The hospital I work at recently started implenting pyxis on all floors. We're using the pyxis to dispense medications. This is suppose to help reduce waiting time for new meds from pharmacy since they'll be on the floors already in our pyxis. Fine. whatever.
I like pyxis. It's user-friendly and fast.
I just HATE that I'm only allowed to take out meds for one patient at a time when I can have up to 7 patient in my shift!
So I basically look like I'm crazy - I go to the pyxis, get 1 patients meds, go to said patient and give meds and do whatever else I have to do...then GO BACK TO pyxis and pull out another patient's meds and go to their room, and so on....I start passing out my 10am meds at 9am and these past two days of working with pyxis, it's been 1130 and I'm still passing out 10am meds!
It's our stupid hospital administration that is behind this latest stupid policy.
Such a complete waste of time!!!!
What is your hospitals policy in regards to pyxis and pulling out meds??? Is it one patient at a time??? Or can you pull out all meds for all patients????
Hospitals in my area do the whole "fire drill" like Zofran's. Sometimes there is such a pile up of nurses at the Pyxis, it's like a hockey game! Then you gotta do the whole in room scenario with the MAR and scanning, etc.
Just Luv, luv, luv, it when you get through the "fire drill" and halfway through scanning and admin business and one or two of your med barcodes is damaged.
Specializes in Emergency Dept. Trauma. Pediatrics.
The hospital I am doing clinicals at use pyxis and doing one patient at a time is policy there. It seems safer to me, we also have the eMar and scan all the meds. Insulin and wasting and another injection med that I can't remember off hand have to have another nurse verify with the pyxis. They have the fingerprint scan on it as well. None of the nurses I have worked with have expressed annoyance with that so far. On the larger halls of the hospital there are 2 med rooms and 3 machines, 1 machine in the smaller med room and 2 machine in the larger med and supply room.
On the smaller unit I worked on there were 2 machines. I don't know if it is like that on all the units, just the floors I have been on so far.
We had pyxsis at our hospital also, and the policy didn't change until we went to scanning meds to sign them off that we were only allowed to pull one patients meds at a time, apparently it's a JCAHO mandate...we also had only 1 pyxsis for 20 patients and 4 nurses. In the beginning, it was horrible going from pulling all 6 patients meds to pulling one at a time, but then it got better...and even still, we would pull 2 patients meds at a time if they were in the same room...or if we were only giving heparin sq but to 3 or 4 different patients at the same time, we would pull all of the heparin we needed and then just go room to room. It will get better.
We have pyxis and we pull out one patient at a time. I usually start passing my 9:00 meds at 8:00 and am usually done by 10:00. That includes doing my assessments on each one too. We have 5-7 pts normally. On days that I run later than that, it's because I get interrupted 10,000 times for prn meds, beeping IVs, new orders, getting a pt ready for a procedure, etc. OK, so I run late once a week at least...LOL.
We have drawers for each bed in our med room for things like ointments, liquid meds, etc that don't go in the Pyxis. Sometimes, if I'm running early (ready to pass my 9:00 before 8:00, I'll pull out several patients and put them in their drawers. I still go back to the med room though between patients.
With my later meds, if I'm giving an IVP med to one room and a pill to another (something obviously different and hard to confuse) I'll pull them out together and take them down the hall together. But I don't do this for my morning pass since some people have tons of meds.
Specializes in Certified Med/Surg tele, and other stuff.
Quote:get report, do assessments and vitals, check charts for new orders, go to pyxis and pull out meds. i DON'T pull meds for one patient, pass them, then go back to the pyxis for the next patient, etc... it's a waste of time and makes no sense to me. yeah it's supposed to be safer, but what's to keep u from taking meds for one pt and going to the wrong room/bed and giving the wrong meds? our pharmacy provides us with plastic baggies (some nurses use biohazard bags even though we're not supposed to, lol) and what i do is write the room/bed number on the bag and make one for each patient.
when there's a med that is not in the pyxis (pt specifics) the pharmacy gives us a pre-printed label with the patient's info, med info, MD info, etc and i use that instead sometimes. END QUOTE
How is someone's safety a waste of time?
Quoted: yeah it's supposed to be safer, but what's to keep u from taking meds for one pt and going to the wrong room/bed and giving the wrong meds?
How about taking the MAR with you, and comparing bracelets?
This is the first time I have used pyxis and we are going to the scan mode soon. I don't like to be passing meds all day either, but if it keeps my butt out of hot water by making a med error, then I'm all for it. I'll sleep better at night.
Yes, we have a pyxis at my job. I am responsible for five patients. I use dixie cups and write each patients last name on the cup. I only pull my narcotics for each patient one at a time for safety. I place my medication in my locked computer lab top storage holder. Each patient has a wrist band with three pieces of information on the wrist band to ID them. First scan their wrist band, second ask the patient for their full name and social security number. Third their picture is also available for identification in our computer system. Fourth each medication is scanned prior to administration. I love our pyxis and no med errors on my behalf by identifying prior to administering meds.
Specializes in Emergency Dept. Trauma. Pediatrics.
I should also add, the day shift nurses usually have 3 patients, very rarely 4, I do evening clinicals and my nurses have never had more then 4 patients but more typically it's been 3. I come on during day shift and leave at 11.
The RN have 3 patients and the LPN have 5 patients. The five patients the LPN has are usually catergory 1 or 2. The RN are accountable for the LPN such as IV pushes, blood, new admits etc...
That is great all nurses have 3 patients at your work place.
Specializes in Emergency Dept. Trauma. Pediatrics.
The RN have 3 patients and the LPN have 5 patients. The five patients the LPN has are usually catergory 1 or 2. The RN are accountable for the LPN such as IV pushes, blood, new admits etc...
That is great all nurses have 3 patients at your work place.
I have only seen the day shift nurse have 4 once and that is when they are getting a new admit shortly before shift end when patients will be shifted around anyway. The hospital I am doing clinicals at is known for having really good ratios.
I've seen people post about this "pyxis" but am unsure what such a thing is---isn't it a med cart so to speak? Why call it a pyxis? Guess I'm too "old school".
Specializes in Telemetry, IMCU, s/p Open Heart surgery.
I hate to say this, but I can't imagine why you'd pull more than one patient's meds at a time. You don't look ridiculous - you look safe and smart.
I've never worked anywhere that didn't have a Pyxis, and I've never seen anyone pull more than one patient's meds at a time - and I've had as many as seven oncology patients on a night shift. I can also honestly say I've never walked into a patient's room with the wrong medications (i.e., Patient Y's meds going into Patient X's room), and I can assure you I'm not perfect. I've had a med error - because I missed an order, not because I went to the wrong room with the wrong meds (which it would seem to me is ten times more likely if you're pulling meds for multiple patients at once).
Why would you put meds in plastic baggies? There's an awful lot of wasted time sorting meds and labeling them right there...
These are questions, not judgements, because I don't understand how this saves time or prevents errors. It goes against everything I've ever seen, was ever taught, or can even comprehend.
no sorting... as the little boxes pop open i put the meds in the bag... i've worked on several units in my hospital and we all do it this way. why wouldn't you put med packets in a baggie? would u just go in the room with loose med packets? and that's how the pharmacy gives us pt specifics and insulin... with a patient sticker in an individual bag for each pt. we use the COWS (computer on wheels) that have drawers and we just all sort out our shift. flushes, swabs, etc in one drawer and bottom drawer for meds. so what i do when i go in a pt room is pull up their med profile on the computer and double check and go over meds with the pt.
i mentioned the med error of going into the wrong pt room by taking out meds one by one is b/c i know someone it happened to. they had one pt's meds with them, got called into another room and somehow got confused and almost gave the wrong meds.
bottom line, we need to double and triple check orders and what we're giving our patients. i don't think there's any one fool-proof, safe way of giving meds. i've found wrong meds, expired meds, and right med, but wrong dosage in the pyxis boxes.
The only time I ever draw out more than one patient's meds from the pyxis is if the are the same meds - example, if I needed to give heparin shots at 0600 - I would get all the heparin out at the same time - and heparin only. I tried to pull two patient's meds out to save time once, and got all mixed up, ended up wasting much more time than walking back and forth!
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netglow, ASN, RN
4,412 Posts
Hospitals in my area do the whole "fire drill" like Zofran's. Sometimes there is such a pile up of nurses at the Pyxis, it's like a hockey game! Then you gotta do the whole in room scenario with the MAR and scanning, etc.
Just Luv, luv, luv, it when you get through the "fire drill" and halfway through scanning and admin business and one or two of your med barcodes is damaged.