just a quick question--kind of debating with pharmacy dept at my hospital
re-the pixis and returning meds
i always thought safe nursing practice was--if you remove a narcotic to administer and for whatever reason, it is not given-- it should be wasted and signed as such by 2 nurses witnessing this--even if the med was never removed from it's vial or it's carpuject tube
my pharmacy states we can return these to the external return bin. these bins are emptied weekly by a pharm tech.
now-- my dilemma. i am the last nurse to sign out this med (call it dilaudid). i never open it or crack it's seal. i return it to the return bin. pixis records that i have done this. 3 days later a pharm tech empties the bin. how do i know they don't pocket that med and then claim i never actually returned it? my word against someone else's?
am i the only one that thinks this could be a problem? my pharmacy director thinks i'm making a mountain out of a molehill.
i don't think i am. so, i am asking for your input-- how do you guys handle this in your units?
As a pharmacy tech, I completely concur. At our hospital, you waste the medication with a witness. If it's sealed, you can put the medication back. NEVER is the drug returned to the medication bin as anyone can walk in. If it's absolutely necessary, go to the pharmacy and manually check it back in. Save your license because if anything happens, we can easily pull it up a full detailed report of who, what, when etc
Our Pyxis is also set up so that when you're returning it, which removes the charge from the patient, you must have two RNs verifying. In this day and age of cost containment, I can't imagine wasting an unopened vial or syringe.
We use PIXIS at our hospital and have this same policy. Howevcer, our PIXIS is linked to our charting system and automatgically charts everything we do into our charting system with these drugs. So If we pull out and return narcs it is charted in this systme which is setup so that no one has access to ever trully delete anything. Even if you delete something it charts that so and so logged in under their nae and deleted this thing that was previously there. Do your system link do another program?
In our pyxis the narcotics are in a separate drawer, and when you return an unopened "waste" a bin slides open in *that* drawer...not the same bin used for other returns.
You guys have given me great ideas--Thank you all so much-- I had my clin manager review your responses and she's with me on this--our process needs to be fixed--hopefully we can get the phamacy department on board!
We use PIXIS at our hospital and have this same policy. Howevcer, our PIXIS is linked to our charting system and automatgically charts everything we do into our charting system with these drugs. So If we pull out and return narcs it is charted in this systme which is setup so that no one has access to ever trully delete anything. Even if you delete something it charts that so and so logged in under their nae and deleted this thing that was previously there. Do your system link do another program?
The in-patient part of the hospital utilizes eMar- I'm not sure exactly how that works --I know the med ordered must be in the patient's profile before it can be removed. This is done by the pharmacy dept after they receive a copy of the physician's orders. Our ED is a non-profile area currently-- all you need to do is pick your patient and then pick the med you want--every med that is stocked in PYXIS can be removed for that patient if needed! Your selection is only limited by what is stocked in the machine
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mulan027
22 Posts
As a pharmacy tech, I completely concur. At our hospital, you waste the medication with a witness. If it's sealed, you can put the medication back. NEVER is the drug returned to the medication bin as anyone can walk in. If it's absolutely necessary, go to the pharmacy and manually check it back in. Save your license because if anything happens, we can easily pull it up a full detailed report of who, what, when etc