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Appendix E

—

Management and Monitoring Recommendations

214

Pyxis MedStation 4000 System Console User Guide

System configuration recommendations

This section includes the following topics:

•

Drawer configuration and medication location

 on page

214

•

Control the station formulary list

 on page

214

•

Order entry and verification

 on page

215

•

Medication distribution

 on page

215

Drawer configuration and medication location

The following list provides guidelines for configuring drawers and deciding 
where to place medications:

•

Consider using individual pocket access (MiniDrawers, CUBIE pockets, or 
Carousel drawers) for most medications, restricting the use of matrix drawers 
to floor stock medications, over-the-counter drugs, and those medications 
which have minimal, if any, clinical risk.

•

Consider keeping internal and external preparations clearly separated.

•

Avoid placing medications with similar appearance or similar names in the 
same matrix drawer and certainly not in proximate pockets.

•

Separate injectable drugs as much as possible, especially those in similar 
containers (for example, vials).

•

Place more commonly used medications in top drawers for easy access.

•

Emergency medications (such as code blue items) should not be kept 
exclusively in stations.

Control the station formulary list

The following list provides guidelines for managing the formulary list:

•

If distributing nearly all medications via the MedStation profile-mode system, 
consider activating the Display options with a value of ALWAYS at the 
console for the entire formulary.

Virtually all ordered medications appear in the patient’s profile at the station 
when entered/verified by pharmacy regardless of whether or not they are 
loaded. Nursing is then aware that the order has been entered/verified by 
pharmacy. Only ordered medications with Display Options set to ALWAYS 
appear on the Ordered Meds Not Loaded report at the console, located in the 
pharmacy. 

•

If distributing a limited number of formulary medications via the Pyxis 
MedStation profile-mode system such as controlled substances and floor 
stock, consider setting the Display options to Always for routine facility-wide 

Summary of Contents for Pyxis MedStation 4000

Page 1: ...Pyxis MedStation 4000 System Console User Guide May 2011 DME 10000152350 Ver 00 Matl Number 133591 01...

Page 2: ...l ISM est conforme la norme NMB 001 du Canada Information to User Caution Any changes or modifications not expressly approved by the party responsible for compliance could void the user s authority to...

Page 3: ...olution 2 Unit dose workflow 3 Pyxis MedStation system components 4 Network information 6 Comprehensive reporting 6 System communication 8 Interface options 8 Chapter 2 Console Basics Getting started...

Page 4: ...w 38 Editing a formulary item 44 Editing accessed inventory 45 Enabling Scan on Load Refill 47 Enabling undocumented waste 47 Configuring the multi scan medication feature 48 Formulary equivalencies 5...

Page 5: ...5 Deleting an area 96 Deleting a nursing unit 96 Clinical data 97 Predefined Clinical Data Categories CDCs 97 Using a CDC response 102 Adding a multiple response list 104 Editing a multiple response l...

Page 6: ...unication ports 138 Adding a virtual file 138 Editing a virtual file 138 Deleting a virtual file 139 Renaming a virtual file 139 Copying a virtual file 140 Updating information globally 141 Updating t...

Page 7: ...notice 184 Using brain transplant to restore a database 185 Checking the communication status of a station 185 Running a brain transplant 185 Communication problem with Pyxis Procar 187 ADT communica...

Page 8: ...8 Clinical and operational alerts 209 Alerts 209 Appendix E Management and Monitoring Recommendations Security recommendations 212 General recommendations 212 Controlled medications 213 System configu...

Page 9: ...Pyxis products at 800 727 6102 or 858 617 2000 Conventions This guide uses the following conventions The names of document titles cross references and text that requires emphasis are formatted in ita...

Page 10: ...e console Chapter 5 Inventory Describes how to use the Inventory feature to manage your hospital s inventory as it moves from the Pharmacy out to the patient Chapter 6 Reports Provides reports report...

Page 11: ...is MedStation system includes a network of secure storage stations located in patient care areas throughout the facility Each station is controlled by its own microprocessor and functions similar to a...

Page 12: ...g on your needs the Pyxis MedStation system can manage Controlled medications Floor stock Pro re natas PRNs profile mode recommended First doses profile mode recommended Some IV solutions and sets Up...

Page 13: ...able to reduce nine identified points of potential time delays and errors down to a manageable five Unit Dose Order is written and pulled from chart by clerk Prescription is delivered to pharmacy Phar...

Page 14: ...link patient orders and other pharmacy profile information CareFusion representatives configure and install the Pyxis MedStation system for you Stations one or more The stations are the clients in th...

Page 15: ...em components Pyxis MedStation 4000 System Console User Guide 5 L IMITED R ELEASE 1 DRAFT 5 4 11 Scanner A scanner capable of reading linear and 2D barcode symbols is standard equipment on both the st...

Page 16: ...billing system through Pyxis Procar Comprehensive reporting Many facilities have numerous stations located throughout a variety of patient care areas so comprehensive and accurate reporting is critica...

Page 17: ...erate summary reports of all transactions for that station for up to the most recent 32 hours To store information electronically or to generate custom reports you can archive the console data and imp...

Page 18: ...systems CareFusion will collaborate with any hospital information system vendor to complete these interfaces There are five basic interface options ADT interface Although ADT information can be manual...

Page 19: ...his information electronically to automated nurse charting systems Additional data fields in the Remove and Return processes collect information such as injection sites observations and other medicati...

Page 20: ...Chapter 1 System overview 10 Pyxis MedStation 4000 System Console User Guide L IMITED R ELEASE 1 DRAFT 5 4 11...

Page 21: ...Pyxis MedStation 4000 System Console User Guide 11 Chapter 2 Console Basics This section includes the following topics Getting started 12 Using the console 14...

Page 22: ...e standby screen displays the Login Window CommStatus and Help menu options Your system administrator provides you with a user ID and a first time Password 1 In the standby screen click Login click on...

Page 23: ...efore you can access the console you must have a password Your system administrator assigns a temporary password to you 1 In the menu bar click Change Password 2 In the Change Password dialog box ente...

Page 24: ...rd Change your password Window Turn display of the Attention Notices pane and XQ Viewer pane on and off Do not leave the XQ Viewer open use only as a support tool Help Access Online Help to get inform...

Page 25: ...he applicable item 2 To select an option from the open menu release ALT and enter the underlined letter of the desired option NOTE You can also activate on screen buttons using quick keys in the same...

Page 26: ...Chapter 2 Console Basics 16 Pyxis MedStation 4000 System Console User Guide...

Page 27: ...ur facility such as station names users patients and formulary This section includes the following topics Devices 18 Formulary management 38 Formulary equivalencies 50 Variable dose 54 Combination dos...

Page 28: ...in your facility 1 Select System Setup Devices The Devices dialog box appears This dialog box includes the following options Add Adds a station or other device to the system Edit Updates an existing...

Page 29: ...ck Add 3 In the Device Type Selection dialog box select the type The options are MEDSTN A station operating in non profile mode RX A station operating in profile Rx mode ANESTH An Pyxis Anesthesia Sys...

Page 30: ...name of the nursing unit is commonly used Status Displays the current status of the station which might include InService OutofService BrainTxPlant Pending InService Pending OutofService or NonLive Bu...

Page 31: ...station from operating correctly This option appears after you save the current information 3 Set the timeout options as necessary Anch Pg Timeout In hours 0 99 and minutes 0 59 enter the time after...

Page 32: ...on Inventory Prints slips when medications are inventoried Return Prints slips when medications are returned Waste Prints slips when medications are wasted Outdate Removal Prints slips when medication...

Page 33: ...option Application of this feature might be limited to certain areas such as an OR or post anesthesia care unit PACU Display Last Access Transmits throughout the Pyxis MedStation system to all statio...

Page 34: ...nsole to poll each station for transactions or activities that need to be reported select the Polling check box and indicate when the following should occur Poll Data If the console sends or receives...

Page 35: ...settings for profile mode If the selected station is not being used in profile mode skip to Entering the hardware settings on page 27 Entering the settings for profile mode This section describes how...

Page 36: ...licable options To override a patient s profile at this station select at least one of these override groups This group must match the override group of your formulary item and pocket 4 Update the lea...

Page 37: ...are removed Removal time is the administration time Meds Due Reminder Select to be reminded when medications are due 7 Complete the steps outlined in the next section Entering the hardware settings En...

Page 38: ...lf For more information see drawer descriptions in the Glossary Address Enter the drawer address location Status This box displays the current status of the drawer Subdrawer Enter the subdrawer number...

Page 39: ...ver a maximum of four categories are allowed per Remove Return or Waste transaction for each medication 1 Click the Clin Data tab The Clin Data tab appears listing all CDCs that have been defined in C...

Page 40: ...munication and message processing To continue the setup process Complete the steps outlined in the next section Entering station privileges for temporary users CAUTION Contact your CareFusion represen...

Page 41: ...e following procedures but who do not have the authority to perform them Wasting a medication Returning an item Completing an inventory Documenting a discrepancy Recovering a drawer Emptying the Retur...

Page 42: ...s not usually have access A temporary user has access for up to 99 hours depending on the time period defined on the Settings tab For more information see Entering the general settings on page 20 Cred...

Page 43: ...e station Independent Inventory Count Lets you inventory medications without a witness You can recover a failed drawer and conduct the subsequent inventory of that drawer without a witness assuming yo...

Page 44: ...ems and pockets have the same override group as you select here If you do not activate any override groups temporary users are unable to access override medications To select all groups click All To c...

Page 45: ...the information provided in Adding a station or other device on page 19 4 Click Save 5 In the confirmation dialog box that appears click OK to continue 6 To return to the standby dialog box click Clo...

Page 46: ...ce 1 If you are changing the name of a station resolve all discrepancies before continuing 2 Select System Setup Devices 3 In the Devices dialog box select the device and click Change Name 4 When the...

Page 47: ...irmation message appears click Yes to continue 5 If the devices in service a message appears asking Are you sure you want to change the device status to Out of Service If the device is out of service...

Page 48: ...oo Close warning which is for both profile and non profile mode The second is the Due Time On Remove check box on the Rx tab Due Time On Remove gives the dosing times for profile orders The Too Early...

Page 49: ...Name Click to display items by their brand names Med Generic Name When viewing medications by Generic Name begin typing the generic name of the item for which you are searching As you type the system...

Page 50: ...up to 30 characters for the formulary item ID Enter a unique alphanumeric medication ID up to 15 characters Alternate ID If required by your site enter a 15 character alternate ID for the medication...

Page 51: ...security group determines if you can access this medication For you to have access to a medication your security group must match the medication s security group Verify count Select ON if you want to...

Page 52: ...d before the pharmacist check takes place Volume Calculation Allows users to calculate the volume of a medication needed for the ordered dose Enter the strength and volume units in the formulary data...

Page 53: ...Low formulary item value supersedes the site s Stock Critical Low value 8 Enter the Remove Admin Times in minutes as necessary Before scheduled dose time Too Early Enter the number of minutes ahead of...

Page 54: ...Setup Formulary Management Formulary 2 In the Formulary dialog box select the applicable medication and click Edit 3 In the View Modify Formulary dialog box update the applicable information and clic...

Page 55: ...nfirmation message that appears click OK Editing accessed inventory This feature allows you to bypass inventory of those pockets with controlled medications which have not been accessed since the last...

Page 56: ...lick the Formulary Options tab 5 Check the Scan on Remove check box NOTE If processing multi doses check the Scan Once on Remove box This option allows you to scan medications once regardless of the q...

Page 57: ...e Formulary dialog box highlight the medication 3 Click Edit The View Modify Formulary dialog box appears 4 Click the Formulary Options tab 5 Select the Scan on Load Refill check box 6 Click Save 7 Cl...

Page 58: ...to be available on the Pyxis PARx system The multi scan feature is used on formulary items where all quantities of a particular item should be scanned for the pick check and or pick and check processe...

Page 59: ...ary Options tab The View Modify Formulary screen appears 5 In the PARx Scanning Configuration section select During Pick During Check or both check boxes to enable the multi scan feature for each part...

Page 60: ...y The following rules apply when creating equivalencies Equivalencies are defined as multiple units of the same formulary line item not as a combination of multiple formulary line items For example de...

Page 61: ...y items with the same generic name and unit strength mg mEq and so on and medication classification appear in the list at the bottom of the dialog box Generally equivalent items must have a strength o...

Page 62: ...alency Verification message box appears suggesting the equivalency relationship If the dosage forms strengths strength units or medication classes of the two formulary line items do not match a warnin...

Page 63: ...e allows the system to create additional equivalencies between selected items within the same equivalency automatically 1 Select System Setup Formulary Management Equivalencies 2 In the Equivalency Se...

Page 64: ...ing rules apply when creating a variable dose The nurse can access the ordered dose if one or more members of the variable dose are available at the station whether or not all members are present The...

Page 65: ...te enter a 15 character alternate ID for the variable dose 4 Enter the Range details Minimum Enter the minimum dosage range Maximum Enter the maximum dosage range 5 Select the appropriate Units for th...

Page 66: ...r Guide 8 To select formulary items as choices for the variable dose click the Members tab 9 Click Select Candidates 10 In the Variable Dose Candidate Selection dialog box select a formulary item that...

Page 67: ...m you want to change and then click Edit 3 In the Variable Dosage Med Setup dialog box make the required changes to the information on the Data and Members tabs as necessary 4 Click Save The Variable...

Page 68: ...ose All members of a combination dose must be present and available in the station for the nurse to access the dose Therefore do not define combination doses that contain members that are not routinel...

Page 69: ...59 4 Click Add Item The Select med for combo med selection dialog box appears 5 Select or search for the medication to assign to the combination dose and then click Select NOTE The Generic Name and un...

Page 70: ...he item needed as part of the combination dose and click OK The New Combo Med Setup dialog box appears with the members in the Combo Dose Contents section 7 If you need to change the quantity of a mem...

Page 71: ...bination Dosage Meds dialog box select or search for the combination dose to update and click Edit 2 In the View Modify Combo Med dialog box use the following as applicable Add Item Add another item t...

Page 72: ...lains how to delete a combination dose 1 Select System Setup Formulary Management Combination Dose In the Combination Dosage Meds dialog box select or search for the combination dose and then click De...

Page 73: ...the area to which you assign the kit display the kit Adding a kit The following procedure explains how to add a kit 1 Select System Setup Formulary Management Kits 2 In the Kits dialog box click Add 3...

Page 74: ...d click OK d Repeat steps b and c until all applicable items have been added e Click Close to return to the Select med to add to kit dialog box 5 To designate what areas the kit should be available in...

Page 75: ...tity and click OK d To add additional items repeat steps b and c e Click Close to return to the Select Med to Add to Kit dialog box f Click Close to return to the View Modify Kit dialog box 4 To chang...

Page 76: ...ck Remove All 7 Click Save 8 In the confirmation message click OK The Kits dialog box appears Deleting a kit The following procedure explains how to delete a kit 1 Select System Setup Formulary Manage...

Page 77: ...the process of creating users that have the same privileges Creating templates for user privileges If you have a group of users you would like to define as having the same privileges templates save yo...

Page 78: ...n page 71 6 Click the Station Privileges tab and select the applicable options For more information about these options see Assigning station privileges to a user on page 72 7 Click the Med Privileges...

Page 79: ...the upper section of the dialog box complete the following fields User ID Enter a unique user ID up to 10 characters First Name Enter the user s first name in this field up to 20 characters Last Name...

Page 80: ...select the areas in the Available list and click Add 5 In the BioID section of the Areas tab indicate whether the user must log on with a user ID and biometric ID click Use BioID or with a user ID and...

Page 81: ...to pockets that are not granted through medication privileges add and modify formulary items and access reports and the archival feature Enable This Privilege For Basic Pharmacy Privileges Most pharm...

Page 82: ...ulary and run the autoload function at the console for all medications that have security access If running in profile mode users with this privilege can create equivalencies combination doses and var...

Page 83: ...discrepancy Recovering a drawer Emptying the Return Bin Activate Create Temporary User Charge nurses or other users who can give another user temporary access to a station Admit Edit Discharge Patient...

Page 84: ...it edit or discharge patients at the station Users with this privilege have a Patients button in the Main Menu at the station Create Permanent Users Allows you to create permanent users at the station...

Page 85: ...d Allows you to load a medication that requires Rx Check without having another user check the medication Independent Refill Allows you to refill a medication that requires Rx Check without having ano...

Page 86: ...privileges click Save The user is added and a blank Add New User dialog box is provided so that you can continue adding users 5 Click Close to return to the main Users dialog box Filtering the users l...

Page 87: ...itional options might be available for update via the Global Edits option For information about updating user information globally see Updating user information globally on page 148 This section inclu...

Page 88: ...applicable template and click Edit 4 In the Edit Template dialog box update the applicable information on each tab 5 Click Save 6 You are returned to the User Template Selection dialog box Deleting a...

Page 89: ...ers 2 In the Users dialog box click Privilege Templates 3 In the User Template Selection dialog box select the applicable template and click Deactivate 4 In the confirmation message click YES to conti...

Page 90: ...iles Patient information is entered by your facility Information can be entered for temporary patients at the station not the console Adding a patient file The following procedure explains how to crea...

Page 91: ...ere the patient is located Bed Enter the bed where the patient is located Visit Nurse Unit Select the nursing unit where the patient is temporarily located for example OR Visit Discharge Enter the dat...

Page 92: ...group DRG code Patient Scan Code Enter this information by scanning it or typing it 7 Click the Clinical tab 8 Enter the applicable information Date of birth Enter the date of birth in mm dd yyyy for...

Page 93: ...New Order Setup dialog box 10 To get to the New Order Setup dialog box click Add 11 Enter the order information for your patient in these areas Order Determined by your facility Order Description Ent...

Page 94: ...Order Stop Enter the date and time that the order is to end For PRN orders the stop time is often an automatic stop time based to facility policy For scheduled medication orders the stop time is norm...

Page 95: ...nt Administration DEA number of the prescribing physician In the Med Info tab click Add Med to select your medication The Add Edit Patient Order Select a Med dialog box appears 13 Click Generic Name o...

Page 96: ...nsole to display full patient allergy information from your facility information system It also can be manually entered within the Pyxis MedStation system network This feature also displays multiple r...

Page 97: ...Highlight an allergy in the Allergies list box and click Edit to update information for that allergy 5 Enter information in the Add Edit Patient Allergies dialog box Description must be filled in Sev...

Page 98: ...e severities exist for a single allergy they are listed in multiple rows each containing the same description type and code When multiple reactions exist for a single allergy they are also listed in m...

Page 99: ...ormation regarding the various tabs and fields see Adding a patient file on page 80 4 Click Save Discharging a patient The following procedure explains how to discharge a patient 1 Select System Setup...

Page 100: ...reconciliation This feature allows customers to associate temporary patient data with permanent patient data The feature Requires users to have System Administrator privileges to associate temporary a...

Page 101: ...ature select System Setup Patients 2 In the Patients dialog box click Reconcile Billing The Patient Reconciliation dialog box appears 3 In the Permanent Patient section click Change to load patient in...

Page 102: ...he Patient Reconcile List box to enable the Remove From List button Click the button to remove the change record from the list box 10 When the list box contains entries the Reconcile Billing button is...

Page 103: ...ect more than six nursing units to be assigned to one area to a maximum of 15 units 1 Select System Setup Area Configuration Areas WARNING The association of Nurse Units to Areas governs how the syste...

Page 104: ...dd Doing this moves the unit to the Primary NUnits box 4 In the Primary NUnits box highlight the NUnit and click Remove Doing this moves the unit to the Available NUnits box 5 Click OK The new unit ap...

Page 105: ...d Nurse Unit Maintenance dialog box select the area that you created 5 In the Nursing Units list select the units that you want to assign to the selected area and click Add The selected unit is listed...

Page 106: ...1 Select System Setup Area Configuration Areas 2 In the Area List section of the Area Nurse Unit Maintenance dialog box select the applicable area and click Delete Area 3 In the confirmation message c...

Page 107: ...Categories CDCs There are 33 predefined CDCs Use predefined CDCs to save time and effort in implementation You can edit or delete the predefined CDCs just as you would edit or delete any other CDCs T...

Page 108: ...t is current INR Type in response INR INR 1 5 Give dose and call MD 1 5 2 0 OKAY TO GIVE 2 0 Hold dose and call MD IV push rate Give IV push over XX minutes Lidocaine PF Is it preservative free CALL P...

Page 109: ...ergy Do not give if pen allergic CALL RPh Possible allergy DO NOT GIVE Has allergy OKAY Not allergic Reason for use Reason for use For pain For temperature Removed For Removed on behalf of Dr John Bro...

Page 110: ...a free form text box into which the user types a response Single Displays a list of responses The user selects one item from the response list when removing wasting or returning the medication Multi T...

Page 111: ...ges 12 To return to the standby dialog box click Close NOTE Clearing the Required check box allows the user to bypass entering clinical data NOTE Clearing the Once check box requires the user to enter...

Page 112: ...Data Edit dialog box enter the new category name in the Name box for more information see Adding a CDC on page 100 4 When you are finished click OK to save your changes 5 To return to the standby dial...

Page 113: ...e and click Edit 3 In the Clinical Data Edit dialog box select One List and click Add 4 In the Add List Name and Responses dialog box enter the name 5 Click Save 6 Click Add 7 In the Add Response dial...

Page 114: ...k Edit 3 In the Clinical Data Edit dialog box select Multiple and click Add 4 In the Add List Name and Responses dialog box enter the Name in the List section and click Save 5 Click OK 6 Click Add in...

Page 115: ...alog box click Edit Responses 4 In the View Modify Responses dialog box update the Name if applicable 5 Select the response to update and click Edit 6 In the Edit Response dialog box update the respon...

Page 116: ...stem Console User Guide 4 In the View Modify Responses dialog box select the response to remove and click Delete 5 In the confirmation message click YES 6 Click Close to return to the Clinical Data Ed...

Page 117: ...ystem Setup Site Specific Options 2 On the Demographics tab of the Site Information dialog box enter or edit the demographic information about your facility 3 Enter your facility s name address and ot...

Page 118: ...s information appears at both the console and station Archive File ID For archive files This identifier differentiates archive data from this system from other sources of archive data Archive Drive Se...

Page 119: ...n to view the subentries The number to the right of the attention notice indicates the number of notices of that type The following background colors are also used Yellow Indicates that a stockout has...

Page 120: ...of discrepancy sorted by medication name device drawer and time Ordered Med Not Loaded Available in profile mode Identifies ordered medications not loaded followed by the order dose route frequency te...

Page 121: ...the console name on page 115 Viewing or modifying a medication warning on page 116 Selecting report options The following procedure explains how to select reporting options 1 Select System Setup Site...

Page 122: ...ons section select the check box for any of the following to ensure that these steps are always taken when the applicable report is generated Sort Console Activity Reports By ID Sort all Activity repo...

Page 123: ...for each maintenance task You can also use it to begin running maintenance at any time even if it is not scheduled NOTE Do not change the Maintenance options without assistance from a CareFusion repr...

Page 124: ...task This dialog box varies slightly depending on which maintenance task you selected 5 In the Start Time box enter the time that the maintenance cycle should begin 6 If applicable in the Data Histor...

Page 125: ...User Last Access parameter to produce a detailed list of inactive users For more information refer to the Pyxis MedStation 4000 System Console Reports Booklet 9 To save your changes click OK and then...

Page 126: ...e confirmation message appears click OK to return to the standby dialog box The new name now appears in reports and selection lists that list console names Viewing or modifying a medication warning Th...

Page 127: ...patient it is recommended to use medication warnings too close as a potential aid in the prevention of duplicate doses being removed from the MedStation These settings can be overridden by settings o...

Page 128: ...ith it This security group is a tool for controlling which medications your users access when you assign them security group privileges For example if you want to remove a medication and the medicatio...

Page 129: ...group name and click Edit 3 In the Security Group Name Edit dialog box enter the new security group name in the Group Name box and click Save 4 Click Close NOTE To toggle a security group s witness r...

Page 130: ...ist 2 Select a name to update and click Edit 3 In the Override Group Name Edit dialog box enter the new name in the Group Name box and click Save 4 To return to the standby dialog box click Close Addi...

Page 131: ...ew medication classification name in the Class Name box and click Save The controlled check box determines Accessed Inventory 4 Click Close Adding a medication classification The following procedure e...

Page 132: ...system These reasons appear at the station for you to choose from when resolving discrepancies You can add to this list of reasons or modify existing reasons based on your facility s policies and proc...

Page 133: ...iscrepancy Resolution Reasons dialog box select the applicable reason and click Edit 3 In the Discrepancy Resolution Reasons Edit dialog box update the text in the Discrepancy Resolution Reason box wi...

Page 134: ...nufacturers of medications nursing unit types pick areas and therapeutic classes Adding an item to a list The following procedure explains how to add items to a list 1 Select System Setup Pharmacy Con...

Page 135: ...he Edit List Entry dialog box update the applicable information and click OK 5 Click Close 6 To return to the standby dialog box click Close Deleting an item from a list The following procedure explai...

Page 136: ...scan code or edit the fields for quantity or vendor name the console sends a message to the stations and the Pyxis Procar which updates their respective local tables When you delete a scan code the co...

Page 137: ...e dialog box appears update the desired field and click Save 4 To return to the standby dialog box click Close Deleting a scan code 1 In the menu bar click System Setup Pharmacy Configuration Scan Cod...

Page 138: ...de 2 In the Scan Code dialog box click Scan 3 Scan the scan code number 4 If the number is already in the system the following dialog box appears This shows you the medication and its properties You c...

Page 139: ...Main ten ace dialog box appears but with the Med Description section filled in Click Save You are returned to the original Pharmacy Configuration Scan Code Maintenance dialog box to search again if n...

Page 140: ...Chapter 3 Setting Up the System 130 Pyxis MedStation 4000 System Console User Guide 4 Click Close to return to the main dialog box...

Page 141: ...he menu bar select CommStatus 2 Click the applicable tab depending on which information you want to view The following describes the information available for each tab Devices Displays a list of devic...

Page 142: ...ice successfully linked with the console FC This is the failure count The number of successive times that communication has failed between the device and the console A high count indicates something m...

Page 143: ...ive sessions Sessions Displays the session status for all methods The fields are CommBox Specifies which communications PC this device is configured to communicate with Session Displays active session...

Page 144: ...an error The packet is retransmitted until it is error free or fails seven times and must abort c2 Second transmission retry counter that increments when a message packet transmission has an error The...

Page 145: ...explains how to change the rate at which the information is updated 1 In the menu bar click CommStatus 2 In the Refresh Rate section of the Communication Status dialog box select the applicable setti...

Page 146: ...Chapter 3 Setting Up the System 136 Pyxis MedStation 4000 System Console User Guide...

Page 147: ...4000 System Console User Guide 137 Chapter 4 Utilities This section includes the following topics Using virtual files edit to define communication ports 138 Updating information globally 141 Archiving...

Page 148: ...mputers on which the console and or workstation are running File Name Enter the name of the file 4 In the empty box enter the communication information In this environment enter XT 5 Click Save 6 When...

Page 149: ...Virtual Files dialog box select the file to remove and click Delete 3 When the confirmation message appears click OK 4 When the next confirmation message appears click OK Renaming a virtual file The...

Page 150: ...xisting configuration file 1 Select Utilities Virtual Files Edit 2 In the Virtual Files dialog box select the file to rename and click Copy 3 In the Virtual File Copy dialog box complete the following...

Page 151: ...ations to edit specify the new values for formulary data fields specify the new values for formulary options and apply the changes For more information about these settings see the applicable section...

Page 152: ...dialog box appears 4 When you have finished reviewing the selections click Done 5 If the list of medications to be updated is not what you expected modify the selections you made in step 2 otherwise p...

Page 153: ...ation message that appears click OK 13 In the next confirmation message that appears click OK NOTE Note the legend at the bottom of the dialog box each check box can have three values instead of the u...

Page 154: ...k Utilities Global Edits Devices 2 In the Choose Device Type dialog box select the type of device to update 3 In the Select Type devices to global edit dialog box do one of the following Select the de...

Page 155: ...or Type devices dialog box make the applicable changes on the Settings tab 6 If you are updating stations that use profile mode click the Rx tab and make the applicable changes NOTE Stock Out Bulletin...

Page 156: ...b and make the applicable changes 8 To activate or deactivate a clinical data category select the category name and click Edit List Assignment 9 Select the applicable information and click Select to a...

Page 157: ...ructed you to do so click the Adv Comm tab and make the applicable changes m 12 Click the Stn Privs tab and make the applicable changes CAUTION Do not change the information in this dialog box unless...

Page 158: ...6 In the confirmation message that appears click OK to return to the standby dialog box Updating user information globally The following procedure explains how to update selection criteria for multipl...

Page 159: ...6 In the User Expiration Date section enter the date on which the logins expire 7 To review the list of users who match the selected criteria click Review Selection review the list of users and click...

Page 160: ...MedStation 4000 System Console User Guide 8 Click the User Data tab and make the applicable changes 9 Click the Console Privileges tab and make the applicable changes 10 Click the Stn Privileges tab a...

Page 161: ...151 11 Click the Med Privileges tab and make the applicable changes 12 When you are finished click Continue 13 In the Global User Edit Confirmation dialog box verify that the changes are correct and t...

Page 162: ...nsactions suffix PYX User modification transactions suffix UTX Resolved discrepancies file suffix DTX Clinical data responses file suffix CDC Legend of codes file suffix KEY Viewing or deleting the li...

Page 163: ...that appears click YES 5 To return to the standby dialog box click Close Selecting archive data This section includes the following topics Creating or editing archival data for pocket access transact...

Page 164: ...ket Access dialog box select each option or click All of the Pocket Access transactions to archive 5 Click Save 6 In the Archive Specification dialog box click Close 7 In the Archiving dialog box sele...

Page 165: ...ransaction field to archive or click All and then click Save 5 In the Archive Specification dialog box click Close 6 In the Archiving dialog box select one or more files to archive The Archive button...

Page 166: ...s active 7 Click Archive 8 In the confirmation message click Yes The file is archived 9 In the confirmation message click Close Creating or editing archival data for temperature log transactions The f...

Page 167: ...CareFusion recommends that you use disks available from CareFusion because these disks are high quality and have been rigorously tested to ensure their suitability and reliability 1 In Utilities Archi...

Page 168: ...as to be included in the archive file 5 To indicate when the task should run select the applicable Active Days check boxes 6 To save your changes click OK and then click Save 7 In the confirmation me...

Page 169: ...you set up your inventory you can use inventory reports to gain information about medication usage and make decisions before refilling unloading replacing and editing station and pocket contents This...

Page 170: ...Station Inventory 2 In the Inventory Select a Station dialog box select the station into which you want to load medications and click Select You can limit the number of stations displayed by selecting...

Page 171: ...t 6 If you selected a MiniDrawer do the following when the next Inventory Select a Drawer dialog box appears a If the MiniDrawer does not currently have pending or loaded medications select one of the...

Page 172: ...is preconfigured as a Matrix multi drawer or single drawer c Click Select and then click YES when the confirmation message appears d If you selected Matrix for this MiniDrawer select the applicable p...

Page 173: ...oup from the list NOTE You can sort the pockets list by clicking the appropriate button by Empty Pockets in the selected drawer by All Pockets Generic Names or by All Pockets Brand Names If you are us...

Page 174: ...count or level at which the medication should be refilled This level is an important threshold in Inventory reports and messages Current The actual number of this medication that you intend to load in...

Page 175: ...he Inventory Meds for station dialog box click Block Meds 4 In the Blocked Item List for station dialog box highlight the medications in the Authorized Medications list on the left NOTE A rule of thum...

Page 176: ...ide 5 Click Add to move the medication name to the Blocked Medications list on the right 6 Click Save Blocked items appear greyed out in the console lists NOTE Blocked inventory all applies at the sta...

Page 177: ...e pocket options such as Standard Med or Outdate Tracking 1 In the menu bar select Inventory Station Inventory 2 In the Inventory Select a Station dialog box select the station to load the medications...

Page 178: ...this feature for pockets that no longer exist in modified matrix drawers or for the Return Bin 1 In the menu bar select Inventory Station Inventory 2 In the Inventory Select a Station dialog box selec...

Page 179: ...User Guide 169 Chapter 6 Reports The console provides reports to help you manage and monitor your system This section includes the following topics Available reports 170 Report descriptions 171 Gener...

Page 180: ...s with the system a transaction history for specific stations Activity reports include specific information on all accesses charges and credits loading and unloading discrepancies in the system and re...

Page 181: ...specific stations that contain medications that are seldom or never used My Items Aging Lists the inventory of My Items for selected users or all users only available for Pyxis Anesthesia System Pende...

Page 182: ...aximum levels are set appropriately Outdated Med Removal Lists the types and numbers of medications being outdated at the stations Profile Override Lists all Profile Override transactions that occurre...

Page 183: ...System Archive Specifications Lists the fields selected for archiving within the three file types Pocket Access User Transactions and Documented Discrepancies Areas Lists all areas the nursing units...

Page 184: ...such as hospital demographics system options and report and maintenance options The information presented represents what was defined using the Site Specific Options in the System Setup menu SMART Re...

Page 185: ...ist of reports select the applicable report and click Select The dialog box for the selected report appears the dialog box that you see varies depending on the report that you selected Note that the s...

Page 186: ...tion 4000 System Console User Guide 7 To print the report click Print and then click OK when the confirmation message appears that indicates that the report has been added to the queue 8 Click Exit to...

Page 187: ...Batch Reports dialog box click Add 3 In the upper section of the Reports List dialog box select the applicable category 4 In the corresponding list of reports select the applicable report and click S...

Page 188: ...ay and time It does not interrupt the printing of a report in progress nor does it interrupt a user who is logged on to the system at the same time 11 To return to the standby dialog box click Close V...

Page 189: ...he applicable report and click Delete 3 In the confirmation message click YES 4 To return to the standby dialog box click Close Enabling or disabling a batch report You can temporarily disable a batch...

Page 190: ...Chapter 6 Reports 180 Pyxis MedStation 4000 System Console User Guide...

Page 191: ...is section offers remedies to potential problems involving the console and its components This section includes the following topics Attention notice bulletin 182 Using brain transplant to restore a d...

Page 192: ...mains on the dialog box until either the discrepancy is resolved or after 31 days have passed Critical Override Allows a user to a remove formulary items without an order when the override group to wh...

Page 193: ...nplugged and rebooted If you are unable to find someone you might need to make several round trips between the station and console to localize the problem Have your information systems IS department c...

Page 194: ...ts the communication device with the console Gently wiggle each end of the line while carefully clicking them into their sockets 3 Verify whether the communication link has been reestablished a On the...

Page 195: ...ation status 1 In the menu bar select CommStatus The Communications Status dialog box appears For more information see Communication status on page 131 A value other than 0 in the column labeled FC fa...

Page 196: ...us after brain transplant section select the applicable option and click OK 6 In the confirmation dialog box that appears click OK The console restores the station tables with data from the console da...

Page 197: ...plugged into a socket and into the back of the Pyxis Procar If power resumes go to step 2 If power still does not resume contact the TSC 2 Check the communication status between the console and the Py...

Page 198: ...nt order not displayed at the console on page 188 Patient or patient order not displayed at the console If a patient s data does not show up at the console troubleshoot first for a communications prob...

Page 199: ...he port if the patient record still has not shown up on the console contact the TSC Patient billing information problems Go through the troubleshooting process as explained in the Patient or patient o...

Page 200: ...e report does not include data from the past few hours change the To time parameter to NOW This enters the current time into the time selection and causes the most current data to print If data for a...

Page 201: ...emergency power generator the uninterruptible power supply UPS device included with the console provides enough power to complete currently processing tasks and effect an orderly shutdown of the cons...

Page 202: ...inter is out of paper 3 Determine whether the printer is offline Press the On Line or Select button depending on the printer model on the front panel 4 Make sure that all covers are seated properly 5...

Page 203: ...as access to the computer s operating system level where testing can be accomplished using sophisticated software tools Has sophisticated software diagnostic tools and repair options at hand including...

Page 204: ...the medication is shaded the medication is one of the following Not loaded at the station Out of stock Not accessible to you due to lack of security privileges for the medication In a failed drawer A...

Page 205: ...on when patients are at risk for potential adverse drug events This section explains Pyxis Advisor dashboard setup at the console This section includes the following topics Accessing Pyxis Advisor in...

Page 206: ...ole To access Pyxis Advisor on the console you must be first logged on as a system administrator 1 After logging on select System Setup Pyxis Advisor The Alert Management Service window appears 1 Clic...

Page 207: ...each station 5 Click the User Properties tab This dialog box shows the user and user ID with station access a In the Advisor Alerts column click to configure whether the user account receives or cann...

Page 208: ...that the alert management service has not attempted to connect to the console database 7 Click the Pyxis Advisor tab The Console PEA Configuration dialog box appears providing information about the s...

Page 209: ...sole database name The Alert Management service obtains information from the console database configured as the data source MedStations Patients Miscellaneous information 10 In the Sync Frequency text...

Page 210: ...l panel 200 Pyxis MedStation 4000 System Console User Guide 11 Click Save Changes or Discard all Changes depending on your choice 12 When done exit the dashboard by clicking the exit button X at the u...

Page 211: ...e following topics Pyxis Nurse Link overview 202 CAUTION Pyxis Nurse Link supports only user ID password logins when this application is launched If there are any positive identification requirements...

Page 212: ...the user to select a remove transaction or medication to document waste remotely through three methods Removed Meds All Meds and Undocumented Waste Removed Meds The remove transaction list displays a...

Page 213: ...t can and cannot use the Remote Queue and Waste functionalities of the Pyxis Nurse Link application The user has the ability to view all patient information Using remote privileges 1 Select System Set...

Page 214: ...s MedStation 4000 System Console User Guide Adding remote privileges to a template Follow the template setup steps in the Users section on page 67 of Chapter 3 Setting Up the System The new Remote Pri...

Page 215: ...Pyxis MedStation 4000 System Console User Guide 205 Appendix D Cerner This section includes the following topics Cerner overview 206 Clinical and operational alerts 209...

Page 216: ...ner Millennium During implementation the Pyxis MedStation system console and the CareFusion Interface are configured to provide data to Cerner Millennium through CareAware Cerner s integrated device c...

Page 217: ...Edit The Edit User dialog box appears 3 Click the Remote Privileges tab 4 Check the Queue box Adding remote privileges to a template Follow the template setup steps in the Users section on page 67 of...

Page 218: ...and your station account The link is used to determine the station medication location and stock availability information that displays within Cerner PowerChart This is based on your assigned medicat...

Page 219: ...led Drawer when a station drawer fails Order meds not loaded when an order is received for a medication that is not loaded in the station associated with the patient s nursing unit or visit unit Overr...

Page 220: ...Appendix D Cerner 210 Pyxis MedStation 4000 System Console User Guide...

Page 221: ...facility in meeting the expectations or requirements of accrediting and regulatory agencies such as the The Joint Commission the DEA the state board of pharmacy and the state bureau of drug control T...

Page 222: ...tiality is compromised Consider requiring password changes on a periodic basis Maintain a system to immediately remove users upon termination of employment along with a regular review of users by each...

Page 223: ...control and document key access Load all controlled drugs into stations even special patient specific orders Inventory controlled drugs in each station on a periodic basis for example weekly Activate...

Page 224: ...mate pockets Separate injectable drugs as much as possible especially those in similar containers for example vials Place more commonly used medications in top drawers for easy access Emergency medica...

Page 225: ...MedStation users Technicians pick and prepare medications for load or refill into a station under the supervision of a registered pharmacist The pharmacist checks medications prepared by a technician...

Page 226: ...Appendix E Management and Monitoring Recommendations 216 Pyxis MedStation 4000 System Console User Guide...

Page 227: ...a large auxiliary Bin Drawer A flexible matrix drawer that is twice the height of a single drawer and can be configured as one large bin A bin drawer is useful for storing large items such as IV bags...

Page 228: ...a medication when it is removed returned or wasted Combination Dose Combination doses require the removal of more than one item to fulfill the medication order For example cefazolin 1 gram Add Vantag...

Page 229: ...n the system that are commonly used together to treat a patient usually in association with a specific procedure or treatment Also refers to the kit feature which is used to create and edit kits at th...

Page 230: ...e when a specific medication should be refilled If a medication s stock falls at or below the minimum level it shows up in the pharmacy reports for refill The minimum levels can be adjusted to reflect...

Page 231: ...ontain 2 4 6 8 or 12 pockets Matrix drawers can contain up to 48 defined pockets Polling Refers to the continuous communication between the console and the station The console polls all stations with...

Page 232: ...onsole Refill A procedure designed to replenish inventory in the stations Remote Stock Items managed by the Pyxis MedStation system but stored outside the station Remove by Time Allows the nurse to re...

Page 233: ...cation This type is used to allow access to only the number of doses requested Standard Stock Standard stock consists of standard medications that are frequently used in the clinical setting where the...

Page 234: ...For example to fulfill an order for Morphine Sulfate 4 10 mg injection Inj the nurse must select from 4 mg 8 mg or 10 mg syringes depending on the patient s pain level A variable dose of Morphine Sulf...

Page 235: ...ts always drop trailing zeros but show a leading zero if calculated value 1 Standard display is to three decimal places Waste The process for discarding a medication might require a nurse witness for...

Page 236: ...Glossary 226 Pyxis MedStation 4000 System Console User Guide...

Page 237: ...ansfer From To User 172 add area 95 batch report 177 clinical data category CDC 100 clinical data category CDC response 103 clinical data category CDC response list 104 combination dose 58 discrepancy...

Page 238: ...gistered report 173 BioID Global report 173 BioID User Activity report 173 blind count enable 23 block loading 165 brain transplant 185 bulletin 109 optional 109 troubleshoot 182 unsolicited 111 bulle...

Page 239: ...y 52 formulary item 45 item from list 125 kit 66 list of archive files 152 medication classification 122 nursing unit 96 nursing unit from area 95 scan code 127 station or other device 35 user 78 vari...

Page 240: ...Wide Med Summary report 171 I information network 6 interface admissions discharge and transfer ADT 8 billing 8 medication charting 9 option 8 pharmacy profile 8 wholesaler 9 inventory assign medicati...

Page 241: ...verride group 120 security group 118 National Drug Code See NDC NDC barcode entry network information 6 non profile 19 nursing unit add 93 add to or remove from area 95 delete 96 O operating room OR c...

Page 242: ...its report 172 Reconciled Patients report 174 reconciliation patient billing 90 Refill Pick Delivery report 171 remote diagnostics 193 remote privileges Pyxis Nurse Link 203 206 remote privileges temp...

Page 243: ...tus 185 delete 35 delete item from list 125 in or out of service 37 update 31 35 item on list 125 Statistics report 174 status communication 131 station communication 185 Stock Critical Low 43 Stock C...

Page 244: ...ory CDC 102 clinical data category CDC response list 105 combination dose 61 device 35 discrepancy resolution reason 123 equivalency 52 formulary item 44 globally 141 item on list 125 kit 65 medicatio...

Page 245: ...Index Pyxis MedStation 4000 System Console User Guide 235 workflow unit dose 3 X XQ Messages report 174...

Page 246: ...Index 236 Pyxis MedStation 4000 System Console User Guide...

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