Pharmacy and Nursing services may use the Omnicell System as a delivery and charging system for the following types of medications:
- Controlled substances
- Stock medications
- Patient’s initial dose of medication when the pharmacy is closed
AUTHORIZED ACCESS back to top
1. The Omnicell User Competency Checklist must be completed and forwarded to the Omnicell System Manager in the pharmacy. “User IDs” will be entered and maintained by the Pharmacy System Manager.
2. A temporary password is to be issued with the user ID. The user must immediately access the Station or console, as appropriate, and follow the prompts to change the temporary password to a private, permanent password. This new, private password must be kept confidential.
3. New users who are not in the database need a temporary ID. A temporary access ID is usable for 24 hours will be assigned by the Department Director, Nursing Supervisor or designated charge nurse for agency nurses or for nurses floating who are not from the per diem pool. The temporary user must immediately access the Station and follow the prompts to change the temporary password to a new private password.
4. A nursing instructor will be assigned an ID and password. This ID and password will be used by the instructor for the nursing students working with that nursing instructor. The ID and password must remain confidential and may not be shared with the students.
5. When creating a temporary ID and password for any personnel, the following information is required: full last name, first initial, license classification:
- RN = registered nurse
- NS = nursing supervisor
- LPN = licensed practical nurse
- DIR = director
- CN = charge nurse
- RPh = pharmacist
- NI = nursing instructor
- TECH = pharmacy technician
6. Individuals may have different access privileges assigned to them. This will be determined by the Department Director and the Pharmacy Director. A description of functionality of the access privileges is available in the OMNICELL OPERATOR’S MANUAL (located in the Pharmacy)
7. All requested additions, deletions or changes to access Ids must be sent to the Pharmacy Omnicell System Manager for implementation with a completed Omnicell User ID Verification Statement.
8. Any user with access to the system may change their password at any time.
Accessing the System back to top
1. Enter User ID.
2. Press Enter
3. Enter Password
4. Select Patient Name
5. Select Medication. To Select a particular medication in the All Meds List, scroll through the list or enter the first few letters of the medication name and you will be advanced to that alphabetical location.
6. Enter the quantity to remove
7. Press Enter
8. Press Remove Meds. The drawer containing the medication will light. Open the drawer and the lighted bin. If prompted, verify the medication count, and press YES if the quantity shown is correct. You will be required to verify the count remaining on all controlled substances.
9. Open the Bin and remove the selected medication and quantity.
10. Close the bin(s) and the drawer.
11. Repeat until all medication has been removed.
12. Press EXIT. This removes the user name from the Omnicell so that unauthorized use cannot occur.
RETURNING MEDICATIONS back to top
A medication removed from the station that is in it’s original package and not administered to the patient will be returned to the station.
To return a medication:
1. Select the patient
2. Select the medication to be returned
3. Select the quantity to return.
4. Find the lighted drawer and open it. Return the medication to the appropriate bin. Verify count remaining if prompted.
5. Close the bin and drawer
6. PRESS EXIT.
If the tamper-evident packaging of any product is in any way damaged, the product must not be returned to the Omnicell machine. Instead, the product must be returned to the Pharmacy.
WASTING MEDICATIONS back to top
Controlled medication wastes are defined as all or part of a medication that is not in it’s original sealed package and not administered to a patient. If the tamper-evident packaging is compromised, then the product must be wasted.
If an entire dose of medication needs to be wasted it should be returned to the Pharmacy for destruction. Partial doses of a controlled substance may be wasted on the patient care unit.
If a controlled medication originally taken from the station needs to be wasted, it will be documented at the station by using the “Waste” option”. Two licensed employees (IE: RN, LPN, RPh.) are required to waste a controlled substance. The second licensed employee enters his/her User ID and password as a witness to the medication waste procedure.
TO WASTE A MEDICATION:
1. Access the system.
2. Select the medication
3. Select WASTE ITEM
4. Enter the quantity to be wasted
5. Press Enter
6. Enter the reason for wasting the item
7. Press EXIT.
The wasted controlled medication must be documented at the time the medication is wasted.
DISCREPANCIES back to top
1. When the actual count of a medication at the station differs from the displayed count for that medication, a discrepancy exists. All controlled substances (meds classified as Class I-V) discrepancies are logged and can be printed out at the station. All unscheduled discrepancies are logged, but are then automatically resolved and sent to the pharmacy console.
2. Any controlled medication discrepancy discovered must be reported immediately to thecharge nurse.
3. A controlled medication discrepancy must be resolved either at the time of discovery orbefore the shift change. A controlled medication discrepancy is resolved between the user discovering the discrepancy and the user with the previous access. If the previous user is not working, every effort must be made to contact that person. The charge nurse must assure that all discrepancies are resolved. When a discrepancy exists, the Omnicell will highlight the discrepancy box at the bottom of the screen. Additionally, a screen-saver indicates that there are discrepancies present. A detailed report covering a specific time-frame may be printed by contacting the pharmacist covering the nursing unit.
4. Once a resolution has been established, two licensed users will use the “Resolve Discrepancy” function to provide an electronic explanation for the discrepancy. The users must use free-text to record the reason for the discrepancy indicating as much information as possible.
5. Pharmacy will review the Discrepancy Report for valid explanations and for discrepancies which may require further investigation. Adherence to wastage/witness documentation will also be reviewed.
6. If a discrepancy is not resolved, the charge nurse must create an event report. This must include the employees involved, the medication and strength involved and quantity unresolved. The charge nurse must immediately notify the Pharmacist in Charge so that timely investigation of the discrepancy may occur.
ENTERING PATIENT INFORMATION back to top
1. The patient’s name should appear on the station census list. This information is obtained via an interface with the hospital’s Admission, Discharge and Transfer patient care computer system.
2. For a variety of reasons, some patients may not be listed on the station at the time a medication is needed. If this occurs, select ADD NEW PATIENT. Follow the prompts to enter the patient’s last name, first name, account number and room number. In an emergency the name, and room number must be loaded. If the name is unknown at that time, enter John or Jane Doe-Room 4. The real name and account number must be loaded at some point within the same shift. Use the “return medication procedure” for John or Jane Doe for credit, then re-enter under the appropriate patient.
INVENTORY COUNT back to top
1. A physical count of controlled substance inventory will be performed once each week. Two licensed employees will complete the inventory. Inventory documentation is included automatically in pharmacy records. After the inventory is completed, both employees will sign the inventory documentation sheet and indicate whether all medications are in the correct pocket.
2. The pharmacy Omnicell system manager will monitor the weekly shift counts by printing a report from the console.
3. The frequency of the inventory count may be re-assessed after using the station over time. This adjustment of frequency may be dependent upon the number of discrepancies that occur on the nursing unit.
4. The decision to change the frequency of inventory count will be made jointly by the department director and the pharmacy director.
STOCK REPLENISHMENT/EXPIRED MEDS back to top
1. The pharmacy will be responsible for maintaining adequate inventory of all medications in the Omnicell station.
2. When inventory levels drop below the established levels, a report generates at the:
3. Pharmacy console. The main pharmacy technician refills the non-controlled medications.
4. The pharmacist working inside the pharmacy prepares the controlled substances for delivery by the decentralized pharmacists.
5. Pharmacists and technicians shall be assigned Omnicell Machines to check for expired medications. Nursing shares the responsibility of checking for expired medications. If expired medications are found, the pharmacy shall be notified for removal and replacement.
STOCK AND INVENTORY LEVEL CHANGES back to top
Changes to the inventory and stock levels will be made based upon patient need and prudent management of excess inventory of product.
REPLACING OMNICELL PAPER back to top
1. All nursing staff should learn how to replace the paper at the station.
2. Extra rolls of paper will be kept on the top of the Omnicell station. Additional rolls of paper are stored in the Pharmacy.
PROBLEM SOLVING back to top
1. Each nursing unit has designated resource nurses on each shift to answer questions and assist other nurses on utilizing the station. Additionally, a station reference guide is located at each station to answer questions.
2. If a problem cannot be resolved by referring to the Omnicell station reference guide or the resource nurse, contact the pharmacy. If necessary, the pharmacy can contact Omnicell for assistance. If the pharmacy is open, it is the responsibility and expectation that the pharmacy will contact the Omnicell Corporation for support.
3. If the pharmacy is closed, the nursing supervisor may call the Omnicell 800 service number found on the station for additional assistance.
POWER OUTAGE/EMERGENCY PROCEDURES back to top
1. If the station is plugged into the emergency power system the station should remain operational.
2. The pharmacist has access to keys if it becomes necessary to manually open the station for medication access.
3. Any controlled substance removed from the station during down-time will be documented on the controlled substance (narcotic) sign-out sheets. These sheets will be sent to the pharmacy after the system is back on line for the purpose of accountability.
4. Omnicell will plan and coordinate resolving the software or hardware problem. Pharmacy will make this call if the pharmacy is open. The nursing supervisor will call if the pharmacy is closed.
5. A nursing unit may decide to remove medications from another nursing unit station during the time that their own station is not functional
REPORTS back to top
1. Department directors may request special reports from the pharmacy Omnicell system manager. These reports can include reports by medication removal, by nurse, by witness, by discrepancy, and so forth.
2. An “activities report by medication” will be printed to act as a record of all controlled substance medication administration. This document will be kept by the pharmacy as required by law.