Kelli Donovan, CPhTAdventist 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

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