[MEDITECH-L] Pyxis pull meds and 5.6 emar
Dana Pfingstler
For those of you who are live with BMV/EMAR 5.6 are you having an issue with
the inability to change the dose on dispensing machine over ride meds? And
if you are, how are you handling this?
As it is now, if I pull Ativan 2 mg/ml from the pyxis as an over ride dose,
but only want to give 1 mg I am unable to change the dose. I have asked
Meditech about this, and am told it is working as designed.
This, in my mind, raises a lot of issues and concerns. Many times we give
partial doses of meds pulled from pyxis and we need to be able to change the
dose accordingly.
I was told by my Meditech specialists to poll other hospitals as to how they
are handling this. Or, I could have the users file the incorrect information
and then edit to change the dose, as it will allow me to do that.
Dana Pontious, RN
Nursing Analyst
Elk Regional Health Center
St Marys, PA 15857
814 788-8682
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Morris, Linda (Lincoln)
Dana,
We are Meditech Magic 5.5.2 so this may function differently in 5.6. I also can’t tell from your scenario if you have a charting interface from Pyxis to Meditech or if you are referring to the created override order in Meditech and subsequent EMAR charting by the nurse. So….I hope this answer is relevant to you.
We recently had our charting interface from Pyxis to Meditech removed because we came up with BMV. With the charting interface, override orders were created for the full amount in a vial and auto documented as such. If the nurse did not give the full amount, they needed to manually edit the auto documentation on the EMAR. After removing the Pyxis to Meditech charting interface, the nurses were having trouble documenting on the EMAR because they always received the error, order has been dc’d to you want to administer anyway? In consulting with Meditech, we decided to change the Auto DC Stock Order? flag in the Dispensing Machine Dictionary to Y. With the flag marked as Y, the nurse does not receive the DC error message. The added benefit we found is the order created in Meditech is a zero dose order so the nurse can document how much they gave from the vial. The sig of the created order when the flag is set to N is .DISP. The sig of the created order when the flag is set to Y is .STK-MED. The system sees a .STK-MED order created from Pyxis different than those created from Departmental Routines and does appear on the nurses EMAR even if you have the default sort set to N for seeing Stock Orders. The only draw back we have found with the change to the Y flag is the Pyxis created .STK-MED order is not showing up in EDM for the physician. Hope this helps.
Linda Morris
Pharmacy Operations Specialist
Saint Elizabeth Regional Medical Center
Lincoln, NE
_____________________________________________
From: medit...@MTUsers.com [mailto:medit...@MTUsers.com] On Behalf Of Dana Pfingstler
Sent: Monday, April 02, 2007 2:42 PM
To: Meditech L
Subject: [MEDITECH-L] Pyxis pull meds and 5.6 emar
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Jeff Lee
We’re bringing e-MAR (Magic 5.5.2) to our PACUs and we discovered that you can not do much with Full Doc on dispensing machine (DM) overrides as you discussed below. However, with Scan Med (SM), you have more flexibility. One scenario is the nurse pulls a 10 mg morphine and gives a small dose at short intervals. With Full Doc, you can only document on a DM order once (working as designed). Edit Doc does not leave an appropriate audit trail in PCI, etc, so I don’t recommend that. SM allows you to document multiple times on the same DM order.
For this reason we are leaning toward BMV in PACU over plain e-MAR. Also, I’m concerned about using the DM orders solely for PACU BMV because of interface downtime and delays. We’re considering turning off the DM orders from PACU e-MAR and just using the Enter Med e-MAR feature for all dose documentation. We have been using this successfully for inpatient e-MAR DM override scenarios. Any thoughts/comments on this approach?
(205) 750-5323
jl...@dchsystem.com
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From: medit...@MTUsers.com [mailto:medit...@MTUsers.com] On Behalf Of Dana Pfingstler
Sent: Monday, April 02, 2007 2:42 PM
To: Meditech L
Subject: [MEDITECH-L] Pyxis pull meds and 5.6 emar
Hi,
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