travelers... Now the moral is SOOO LOW and nurses are SO PI$$$ED OFF

Forgive me for ranting, just have to vent:o

[Faby]

Hi: I'm talking from a third world country , and it isn't that bad here. We don't have to charge anything unless it is a medical indication, like meds. it's terrible the situation in what you are cause it adds a lot of administrative work.

Besides, have you ever in your hospital made any research on handwashing? You know it is the most simple and old way of preventing infections, crossed, postoperation, etc. There is widely known that not every individual of the health staff cares about handwashing, and it isn't niether expensive neither difficult to wash hands propperly.

[boggle, ASN, RN]

I love our pyxis for supplies, .....BUT...., ours is stocked and programmed so we can withdraw BUNDLES of syringes, or WHOLE BOXES of alcohol wipes, WHOLE SLEEVES of drinking cups, etc, and charge those as floor stock We almost never run out of stock now.

We have an emergency override that opens all the doors for those true emergencies.

It's up to your hospital to decide how the pyxis will be programmed and stocked. It can be a tremendous help or a nightmare.

It sounds like your hospital has made its choice.

[SICU Queen]

Completely UNBELIEVEABLE, but somehow... I'm not surprised. What is nursing coming to?

[Teshiee]

Like many of us we use the PYXIS for meds only....That sounds so trifling what they are doing putting floor stock in the machine. I know in some hospitals they use Omnicell for supplies it can be a real pain in the ass. I guess they want to keep control over cost. Hell if they are willing to be that stingy they should give you guys a raise.

[nell]

One of the great things about this board - learning the good and bad about things you wouldn't have ever heard of.

If our hospital starts talking about a Pyxis for supplies (or if one just shows up in place of our supply cart) I'll know the things to look for and the questions to ask.

It does sound like an appropriately programmed supply Pyxis can help control costs and ensure adequate supplies. We certainly run out of a lot of things on our carts, and having to enter charges into the computer is a pain (some things have to be typed in) and things are often missed. On the other hand, our most recent new employee (5 months) has yet to recieve a working Pyxis code ....

Thanks for this board Brian!!!

[dianah, ASN]

Pyxis good so far for po and iv/im meds, great for narcs (count once a week!! Small area, so no real discrepancies -- RNs pretty responsible). As I'm in a Radiology Dept, doing sedation and procedures (including heart caths), we have a small locked tackle box-thing filled with emergency meds for allergic reactions (remember, we give a LOT of IV and IA iodine) and D50 (pts mostly NPO, get diabetics w/bottomed-out sugars at times). We couldn't see us running to Pyxis while the welts popped up or pt trying to breathe w/laryngeal edema (worst-case imagined, of course). If we use anything from THE BOX, we call Pharm and they send up a new, locked box. Have them in each CT room, in MRI and where IVPs are done. List of meds on top of ea. box. Works for us.

Suggest: present to managers how other hospitals use Pyxis (i.e., NOT for individual alcohol swabs), and give arguments for change a strong slant toward PATIENT SAFETY (Risk Management!!!), INFECTION CONTROL and nurse efficiency (can't give good pt. care when running to get individual swabs, etc, so pt care will suffer, problem will ultimately affect pt [customer] satisfaction and they'll go elsewhere, etc, etc. Use the jargon for your cause). Good Luck!!

[Spstudent]

Hi there..

This is my very first post here!

I just wanted to respond to the pyxis situation. The hospital that I work in keeps EVERYTHING in the pyxis.. yes, we have alcohol wipes, styrofoam cups, urinals, everything! But, we have two units: one is for standard supplies, and the other one is for medications.

I'm not a nurse yet (junior year student) so I'm not sure exactly how the med pyxis works, but I'll tell you how we get around some of the annoyances:

First of all, we take large amounts of supplies out of the pyxis at once, and charge them all to floor stock. We simply just leave them other places, or put them in our pockets. No one has complained about this, (namely supervisory types) because I don't think they really pay attention. Also, our crash cart is always kept fully stocked, so that in a code, we don't have to fumble around for things. It is then promptly stocked up again after the code (incidently, we had a code a few weeks ago, and they couldn't find half the things to re-stock it in the pyxis!)

As far as the med pyxis goes, I'm not sure how the nurses do this, but they always have pockets full of nitroglycerin... (cardiac floor) and the only time I ever see them working with the pyxis is when they are doing regular timed meds.

Good luck!

Sarah

[adrienurse, LPN]

It is your administration that decided to place the non-pharmaceutical supplies in the pyxis system (can we say cheap b****rds). They can to told to stop doing this. I really like our pyxis, much better than the meditrol sytem we had before.

[NSDRN]

I also work at PCMH and wanted to clarify that as Boggles said our pyxis' also allow you to pull out entire boxes of alcohol swabs, cups, syringes, etc.

The unit I work in has not installed the pyxis' yet, but I have floated to units where they are in operation. When you need alcohol pads, guaze, etc you pull out an entire box and place in a drawer or wherever. On the unit each pt.'s room will have it's own supply pyxis.

Only the items we now charge for will be charged for with the supply pyxis system. The point of putting non-chargeables in the pyxis is to ensure that we always have these items in stock.

Just wanted to clarify.

[SherRN]

Originally posted by adrienurse

It is your administration that decided to place the non-pharmaceutical supplies in the pyxis system (can we say cheap b****rds). They can to told to stop doing this. I really like our pyxis, much better than the meditrol sytem we had before.

We had Meditrol also. Never thought anyone else did. I went to HOU and took the 1st class on it at Owen Pharm. We have just gotton Accudose. We are all learning to get out of the way when the drawers open. Luckily we do not have supplies in there yet.

But every time you turn around you have cheaper supplies. The best one yet was the OB stool square is now 1/2 its former size. I guess a S--- Window is the same no matter what size.:roll

[preciousnurse]

I cannot believe you guys who say that you keep alcohol wipes in the Pyxis. I just grap some in the morning at the station or clean utility and keep them in my pockets. We have two the things, one for supplies and the other for meds, however we have floor stock of sterile gloves 4X4's, alcohol pads, baby lotion and soap etc.... I cannot believe that. You also should have your code cart already stocked. Ask your upper management why they are doing it like this and point out to them that the Pyxis machine will save them loads of money just being stocked with the stuff that it is supposed to be stocked with. It has saved us tons of money, plus it is really cool once you get used to it. Good luck and let me know how it goes. Remember, it only takes one person to make suggestions to get stuff happening if you have sluggish upper managment.

[Heidi]

i AM AMAZED. WHERE I WORK WE HAVE FREE ACCESS TO ALL THE ITEMS YOU STATE.However DRUGS/narcotocs are in locked drug cupboard, for controlled drugs we have a controlled drugs book which we sign in and out, the rest is either ward stock or imprest from pharmacy.