Pyxis (almost) nightmares. PLEASE be careful. - page 2

The Pyxis is a touchscreen, and we all know how sensitive touchscreens can be. Plus, there are many ways to go about pulling the med for the patient. Search by pt name, search by bed number, search... Read More

  1. by   JMBnurse
    I never worked in ICU or the ER during my nursing career, but I agree that drugs like sux should never be in a pyxis. That is a drug along with many others, such as, versed, diprivan and injectable potassium that should always have to be pulled from a very secure location with a total of 2 nurses witnessing. On the med-surg floors in the hospitals where I worked, they would have never been in the pyxis. I understand that in other areas drugs like that need to be available quickly, but they should never be stored in any location where an error could easily occur. Anytime I ever saw a drug like that show up in a patient's pyxis profile on my floor, I would immediately call the pharmacy and tell them to remove it and they would. It is possible to significantly decrease the number of medication errors if dangerous drugs like these are stored separately and securely. I was always very careful when I administered meds, especially since I was an oncology nurse and chemo errors could be deadly. However, quite frankly, I was concerned about some of the others nurses I worked with over the years and I would have been terrified if I was scrolling through a med profile and saw sux there. It's way too risky. There has to be a better way.
  2. by   phoenixrn
    My routine: I check the MAR, then pull the meds. Then, I chart the meds one by one against the MAR, checking the name and correct dosage again, then opening the package, announcing the medication and its purpose to the patient.

    Almost fool proof way to double check whilst also doing patient education about their medications.
  3. by   Anna Flaxis
    Quote from subee
    Sux does not belong in a pyxis. Wayyyyyy to dangerous ; plus it has to be kept refrigerated. To make this even a dumber move than it is, it's CHEAP.
    My thoughts exactly.

    Our Sux is kept in a paralytic kit, in the refrigerator which is tied to the Pyxis. To pull Sux, you log into the Pyxis and enter the patient, but you have to actually physically open the refrigerator and select a paralytic kit.
  4. by   bezany
    bedside scanning is a lifesaver, as long as we dont bypass it. At my hospital we scan the patient armband and then the med, we use an electronic mar. It is virtually impossible to give the wrong med if we follow the procedure. I still do a 5 rights and physically check the med both when pulling it from the pyxis and prior to opening the package at the bedside or spiking the bag.
  5. by   kath<3
    As a nurse, who previously worked as a pharmacy tech, I would also like to add....check the medication after you pull it. Sometimes wrong meds can be put in a drawer (extended release tablets placed in immediate release drawers etc). Nobody is beyond making errors. Always always double check your meds.
  6. by   bezany
    I would not want to be pulling narcs for agency staff, thats crazy! temporary codes can be given to agency staff and if i were in a facility where they didnt have access, i would be advocating strongly for that.
  7. by   Karenrussell73
    I had an awesome preceptor when I was a new grad and was oriented to Pyxis. The best advice I received was to double check the med I pulled from the individual pockets before closing the drawer. I can't tell you how many times someone dropped the wrong med back into the wrong pocket. Like someone already stated, the 5 Rights should protect you if your error makes it tomthe bedside, but a 2-second peek will prevent your heart keeping into your throat!
  8. by   QueenMangin
    We're up to 8 Rights...
  9. by   marycarney
    my routine - after a near miss - is this. as soon as i have the drug in my hand after removing it from the drawer, i hold it up to the screen, compare the label to the screen and then say the name of the drug out loud. you are then engaging your eyes, ears, voice and hands in the process of drug verification.
  10. by   cosmicmama
    The Pyxis should be reprogrammed to require a witness to pull something as dangerous as sux. That is how it is at our facility. Also, in my L&D unit, we have to have a witness to pull Mag and Pitocin for pregnant patients.
  11. by   dudette10
    I have no idea why it was in our Pyxis, and I also had no idea it needs to be refrigerated. When we call Code Blue, one of the kits that the ICU nurse or RT brings contains sux (which is also not refrigerated), so why would floors need it available?
  12. by   marycarney
    Because if there is more than one code going on - someone doesn't necessarily get the kit.