Pyxis questions

We just upgraded, we now have to track down another nurse to witness our waste of nothing. If the patient has 50mcg fentanyl q 1minute ordered, and we give two 50mcg doses out of the same 100mcg vial, the pyxis requires that have a witness for our waste of 0 mcg. If you know how to make that more tolerable, other than taking a bat to the pyxis, feel free to share.

Hello, my first question is, at the facility you work in, was waste not required to have a witness before your upgrade? All waste should be witnessed, to assure there is no diversion of the balance. In your case I can see where it would be annoying to have to get a witness if you are using the whole vial for two doses. Unfortunately, because the dose is set in pyxis at 50mcg the system is going to assume there should be a waste of the other 50mcg. A variable dosing prescribed of 50-100mcg would prevent the system from flagging for waste, but precise documentation in the patient chart is suggested to cover yourself. It creates more work no matter how it's sliced. The other option is to waste the other 50mcg and just pull another vial, but either way you will still need to get a witness. I don't recommend using both doses from the same vial unless you are very diligent on documenting the usage in the patient charts. This creates confusion with any controlled substance audits. There is also a function in the system that allows you to forward a balance, assuming it is turned on by your system administrator. This may work, keeping you from having to document the waste is pyxis. I always like to stress the need for clear and concise documentation of any controlled substance.

Thank you?

Have you had any glitches in your Pyxis station that the Pyxis does NOT ask for a witness to waste a narcotic? It has happened to me at least 3 times. I brought it to the attention of the supervisor but instead of trying to figure out what happened, she reported me to the board for narcotic diversion. I am now facing the prospect of losing my nursing license or at the very least go on 3 years probation. I have contacted the Pyxis manufacturer but after 3 months have still not heard from them. Any information you can give me would be greatly appreciated.