PYXIS

We had the same problems when we started using these machines at our hospital. We had to re-do all the in-services. Then each error required an incident report. Attached to the incident report was a form they have to fill out stating how the error could have been avoided and how to do it correctly. The staff was made aware that the statements would be in their employee file and would be taken into consideration when it came time for the yearly evaluation.

It was amazing to see the decrease in errors. For some reason it seems that a number of our staff members simply did not like the machines and thought that if there were enough errors we would get tired of it and stop using them.

Good luck with this problem.

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Sheryl

If you enjoy word puzzles come visit me at www.CrosswordsForNurses.com

I don't have any brilliant ideas, but I can offer some encouragment--Is the system new to your staff? It took us forever to get used to ours, and at first we hated it, but now ALL of our charged supplies are in a PYXIS, and we do OK...They WILL get the hang of it(afterall, as I tell my Paramedic S.O., there is no such thing as a stupid Nurse....!)but it does take time...Our manager was willing to have weekly PYXIS meetings until we either stopped making errors, stopped complaining, or figured out how to use it..Hang in there!It will get better.(PS-tell them not to take it personally when the darn thing calls them INVALID!!)

Using the PYXIS is so much slower, it's hard to get used to. When we're in a hurry, it's frustrating trying to get a machine to surrender it's meds. I agree with the previous post. Things will settle down once nurses get the hang of it.

I agree--Once you are used to it, it is a good system--It's the pharmacy that makes it so difficult, be it meds that aren't loaded to meds that take forever to load, getting approval for meds to be in override, etc. Unfortunately our RX saw the need to change the data base just a titch, I think they like to throw us off once we really get the hang of it??? Anyways now when you ask for Percocet it automatically comes up 2, and we are used to it coming up "1" and then if you wanted "two" you would just change the number to "2" but most don't catch that it is now set at "2" and if you only grab 1 perc and don't notice--well, you can imagine how many discrpencies there have been in the last three weeks!! Why did RX do this? They claim it's a new Pyxis program but I don't buy it!!!

It's going to take time. Main thing let them know the pyxis is here to stay. We keep a discrepancy log. Nothing fancy, mind you (a composition notebook) if you make/resolve a discrepancy the receipt is stapled into the book with a complete explanation. The pharmacist in charge of the system prefers us to use "other" for descriptions. We also check for discrepancies once a shift, and count narcotics once per week (Since the system automatically keeps count when done correctly). The RNs are assigned to discrepancy check & narc count, they also have to attempt to resolve discrepancies (with another RN witness). So its in everyone's best interest to use it right.

If you're having a problem with supplies - options are to print out & post an inventory, or to get one of those very small drug name books (they list only generic-brand & brand/generic names). Also, check with whoever stocks it - par levels can be changed depending on usage. We use ours only for narcs & stock drugs, but I've worked other places where it was also used for supplies (dsgs, IVF, foleys, etc)

We have had trouble with our nurses also....your incident report form sounds like a great idea...can you forward me a copy of your form....thanks gmama, parker AZ

We had the same problems when we started using these machines at our hospital. We had to re-do all the in-services. Then each error required an incident report. Attached to the incident report was a form they have to fill out stating how the error could have been avoided and how to do it correctly. The staff was made aware that the statements would be in their employee file and would be taken into consideration when it came time for the yearly evaluation.

It was amazing to see the decrease in errors. For some reason it seems that a number of our staff members simply did not like the machines and thought that if there were enough errors we would get tired of it and stop using them.

Good luck with this problem.

------------------

Sheryl

If you enjoy word puzzles come visit me at www.CrosswordsForNurses.com

This thread is quite old, but for those interested, sounds like the nurses are using the pyxis to take out meds (like tylenol) without actually creating a record of withdrawal. One only has to select a patient, choose a med where the drawer is known to have a pocket of medication she/he wants to take, and then cancel the med withdrawal. Yes, this is stealing, but it happens all the time. If you suspect an individual with this, you can print a report of activity by user, and one can see the activity done in the last 24 hours. Any transaction that opens a drawer leaves a record of the activity (even when canceled-shows activity as canceld removal), although the machine cannot know what the user actually took. I used to work for pyxis, and I have been a user for a number of years. People who divert narcotics are usually very sophisticated in how to divert "under the radar" by not leaving descreapancy, but usually leave a trail of unusual activity. Bear in mind that none of this is "proof" of illicit activity, but ususally is a starting point when investigating suspected activity. Hope that helps