What exactly is a pyxis?

Specialties Med-Surg

Published

Silly question, I know...but in the hospital where we do our clinicals (Im still a student, to graduate in May) they still use the roll around med carts. The hospital where I have accepted my first job uses a "pyxis", (i think Im spelling it correctly), but I have no idea what that is or how its used!!

Any help?;)

In most cases, you will find the patient's profile medications listed under their name and room number. The override medications are variable to the flloor/unit where it is located and a list of those drugs may be a little harder to find. They also change according to need so they may not be the same all the time.

Up Vote Up Vote ×

Overriding is the process of obtaining medications not on the pt profile that is stored in the pyxis. Ie, doc comes to floor and orders stat Ducolax for nopoopoo. If allowed, pyxis can be overided to obtain meds not set up by phamacy, yet.

Up Vote Up Vote ×
Specializes in Cardiac.

Stat dulcolax? Really?

I can tell you now, that's not something that I'm gonna override...

The meds that I override are the things pts need now, and can't wait until pharmacy updates on the pt profile.

Up Vote Up Vote ×

How does your comment pertain to the OP's question?

Up Vote Up Vote ×
Specializes in Telemetry/Med Surg.
How does your comment pertain to the OP's question?

I can see that the question was about the Pyxis and it got into overriding meds. ducolax is a medication that you don't normally need to get with an override.

Up Vote Up Vote ×
Specializes in Cardiac.
How does your comment pertain to the OP's question?

Because the override function should be used sparingly, and not for things that can wait, like 'stat' dulcolax. It's for emergercies, or urgent pain relief, or for situations that need to be dealth with now. I'm thinking of propofol, metoprolol, K runs, etc. Not dulcolax.

I honestly can never see a time where a person would need a stat dulcolax.

And, manofcare-not every question in a thread has to direclty answer the OP (even though it did). This is called a discussion. Posts flow as we all discuss things. That's how this works.

In some hospitals, they try to limit the amount of overrides, and even watch the activity of those who override frequently.

So, to answer the OP, don't override dulcolax. It's lame.

Up Vote Up Vote ×

We override all the time; but maybe that is because I work nights, and we only have one pharmacist to update profiles. If the hospital is swamped with admits, she might not update a profile for a couple of hours.

When we override, though, we still have to scan the med with our scanner before we give it. Then our handheld devices prompt us to create a "one time dose" order. We are basically updating the profile for a one time dose, and when the pharmacist gets to it, then she will update it for subsequent doses.

When we are overriding, we are taking on a lot of personal responsibility. When you are updating the profile for a one time dose, it prompts you with any possible interactions with current profile meds--and as you know, just about every med has potential interactions with anything else. You have to override this and then give your reasons for the override. You are taking responsibility for this. If it's something simple like, pt has tylenol ordered and I'm giving lortab, I'm comfortable with that. I know the interaction is that you can overdose on tylenol, and I know that I haven't given my pt too much tylenol in the last 24 hrs. Other prompts are things like oversedation potential, and I'm okay with that. But when prompts come up that are more complex, I usually stop and reverify with either the pharmacist or the physician, and chart that I consulted them before giving.

So I suppose it depends upon the system. Ours allows for overriding, but we have to give reasons for it, and verify any interactions or potential allergies. I like having this option. Using the above mentioned dulcolax for example; I might get an order for it at 2000, but if the pharmacist isn't going to get it in for a couple of hours, I'm going to override, because I'm not wanting to give Dulcolax after the pt has gone to bed if I can give it a couple of hours BEFORE bedtime. So I'll override. The med is still documented in the electronic MAR, as are my reasons for overriding.

Up Vote Up Vote ×
Specializes in NICU, Infection Control.

http://www.cardinal.com/us/en/providers/products/pyxis/products/medStation3500/index.asp

This link has a picture, possibly more discriptive...

Up Vote Up Vote ×

Pyxis are great! The pyxis is a large unit that houses anything you want it to- medications, narcotics, supplies, etc. The purpose of the pyxis is to provide a point of service billing for whatever is pulled out. When you pull an item out, it is done under the patients name, which then is automatically billed to that person's account number.

To have access, you must have your entry system ( for us it is your initials and then your fingerprint via biometrics) and then pull want you need, enter the # your taking and then exit out.

Asside from capturing a lot of otherwised missed charges, you can run reports based on a certain patient/staff/medication/etc. For example, we had a situation of a travel nurse who was stealing narcotics and ambien from patients. I was able to request a report for all narcotics and ambien pulled by that nurse and was able to discern this had been going on for much longer than we knew and was being pulled from patients assigned to other nurses as well.

Additonaly, when narcotics are pulled, only the number you request is dispensed, so if you have 20 morphine cartridges in the pyxis and need 1, you won't have to count the whole 20 before taking any. This system has also allowed us to having to physically count narcotics every 24 hours vs every shift (we work 12 hour shifts).

It takes a little time for staff to get used to when using it for supplies, but from the manager's stand point, it is very used to and the staff will get over it quickly.

I highly reccomend them to everyone.

Up Vote Up Vote ×
Specializes in Cardiac.

Additonaly, when narcotics are pulled, only the number you request is dispensed, so if you have 20 morphine cartridges in the pyxis and need 1, you won't have to count the whole 20 before taking any. .

Really? We still have to count all of them... They are just in a little pocket.

Up Vote Up Vote ×
+ Add a Comment