Download Additional information you should know about Pyxis ES. User

12/17/2015
Additional information you should know about Pyxis ES.
User Access

Linked with the Aurora Network. Access can only be obtained by managers
submitting an SMS request to have caregiver added to Pyxis ES.

If you lock yourself out of the Aurora network (caregiver connect, email, computer,
Epic Remote access) you lock yourself out of pyxis and vice versa.

All caregivers will be assigned to locations which managers have deemed appropriate
for everyday access. If floating to an area outside of your normal assignment, you
will need to have Department managers or house supervisor grant you temporary
access to the station.

Local inpatient pharmacy can no longer add or reset access. This will require a help
desk ticket.
Patients

Scheduled admissions (pre-admits) will display on Pyxis 24hrs in advance of their
scheduled admission date and time.

Pre-admit patients will fall off of Pyxis after 30hrs of no activity. This should
improve the accuracy of the patient list on each pyxis station.

Discharge delay will be 2hrs for inpatient area’s and 8hrs for outpatient/procedural
areas.

Admissions with no pyxis activity will fall off the stations after 5 days in
outpatient/procedural areas and 15 days for inpatient areas.

If floorstock patients are used, there will not be a default floorstock patient available.
A patient will need to be manually added as needed. Pharmacy will be reviewing all
manually added patient activity for appropriateness.
Dispensing

New ES workflow is Patient (select patient), Action (Remove, Return, Waste),
Medication (PAM)

LORazepam injection will no longer automatically dispense the key for the lock box in
the fridge when dispensing from the patient profile. The key must be overridden prior
to starting the dispensing sequence. If you forget to do this, attempt to count the
medication remembering that the boxes are clear. Once you enter the count then
cancel dispense and try again.

All Morphine, Ketorolac, and Meperidine orders will cross to pyxis ES as a “range
order”. This means if the order is for one standard dose i.e Ketorolac 30mg, the dose
will display in pyxis as 30mg-30mg. When the order is selected, the user will still
need to enter the dose they want to give the patient. The user cannot request more
or less then the order is entered for.

Anytime you dispense a medication from Pyxis without an order, Pyxis will always
ask you for the amount you plan on giving your patient.

Medication orders that have a dose based on mg/kg will not have a predetermined
dispense amount on the patient profile. When the order is selected, pyxis will prompt
you fill how much of the medication you would like to dispense (1 syringe, 2 tablets
etc.)

Recover Failed Storage Space- This is something we couldn’t train, but if any of
your medications are identified as being in a failed storage space, use the following
steps to fix the failed pocket or drawer. This will allow you to remove your
medications.
1. From Home screen select Recover a failed storage space.
2. Select failed pocket or drawer on the screen starting at the bottom of the
list if there is more than 1 option.
3. Following the on-screen prompts
4. Tap smart CUBIE pocket lid or re-try
Discrepancy Management

All discrepancies should be cleared within 24hrs. If after 3 business days the
discrepancy is still open, the person found at fault will have their privileges revoked.
The user will not get their privileges back until the discrepancy is resolved.

Resolution reasons should be factual.
o
The following are examples of inappropriate resolution reasons

“There were two in the pocket” We know there were two in the pocket.
We want to know why there where 2 in the pocket.

“I don’t know” Even if the reason can’t be determine more detail
should be given as to the investigation. For example “ all
documentation checks out unable to determine cause”

When resolving a discrepancy, you can see the previous 5 transaction and up to 5
transactions after the discrepancy was created

Activity reports at the station can now be run up to 3day into the past if more
information is needed.
Visual Indicators
Symbol
Meaning
Buttons and Icons
Symbol
Critical Override – indicator appears when
the device has not been communicating with
the server for a determined period of time or
if the current time is within the device’s
critical override period.
Home – returns the user to the Main Menu
screen.
QUICK REFERENCE
Expand – expands a listed entry.
Device Disconnected – indicator appears
when the device is not communicating with
the server.
Remove – removes a selected entry from a
list.
Discrepancy – indicator appears when one
or more unresolved discrepancies are
displayed on a device.
Duplicate last name – indicates the same
last name for more than one patient.
Medication due – indicates a medication
that is due.
Failed Drawer (Hardware) – indicator
appears when there are one or more failed
drawers or pockets in the device.
Past due removable medication –
indicates a medication that is removable but
not due at the current time.
Interface Delay – indicator appears on a
device in profile mode when the system
detects that the facility has a problem with
the orders interface.
Past due medication – indicates there are
past due medications.
Interface Down – indicator appears on a
device in profile mode when the system
detects that the facility has a problem with
the orders interface.
Selection – indicates that you selected an
item.
Medication Not Actionable – indicates
that a medication cannot be removed,
refilled, or loaded. Select the symbol to see
more information.
Unavailable meds on profile
(Greyed out meds)
Touching a Grey med on profile if
failed storage space is the reason,
navigate to the Main Menu and select
Recover Storage Space to attempt
drawer/pocket recovery.
Meaning
Pyxis MedStation® ES
system
Witness required – indicates that a
transaction requires a witness.
Access Issues
Call IT Helpdesk at 1-800-889-9677.
 Locked accounts or password reset
Call Manger or House Supervisor:

If you can log in but have no access to
patient. You will need to be activated
at the station.
Call Central Pharmacy:
 Supervisor/Manager can’t grant access.
User will need to be assigned to facility.
LOG IN TO THE
STATION
Your Pyxis Username
and Password are
now the same as your
domain credentials
(i.e., email login).
Successful Pyxis BioID Tips:
• Avoid the use of lotion, oil, or any other
substance prior to placing finger on the
Pyxis BioID scanner.
• Select a finger and place it on the
scanner. Avoid rolling your finger.
• Use the screen prompts to guide correct
finger placement.
• If your scan continues to fail, try using a
finger on your non-dominant hand,
especially if you have had trouble with
Pyxis BioID in the past.
BASIC WORKFLOW: “NON-PROFILE”
STATION
1.) Select a patient using All Available Patients
option (suggested).
2.) Select the function.
RETURN TO MAIN MENU
Select “Home” icon to return to
Main Menu.
SEARCH PATIENTS
Search by last name.
ADD TEMPORARY PATIENT
3.) Type in first three letters of medication
(brand or generic name) in the search
field.
To add temp patient, go to All Available
Patients menu and select Add
Temporary Patient.
4.) Select medication(s).
5.) Follow the prompts (e.g., CDC, count,
witness, etc.).
6.) Remove medication(s), close drawer.
7.) Continue to next patient or sign out.
NOTE: List of medications will not display
until the first three letters of the med is
entered into the search field. Search can be
performed using brand or generic name.
WASTE AND RETURN
When performing a waste
or return function, ensure
the waste or return
corresponds with the
correct remove
transaction.
WASTE WORKFLOW
Medications that require a witness and are
removed in excess of the required amount
must be wasted. You can waste the
medication during the removal process by
selecting “Waste Now”. You can also waste it
at a later time by selecting the “Waste Later”
option or simply by closing the
pocket/drawer.
If you choose to Waste Later, the amount
not wasted is flagged as undocumented
waste. If you have undocumented waste that
has not been resolved, an undocumented
waste indicator appears at the bottom of the
main menu.
DISCREPANCY RESOLUTION
*NEW* Discrepancy Workflow
Includes ability to add notes,
perform count, and print detail
around time of discrepancy to
assist in resolution.
BASIC WORKFLOW: “PROFILE”
STATION
1.) Select patient from list using either
patient list option.
2.) Select the function.
3.) Select medication(s).
4.) Follow the prompts (e.g., CDC, count,
witness, etc.).
5.) Remove medication(s), close drawer.
6.) Continue to next patient or sign out.
ORDER PROFILE: “SORTED”
WORKFLOW
When selecting the Remove button from a
patient view, the Med Profile removal screen
on the Due Now tab for the selected patient
appears. If there are no orders/tasks to
display on the Due Now tab, the All Orders
screen appears. You can toggle between
the Due Now, PRN, and All Orders
screens at any time to locate and select
the desired medication for removal.
MEDICATION OVERRIDE
Override is now available as its own action
item. That can be select without being in the
patient profile. Use the search box in the
upper right corner to find meds
PATIENT SUMMARY
When My Patients list is utilized at profile
stations, the Patient Summary offers quick
access to medication orders on a patient
profile.
Troubleshoot
Finding Meds
Patient Information Not Displayed
GLOBAL MEDICATION FIND
WASTE/RETURN WORKFLOW:
SEARCH ALL MEDS
Global Medication Find is permission-based.


Regardless of a user's permission (Global
Find or Extended Global Find), Global
Find results include only facility devices
of the same device type as the currently
accessed device. For example, results of
a Global Find search launched from a
Pyxis® Anesthesia ES device include only
Pyxis® Anesthesia ES devices.
For the user with Global Find
permissions, Global Find is displayed as a
home screen menu option.
The Search All Meds feature is used for
medications that do not have an associated
prior remove transaction. Users can search
and select from a list of active formulary items
that they have security group permission to
remove.
Search All Meds is used for the following
reasons:



Within each Area grouping, Global Find
displays devices in alphabetical order by
device name.

Users need to waste/return a medication
that was not initially removed from the
device.
A transition to a new ADT and/or
Pharmacy Information System (also
known as Host Conversion) inactivates
an old transaction against which a user
needs to reconcile waste.
The item is not stored in the device.
If a new admission does not display as
expected at a device, check to verify
patient is admitted in Epic. If patient is
displaying as admitted, then notify Central
Pharmacy at ext. 3100. This indicates an
interface problem.
Access Issues
Call IT Helpdesk at 1-800-889-9677.
 Locked accounts or password reset
Call Manger or House Supervisor:

If you can log in but have no access to
patient. You will need to be activated
at the station.
Call Central Pharmacy:
 Supervisor/Manager can’t grant access.
User will need to be assigned to facility.
Station isn’t functioning

If the user selects Global Find from a
medication availability tooltip, it searches
devices in which the item is available.
 Screen is frozen or Black. Reboot the
station using the power button in upper
right corner of the back of the main station.
If station still doesn’t work call Carefusion
Help Desk.
 Drawer doesn’t register as being
closed. Carefusion help desk.
Carefusion Help Desk
800-727-6102

Devices in which the item has been
blocked from being loaded (for example,
using Block Load) and devices that are
Out of Service do not appear.
You will need the Site ID. It Should be
labeled below the monitor of the station.