We use AcuDose from McKesson instead of Omnicell, but our process is to
suppress the dispensing machine orders from appearing on the nurse's
e-MAR.  They can only document against the physician's POM order.  If
the physician can not/will not order through EDM/POM (which is rare
now), they prescribe on paper.  At that point the nurse documents on
paper also.
 
Jeff Lee
Assistant Director of Pharmacy, Support Services
DCH Regional Medical Center
809 University Blvd E.
Tuscaloosa, AL 35401
 
(205) 750-5323
[EMAIL PROTECTED]

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From: [email protected] [mailto:[EMAIL PROTECTED] On Behalf
Of Adler, Christine
Sent: Monday, April 30, 2007 2:02 PM
To: [email protected]
Subject: [MEDITECH-L] FW: LIST SERVE QUESTION
 
S.O.S.
 
Meditech Magic version 5.5sr3
 
We recently went LIVE with EDM and are having some issues with using
this product in conjunction with our dispensing cabinet (Omnicell) and
the eMAR.
 
Is anyone else attempting to utilize these products together in their
ER?  If so, any insight to solutions/work-arounds on the below issues we
are having would be greatly appreciated.
 
1.      We have changed Omnicell in ER to be profile dispense, but are
having significant lag times between order entry and appearance on the
cabinet.  Any suggestions or solutions?
 
2.      Due to the aforementioned lag time, we are still seeing a lot of
manual overrides from the cabinet.  The cabinet creates an order on the
manual dispense so the RN can document on this order on the eMAR and we
can set in the CDP so this order is sent to the sign cue of the
physician.  The problem we are having is that we are getting multiple
orders because the physician goes in in the meantime and enters the
order or the RN just wasn't patient enough to wait for the order to flow
to the cabinet-creating double work for the physician and creating a
mess on the clinical review medication screen with duplicate orders, not
to mention that the only way you can get rid of the MED indicator on the
ER tracker is for the RN to document on one of the orders as given and
document given=N on the duplicate order.  It is easy to see why the ER
nurses are not too happy with me!
 
3.      Take home (depart) medications: since we do not have a 24 hour
pharmacy in our community, our ER has small supplies of prefill
medications ready to send home.  These orders do not flow to the
dispensing cabinet either, so no matter what we do with these it will
create duplicate order when manually overridden by the MD/RN.
 
The other module recently brought up is the RXM module in the ER.  Our
nurses are having big issues/concerns that they are not going to pick
the right drug from the list and this is unsafer than the previous
process of paper charting, or that many times the patient just doesn't
know in the ER setting what their dose is, etc.  What have others found
with using RXM.  Who updates the list?  Issues?  Training or set-up
tips?
 
1.      Since we are utilizing RXM in our clinics for prescription
writing and will be using the medication reconciliation piece in POM
shortly, I don't feel I can inactivate a lot of RXM entries to make the
look-up less daunting for the RN staff.
 
Deanna Frosch,RPh
Sauk Prairie Memorial Hospital
 


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