Pyxis, Omnicell, Accudose Comparison

RNinSoCal · Jul 21, 2007

I like omnicell for 2 reasons:

You don't have to count your narcotics

The omni machines are bigger so more meds can be stored in them.

We just switched from pyxis to omni. We used to have 2 pyxis on the unit and we were constantly running between the 2 machines to pull meds (large med/surg, ortho, oncology unit). Now the 2 omnis have the exact same meds stocked so I don't have to walk to 2 machines and wait in line to pull meds for each pt.

I do have to say that I don't like that our omnis don't prompt for a waste co-sign so we have to remember to waste. The pyxis would prompt us and show a cosign screen for waste without additional steps.

The bottom line is, having no dispensing machine at all on a med surg unit is hell.

I remember the time before them and it was tedious, time consuming and there were always missing meds that pharmacy took hours to deliver.

nuangel1, BSN, RN · Jul 21, 2007

i have used the pyxis and accudose .i find the accudose simpler and easy to use .only thing is you can't waste at time med is taken out .you have to go back in to do a waste . i have never used and omnicell.i have no idea of cost .pyxis used to crash .never happens with accudose.

jkarras81 · Jul 23, 2007

THANK YOU ALL!!!

As I understand, all these systems have their pros and cons.

What about the cost? does anyone have a clue?

medicrnohio, RN · Jul 23, 2007

I have used Pyxis and Omnicell. My vote would be for Pyxis. Although it is far from the best it is not riddled with the problems with Omnicell.

Here is a short list of our Omnicell issues:

The machine does not like our fingerprints. You can spend hours trying to get it to take your fingerprint. We have tried lotion, water, etc. The hospitals response....rub the skin on your face or your hair before using the fingerprint ID part.

You have to have a witness for every override med including emergency meds and simple things like MOM or Tylenol.

It is horribly noisy if you don't do things in a timely manner. Like draw up your insulin in 2 seconds flat.

blainer101 · Jul 24, 2007

I've used them while traveling; I liked the accudose the best. No particular reason other than for me it was easier to use (I'm pretty technology impaired).

I agree accudose seems to flow better when getting medications out, nice big screen too.

mustanggirl · Jul 24, 2007

I've only used Pyxis, which I did not mind too much at first, until we got the stupid fingerprint access. :angryfire It sounded great until we got it. It seems impossible to get into at times because for some reason it will not read my fingerprint which is very frustrating especially when you need something such as a vasoactive drip stat. It seemed like it had gotten worse and pretty much everyone could not get into the blasted thing on the first try so we even had a rep from Pyxis come out and repair the stupid thing... it worked slightly better for a day then it seems like it was back to normal. I don't think I should have to put lotion on in order for it to read my finger which they recommended and sometimes work. It should read fingertips without needing skin oil or lotion applied to them first! Has anyone else had this problem and what has worked?

Indy, LPN, LVN · Jul 25, 2007

I like Omnicell because it's got a draw where it dispenses all of the controlled substances into and then the drawer pops out. No counting of narcotics each time you pull morphine, dliaudid, versed, ativan, etc. You just punch in all of your controlled substances and it will dispense them all in the same drawer to you.

Neato! We have an omnicell and it doesn't do that. We count the med each time we remove one. There are different ways to set the machines up, I heard. I'm gonna ask our pharmacist about that.

Indy, LPN, LVN · Jul 25, 2007

I have used Pyxis and Omnicell. My vote would be for Pyxis. Although it is far from the best it is not riddled with the problems with Omnicell.
Here is a short list of our Omnicell issues:
The machine does not like our fingerprints. You can spend hours trying to get it to take your fingerprint. We have tried lotion, water, etc. The hospitals response....rub the skin on your face or your hair before using the fingerprint ID part.
You have to have a witness for every override med including emergency meds and simple things like MOM or Tylenol.
It is horribly noisy if you don't do things in a timely manner. Like draw up your insulin in 2 seconds flat.

Apparently omnicells are set up differently depending on the facility. We have a list of meds we can override, those are what used to be in the "floor stock" and they do not require a witness. But it is picky about fingerprints. I'm getting better lately about getting it to accept my fingerprint but that first week was horrible. Our main problems with the omnicell do not actually involve the machine. It involves how the meds are stocked by pharmacy in the machine, and when, etc.

One thing it does that I haven't figured out yet how to undo: if I look up a patient not in our unit, say, to find out if we have a med in my machine that the floor needs and is lacking, the rest of the shift I have to use the alphabet function to find my own patients because it wants to pull up the whole hospital's census after that. Yeek! It seems to do silly stuff like that when I'm in a hurry.

all4schwa · Jul 25, 2007

I've only used the PYXIS, but I've seen one hospital where every single med was in there. That's a PIA when it's med pass time and every med comes out of the PYXIS. Where I work now, it's just controlled subs or frequently used PRN's that dont get stocked for each pt like tylenol.

jkarras81 · Jul 26, 2007

What happens during a power failure with those systems? How do get meds out of them?

CritterLover, BSN, RN · Jul 26, 2007

what happens during a power failure with those systems? how do get meds out of them?

ours is on a red "emergency" plug, that is connected to a back up generator (just like our vents are).

unless the generator fails, it continues to work. (and if the generators fail, we'll be too busy bagging our patients to worry about passing meds )

i've used both pyxis and omnicell. i liked how pyxis prompted you for a waste wittness; where with omnicell, you have to remember to change to the appropriate quantity, then go back and waste.

the omnicell can be set up so that controlled substances come out into a dispense drawer, which eliminates the need to count those drugs. however, controlled substances can also be put into regular drawers, and then they (and any other controlled substance in that drawer) must be counted.

for some very odd reason, our pharmacy has decided to put lortab into the regular drawer (must be counted); but clonidine and phenergan are in the autodispense drawer. go figure.