"Cancel Remove" function on PYXIS Machine

Have you ever used or are familiar with the "Cancel Remove" function on the electronic Pyxis medication dispenser?

Sometimes, one may be tempted to use this function to access something not otherwise profiled, Say for example to "Cancel Remove" an unwanted but profiled medication to access something else known to be in the same drawer. In my unit Lubrifax Packets come to mind.

If an individual nurse (one of many on the floor) were to use this function say 15 times within a month's time, and there were to be a discrepancy of say 15 Tylenol tabs and 6 Flexeril tabs within the same time period, could the nurse be found to be guilty of diversion of medications when the only witness is a machine?

If so, then what would you suspect the maximum disciplinary action to be?

A) A letter of reprimand from the employer
B) Termination by the employer
C) A letter of reprimand from the state B.O.N.
D) A suspension of licensure
E) A revocation of licensure
Diversion normaly only pertains to narcotics, tylenol and flexaril are not narcotics.

While one usually thinks of diverting drugs pertains to narcs only, diverting is diverting. If it's not on the pt profile/order, and you're pulling meds to give to a pt, you're practicing medicine/outside the scope of your practice. Even something as minor as Tylenol is not worth losing my job/income/license/respect.

Quote from jnrsmommyWhile one usually thinks of diverting drugs pertains to narcs only, diverting is diverting. If it's not on the pt profile/order, and you're pulling meds to give to a pt, you're practicing medicine/outside the scope of your practice. Even something as minor as Tylenol is not worth losing my job/income/license/respect.

Talk about "a machine being the only witness", I had several go arounds with it and had me sobbing in the corner of a med room. On several shifts I was the oncoming 11p-7a med nurse, and the discrepancy icon was not displayed prior to me logging in. I pulled up some meds, did beginning count, removed and closed the lid. It did not warn me that the count was off prior to me opening the pocket. The next time I pulled the same med for different patient, THEN the discrepancy shows up on the screen on my watch under my name. Going back to the previous shift to see who was previously removing such meds (under a global search) it was two nurses who had screwed up the count on prior shift and now the red icon is down in the corner attached to my name and time. I couldn't leave the building the next morning until those discrepancies were reconciled. They brought in the house supervisor, the pharmacist, and an IT guy. They were convinced I diverted. There were no options on the screen for me to clear it up at first and I was told my license would be sent down river. Until one last effort and one last option screen came up for me to put in a "naritive" of the events that lead up to all these off counts being dumped on me. It was the only way the screen was cleared of the discrepancies. Previous shift nurses need to be careful and at least tell the oncoming what happened or at least make all attempts to rectify their problem so it doesn't roll onto the other nurse. I said to the house super "so this machine is going to put my license in Sing Sing if I can't clear this" he said "Yeah it's your ass because your name is on this screen and this machine doesn't lie." Nice huh?

I use that function all the time. We have bar-code scanning, and sometimes the barcode won't scan. If that happens, I take the scanner into the med room, scan a different package (same med), and then do the "cancel remove" and put it back. I don't use it if I actually remove a med like you have stated, however.As far as what you asked specifically, I don't know how the employer would pin that on you unless you happened to be the only person on the entire unit that used that function for that drawer, and honestly, do they even track that stuff if it's not a narcotic? At my facility, they don't. We don't have to count/inventory non-narcotic medications, and the pharmacy doesn't either. If the drawer is empty but the Pyxis still says we have pills in there, we just call the pharmacy to have them refill. Nobody cares if a couple of tylenol are missing (or for that matter, prefilled saline flushes, bags of NS, etc...those are all connected to our Pyxis in a big cupboard style thingy as well. God knows we don't count all of that stuff that we go through.) Did some event happen or is this a hypothetical question? I can't see anyone ever getting reprimanded or worse for the situation you described.

Quote from grandmawrinkleDid some event happen or is this a hypothetical question? I can't see anyone ever getting reprimanded or worse for the situation you described.