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Kelli Donovan, CPhT Adventist Medical Center Portland, OR Why automation? Time-line for set-up Using reports from a Buyer’s standpoint Diversion Lost Charges Choosing machines Choosing medications Load machines Going live Reordering supplies Decreasing stock levels 30% of a prescription drug abusers work in the medical field, and of those 70% ARE NURSES. Types of diversion: falsification substitution omission breakage/wastage theft Falsification: nurse cannot remove medication without medication order in Omnicell Substitution: nurse has no access to any narcotic except one asked for Omission: medication is automatically charged for with electronic record Breakage/wastage: nurses must have witness sign at time of breakage/wastage Theft: There is an electronic record in addition to a charge in billing system of each transaction Dispenser Drawer: Only accessed by Pharmacy personnel. Drops only the narcotic and quantity asked for into a separate drawer. Used for CIIs and most commonly abused narcotics (Hydrocodone combinations) Medium Security Locking Drawer: Holds multiple doses of CIII-CV drugs. Every drawer is locked any only medication asked for opens. Sensing drawers: Used for non-controlled medications. Any drawer can be opened, but the machine records an illegal drawer was opened. ED Department had over $90,000 in lost charges in 2004. Most of the charges came from cardiac drugs (Integrelin, Reopro, etc.) With Omnicell, each transaction has to have a name attached to access the drugs. Reports can be generated to track down “temporary patient” entries. Not limited to high expense items: Tylenol, Lidocaine, Sterile Water, Normal Saline are most common low cost items most often lost charges • Decide on machines for different areas Step 1 • 2-3 hours with nursing/pharmacy staff • Assign medication to machines Step 2 • 2-3 hours per machine • Load medication in machines Step 3 • 4-6 hours per machine Step 4 Step 5 • Go-live • 1-2 hours per machine • Training • 2 hours minimum per employee 9 to 12 hours for each machine Stock level report: Shows up-to-minute quantity in each machine -Order exactly how much to fill each machine -Can choose to move medication from one machine to another, instead of ordering more stock Loaded meds without active orders: Can remove medication from one machine that is not being used and move it to one that has orders for it. -Prevents overstock and possibly outdating -Helps with stock rotation -Decreases stock in main pharmacy