RX100 Willow Inpatient Fundamentals - Chapter 7: Dispensing from ADS Cabinets

Question 1

ADS

Answer 1

automated dispensing system stations or cabinets (eg. Pyxis, Omnicell, AcuDose, MedSelect)

has a main console, often accessed in the main pharmacy, that can be used to manage interface messages, monitor activity, and run reports about all of the cabinets (or stations) throughout the hospital

each ADS cabinet is a separate dispense location or pharmacy (PHR) record, therefore each ADS cabinet has an associated medication (EFY) record

Question 2

what are ADS cabinets useful for?

Answer 2

• common medications
• PRN medications
• regulated medications or narcotics

Question 3

patient profile

Answer 3

list of medications that can be dispensed for a particular patient from a given ADS cabinet

Question 4

ADS load pharmacy

Answer 4

dispense location that does not physically exist, but has a pharmacy (PHR) record with an associated medication (EFY) list, which includes every product and package that should always be dispensed from an ADS cabinet.

**remember, EFY lists do not track inventory, so loading the ADS will only be triggered if the medication is not on the ADS’s EFY list at all

Question 5

ADS load

Answer 5

the ADS system sends a message to Epic when a medication is loaded or unloaded

this interface messages updates the medication list (EFY) for the ADS cabinet; it can now be considered as a dispense location for the medication

Question 6

ADS unload

Answer 6

the ADS system sends a message to Epic when a medication is loaded or unloaded

this interface messages updates the medication list (EFY) for the ADS cabinet; it can now be considered as a dispense location for the medication

Question 7

ADS load label

Answer 7

prints when an order is verified with a dispense location of “ADS Load Pharmacy”

1. label prints but does not tell you which ADS needs to be loaded. the patient unit, room, and bed do print on the top right of the label.
2. the MAR will indicate the med needs to be loaded
3. the order will be added to the patient’s profile in the ADS system, even though the med is not yet loaded

Question 8

ADS and ADT messages

Answer 8

when a patient is admitted, discharged, or transferred, an interface message is sent from Epic to the ADS system

this message causes the ADS system to create or update the patient profile with the correct unit and room, which causes the profile to appear in the correct ADS cabinet

Question 9

when is an order added to a patient’s ADS profile?

Answer 9

AFTER the order is verified by pharmacy

if an order has been signed but NOT verified, it will NOT appear in the patient’s profile

Question 10

what orders will be added to a patient’s ADS profile?

Answer 10

Epic can send a message to the ADS console to add an order to the patient profile when the order is verified with either:
- ANY dispense location (creates a long list of meds nurses have to scroll through on the ADS)
- an ADS as the dispense location (preferred, only lists meds available in the ADS)

Question 11

what happens in Epic when a dose is pulled from an ADS cabinet?

Answer 11

when the nurse dispenses (pulls or vends) a medication from the ADS cabinet, the ADS system sends an interface message to Epic and a dispense action is recorded

unlike most orders, orders from an ADS cabinet do not generate “dispense” actions when they are verified

Question 12

why would an order have a dispense location of ADS load pharmacy?

Answer 12

when a med is not stocked in the ADS cabinet, but is included in the EFY list for the ADS Load Pharmacy PHR location

this means the med should be stocked in the ADS but is not currently stocked. we know it is not stocked because it is not on the EFY list for the ADS cabinet and dispense logic has skipped the ADS cabinets to suggest that the ADS cabinet should be loaded.

Question 13

what is the purpose of a “load label”?

Answer 13

to trigger pharmacy team to physically stock the med in the appropriate ADS cabinet, so nursing can administer to the patient

once the med is stocked in the ADS, the dispense location will automatically update on the MAR

Question 14

when will the ADS medication list be updated?

Answer 14

when a new medication is verified

Question 15

what happens in Epic when a medication is loaded into a dispensing cabinet?

Answer 15

the ADS system sends a message to Epic when a medication is loaded or unloaded

this interface messages updates the medication list (EFY) for the ADS cabinet; it can now be considered as a dispense location for the medication

Question 16

profiled ADS cabinet

Answer 16

displays action med orders for each patient (called the profile) served by that ADS cabinet

nurses can only pull medications on the patient’s profile, or specific medications that are on the ADS cabinet’s override list

**remember that Epic updates the profile when the order is verified (NOT signed)

Question 17

non-profiled ADS cabinet

Answer 17

displays a list of patients that ADS cabinet serves and all medications in the ADS cabinet

nurses can pull any medication loaded in the station

less common; most likely to be used in procedural areas