Avoiding medication errors

My hospital uses the Pyxis system for dispensing drugs-you have to type in a user name and ID yourself by fingerprint. THen pick your pt from a list and you can get their drugs. Narcotics and other expensive drugs (protonix, lovenox, cipro) you have to count every single time you want to get one out.

Then we have MAK. you scan your ID badge, then pick your pt, it shows the drugs due in the next hour, you scan each drug with a handheld scanner, then scan the pt's bracelet before givng meds. If you scan a wrong drug or a wrong pt it tells you. If you don't give a med (for ex, not giving sliding scale insulin b/c the BS is too low) you have to put a reason in. It keeps track of when you give meds so if you try to give PRN meds too soon before time it tells you.

Of course, the machines are only as good as the people giving it. You could always just hand out the drugs without scanning them. BUt its better than just going handwritten.

I find that when you get to comfortable errors happen. No matter how well I know my pt and even if they have been on the ward a month I triple check and check the name bracelet.

We have PYSIS and SCAN-sounds like the MAK mentioned earlier-but I still look at meds when removing them-believe me a pharm tech can make an error too!- then again before giving it-then right as I am getting ready to give to the pt. I know it sounds like overkill, but better safe than sorry!

We've started to have to ask the patient their birthday, in addition to their name and checking their armband.

We also have to bring the med sheets in the room with us, and then open the meds in the room with the patient. I have found by doing this it helps to go over the meds the patient is getting, then they can ask questions, or the institute their right to refuse.