Transcript Safety and Efficiency: Omnicell

Kelli Donovan, CPhT
Adventist Medical Center
Portland, OR
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Why automation?
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Time-line for set-up
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Using reports from a
Buyer’s standpoint
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Diversion
Lost Charges
Choosing machines
Choosing
medications
Load machines
Going live
Reordering supplies
Decreasing stock
levels
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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
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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
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Theft: There is an electronic record in addition
to a charge in billing system of each transaction
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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.
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Sensing drawers: Used for non-controlled
medications. Any drawer can be opened, but the
machine records an illegal drawer was opened.
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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.
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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
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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