Class of 2007 Abstract / Objectives: The purpose of this study is to determine the reason for the concerns expressed by the nurses in two wards of the University Medical Center. This information will be used to identify areas for improvement in the Pyxis procedures. The objectives of the proposed project include the following: 1) To conduct a descriptive prospective study based on the responses made by nurses about the Pyxis machines, and 2) To determine the most common concerns. Methods: The study was a two phase descriptive prospective study of data obtained through two surveys. The first survey was formative in nature to determine the general area that is the source of the concerns, and the second survey was performed to determine specific opinions that the nurses have about the system. The subjects were nurses that use the Pyxis machines in the 4 Northeast and 4 Northwest wards at the University Medical Center during the time the survey was given. The sample size was approximately 45 subjects. This is the estimated amount of nurses that work in the two wards that were studied. All nurses surveyed used the Pyxis system in one of the two wards. Use of the machines was defined as performing any of the procedures that correspond to the system i.e. dispensing, doing returns, wastes, drawer failure recovery, narcotic inventory, discrepancy documentation, and reporting medication errors. The primary dependent variables were the opinions the nurses have about the Pyxis machine system and what specific factors they have concerns with. Demographic variables included age, gender, how long the subjects have worked in the ward, how many hours per week they work, how often they use the Pyxis machine, degree of education, and what shift they work. A preliminary survey was done to determine the general aspect of the system that produces the most concerns. The survey was distributed at the monthly staff meeting in paper form and then presented to the nurses personally while they were working on the floor. The data from the first survey was then reviewed and used to produce a second survey designed and implemented to discover more detailed and specific opinions of the system. The second survey was also distributed in person to the nurses while they were working on the floor. Results: Analysis of the data from the first survey showed that the concerns expressed by the nurses concerns were primarily based around the stocking procedures of the Pyxis system. The second survey showed that the Pyxis machine should be stocked twice a day at 6:00am and 6:00pm, the finger print scanner has caused nurses some problems, and that ZofranTM should be available for override. Conclusions: The study showed that in order to optimize the capability of the Pyxis system, it should be stocked twice a day at 6:00am and 6:00pm with the enough of the appropriate medications to last until the next restock. According to the comments made by the nurses, there have also been significant problems with the finger print scanner, and not being able to override ZofranTM is also an issue. If possible and plausible, addressing these issues would lead to a smoother work flow, a better working environment, and better outcomes for the patients.

Zugl.: Münster (Westfalen), Univ., Diss., 2003

Class of 2010 Abstract / OBJECTIVES: The objective of this study is to compare the number of medication refill errors that occur between the Pyxis Medstation 3500 and the Pyxis PARx automated dispensing systems. The accuracy of refilling Pyxis Medstation 3500 automated dispensing machines by pharmacy technicians at the University Medical Center (UMC) was assessed during six days in July 2009. The accuracy was then reassessed over the course of five days in September 2009, one month after implementation of the new Pyxis PARx barcode technology in August. All medications in both the morning and afternoon Pyxis refill reports generated by the UMC inpatient pharmacy were audited during the chosen days. METHODS: The accuracy of refilling Pyxis Medstation 3500 automated dispensing machines by pharmacy technicians at a 350-bed, tertiary-care, teaching hospital with a total of 50 automated dispensing systems was assessed during five days in July 2009. The accuracy was then reassessed over the course of five days in September 2009, one month after implementation of the new Pyxis PARx barcode technology in August. It was assumed that the following types of medication refill errors would be reduced: 1)Wrong drug, Wrong strength 2) Wrong drug, Right strength 3) Right drug, Wrong strength 4) Filling error/Wrong pocket 5) Overfill of pocket 6) Expired medication 7) Right drug, Wrong form. This study was a prospective evaluation of medication refill errors between an older automated dispensing system (Pyxis Medstation) and a newer system (Pyxis PARx). The addition of PARx barcode technology automates the pick and delivery method in order to enhance security during the medication refill process. When the appropriate drawer is opened, the medication must be scanned using the handheld scanner to make sure the correct medication is being refilled. All medications from each Pyxis refill report on the chosen days were audited during pre and post implementation of the new Pyxis PARx barcode technology. Medications to be audited were identified by collecting data from each automated dispensing system listed on the refill reports for the previous day. Audits were performed on the following day (i.e., Monday’s refill reports was audited on Tuesday) by study investigators. Each completed refill was audited for the above medication errors and a brief description of any errors found was noted. RESULTS: A total of 825 refilled items were audited prior to PARx installation (from dates 7/14/09-7/19/09) and a total of five errors were found. Post PARx installation, 959 items were audited (from dates 9/24/09-9/29/09) and a total of two errors were found. Overall, the types of errors encountered were Right Drug/Wrong Form (1/7, 14.3%), Filling Error/Wrong Pocket (2/7, 28.6%), Overfill (1/7, 14.3%), Expired Medication (2/7, 28.6%) and Right Drug/Wrong Strength (1/7, 14.3%). A Chi-square analysis was done to compare pre and post-PARx implementation errors found. The Chi square value was found to be 1.79 with a p-value of 0.18, meaning that there is an 18% probability that any deviation from expected is due to chance. Thus, per our investigation the installation of PARx did not significantly decrease refill error rates. CONCLUSIONS: In Progress