"Discrepancies" In Epic Documentation

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The dreaded HR meeting happened. It was brought to my attention that there were 7 incidents of Ativan pulled but not given. 7!! Something is way off here. I work in Psych (15 years). I'm not a drug abuser. This is per a pharmacy report. Totally confused. We use Epic, and if something is pulled and not given, it shows up as overdue on the mar. 

Any one have an experience like this?

There's an option u can use that let's you doc a med without scanning it. Is that not acceptable? To doc manually? If so, why is the option there to choose it?

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Because of extremely exceptional circumstances and no I can’t think of any. It’s a trap, just scan everything. If not, you’ll get used to just giving them without scanning and you don’t want to do that. Sometimes the wrong med is in the drawers, and there are countless other things that can go wrong.

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2 hours ago, Faithx14 said:

If so, why is the option there to choose it?

So that the med can still be documented when the processes that they demand (and will write people up for not doing)...don't work!

Only use it if things are actually broken. And call pharmacy every time to let them know it's broken. Plus you can write a little med admin note that says pharmacy was notified and they said it's broken and that you will not be able to scan.

Plus, not using the scanning process is a safety issue so you should fill out an incident report to document that the pharmacy process is not working.

^ I say all of this sort of tongue-in-cheek, it does have a "malicious compliance" ring to it; on the other hand, it's rough out there. Look what you are going through now. Do everything in your power to reduce the opportunities for you to find yourself here again.

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Specializes in orthopedic/trauma, Informatics, diabetes.
On 8/22/2022 at 3:23 PM, Efelliot81 said:

Example: you pull the med scheduled for 1015 and scan at 1021 and EPIC will show the dose due at 1015 as Not Given with a dose given at 1021. This doesn't always happen but I've seen it often enough. These would potentially show up as missed doses on a report but easily researched to show they were actually given.

I have never seen that happen. And I am an EPIC super user/informaticicist. Your facility must have custom settings. In ours, we have an hour before and an hour after to administer a med without it being late. 

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37 minutes ago, mmc51264 said:

I have never seen that happen. And I am an EPIC super user/informaticicist. Your facility must have custom settings. In ours, we have an hour before and an hour after to administer a med without it being late. 

It has happened several times to me in the past.

I don't recall the specifics, but it was not a controlled substance. In the end I had to continue with the administration connected to the med I had pulled and mark the scheduled dose as not given. I included a comment to explain. 

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Specializes in Justice ⚖️ Nursing.
On 8/21/2022 at 8:48 PM, registerednutrn said:

So I worked at a facility that had epic and all of a sudden I get called in saying I had pulled a controlled substance and didn’t scan it I had worked there double digit years so I was given a verbal warning.  Then the next week I get called in and it has happened again so I get written up and drugs tested. So then it happened again the next week so of course  was extremely upset I was suspended a day written up and drug tested I am afraid I’m gonna lose my job  and my license then my boss tells she that she is receiving stacks of controlled substance discrepancies and she doesn’t understand why.  I spoke to several other nurses that were on last write-ups.   I also showed  my boss where the error happened with an antibiotic and I was refusing to give controlled substances anymore.  Well turns out it was all a computer error with Epic but the worse part was I had to fight to get the write-ups remove and they were only removing them if the nurse pushed.  Don’t know if this is what happening to you but something to consider

RNs should get together and sue Epic, or someone. Not kidding!! This is very serious and you should have never had to submit drug tests, emotional turmoil and fear, and possibly of losing so much over something you had nothing to do with!! I'm dead serious.....if it was your mistake...they wouldn't think twice to fire you and go for your license. That's incredibly bad on Epics part....needs to be consequences. 

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1 hour ago, Lust4life said:

RNs should get together and sue Epic, or someone. Not kidding!! This is very serious and you should have never had to submit drug tests, emotional turmoil and fear, and possibly of losing so much over something you had nothing to do with!! I'm dead serious.....if it was your mistake...they wouldn't think twice to fire you and go for your license. That's incredibly bad on Epics part....needs to be consequences. 

I don’t think it’s Epic though. I think something else shady is going. It all starts at the Pyxis/Omnicell. Why are these meds pulled under her name?  Don’t you have to use your fingerprint or personal password. Who has access to the Pyxis/ Omnicell paswds.  If  there’s a pharmacy tech in this chat please let us k ow something.

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On 8/21/2022 at 8:48 PM, registerednutrn said:

So I worked at a facility that had epic and all of a sudden I get called in saying I had pulled a controlled substance and didn’t scan it I had worked there double digit years so I was given a verbal warning.  Then the next week I get called in and it has happened again so I get written up and drugs tested. So then it happened again the next week so of course  was extremely upset I was suspended a day written up and drug tested I am afraid I’m gonna lose my job  and my license then my boss tells she that she is receiving stacks of controlled substance discrepancies and she doesn’t understand why.  I spoke to several other nurses that were on last write-ups.   I also showed  my boss where the error happened with an antibiotic and I was refusing to give controlled substances anymore.  Well turns out it was all a computer error with Epic but the worse part was I had to fight to get the write-ups remove and they were only removing them if the nurse pushed.  Don’t know if this is what happening to you but something to consider

So I asked if it was just me, and they said no I'm not the only one. Before we had epic we had medi tech and I thought nothing of documenting manually if I didn't scan , because as long as they were documented no one seemed to care. There are others over the course of six months they told me, I suppose not all controls or they'd have questioned me by now. They mentioned it's happening on night shifts also. If there " many others" in six months I'm thinking it's due to documenting manually. Thoughts?

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Specializes in Med nurse in med-surg., float, HH, and PDN.

Ah, yes, computers have made all our lives so much easier ... except when they DON'T! My first and only try passing meds from a computer was a total failure because...my fingerprints didn't register AT ALL. And neither did the code # the supervisor gave me to bypass fingerprints. 

From trying and trying to get the damn system to work for an unconscionable length of time, my frustration erupted through my skull and I burst into hysterical tears. They sent me home, and I never went back !

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Hey everyone... thanks EVERY one of you for your support. Turns out, I had a bunch of " flags" of pulled meds, not given, BECAUSE they were wasted/ returned . They were all instances of patients refusing meds, which happens DAILY on a psych unit. So before checking the actual documentation, it was brought to me. That, coupled with the unit bully saying my behavior was "altered"  because she literally yelled at me for something stupid in the middle of the floor which flustered me, led to a meeting where I felt totally jarred.  Felt like they were insinuating diversion on my part.. The incident left me reeling and distressed because people lacked the sense to check the nurse's documentation before questioning them.( me). Oh and another example of my " altered behavior" was that I closed my eyes a few minutes during report. .I was " nodding off".  What the actual ***?!

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Specializes in ED, Informatics, Clinical Analyst.

Don't you have to have a cosigner when you waste?

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Yes, and I did, every one of them 

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