Ever pull the wrong med from the right cubie in the Pyxis?

Yep, immediate release morphine tabs in the extended release morphine tabs slot, at a different strength... that's the main one I remember.

Yep no one's perfect :-)

Yes several times in the LTF I worked at I found the wrong medication in the wrong spot. The medication should have been in a different spot. If I wasn't careful I would have given the pt. the wrong medication.

I have also found the wrong dose of the same medication.

I am not sure if I like the Pyxis I know it is suppose to be more secure but the old way with the bubble packets seemed easier at times.

It would take me some time at the Pyxis to get my medication out b/c I always double or triple checked my medication. There were some nurses that would have their medication pulled within 20 min. Makes you wonder if the pt. got the correct medication.

Once the whole cubbie was wrong. The tech got mixed up and put wrong meds in opposite drawers. We filed incident reports, transferred meds to right spots after having supervisor over-ride Pyxis, and then we were called on the carpet. Seems we should have had a new cart delivered and let the pharmacy fix the mess. Well, it was at night, no pharmacy, and patients needed their meds. Boy, some times you just can't please administration. Seems to me administration should have been jumping for joy that we did not give patients wrong meds and had a bunch of reports, not to mention doctors, patients and patient families to deal with. LOL!

Damned if you do and damned if you don't!

All we have is general medicine trolleys with the patient having medicines that are specific to them.
We have found the occasional wrongly dispensed medicine.

Wrong meds...have caught that.
Lots of wrong IVF in the wrong spot.

Yes, several times and that is why I remember the 5 R's. Besides we scan our meds to the patient armbands so it's not an issue.

Found 10mg Morphine carpujets in the 2mg slot..

Renal med in the tylenol drawer - or something like that - Was definitely different than supposed to be.....


Scarey.

I learned to really watch my IV drugs too. Once had a label on fluid saying Ampicillin, the little bottle attached said Augmentin. Good thing I didn't just activate and hang. I've always double and triple checked myself and that's a good reason why.

ohhhh - I do that too on the IVPB that you have to mix, just to make sure the right med is on the bag!