Care Fusion Pyxis MedStation 4000 User manual

Pyxis MedStation™
4000 System
Console User Guide
May 2011
DME: 10000152350 Ver. 00
Matl Number: 133591-01

Pyxis MedStation™4000 System Console User Guide
Changes in equipment, software, or procedures occur periodically; information
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responsible for compliance could void the user’s authority to operate the
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Contents
About this guide ...................................................................ix
Chapter 1—System overview
The total medication solution.................................................................................2
Unit-dose workflow................................................................................................3
Pyxis MedStation system components...................................................................4
Network information..............................................................................................6
Comprehensive reporting ...............................................................................6
System communication ..........................................................................................8
Interface options.............................................................................................8
Chapter 2—Console Basics
Getting started ......................................................................................................12
Navigating the standby screen......................................................................12
Logging in ....................................................................................................12
Logging off...................................................................................................12
Changing your password..............................................................................13
Using the console .................................................................................................14
Menu bar.......................................................................................................14
Features and functions..................................................................................14
Quick key...........................................................................................14

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Chapter 3—Setting Up the System
Devices.................................................................................................................18
Accessing the devices list.............................................................................18
Adding a station or other device...................................................................19
Beginning the process........................................................................19
Entering the general settings..............................................................20
Entering the communication settings.................................................24
Entering the settings for profile mode................................................25
Entering the hardware settings...........................................................27
Completing the process......................................................................34
Editing a station or other device...................................................................35
Deleting a station or other device.................................................................35
Changing the device type .............................................................................36
Changing the name of a device ....................................................................36
Taking a device in or out of service .............................................................37
Formulary management........................................................................................38
Remove Warning overview..........................................................................38
Editing a formulary item ..............................................................................44
Editing accessed inventory...........................................................................45
Enabling Scan on Load/Refill ......................................................................47
Enabling undocumented waste.....................................................................47
Configuring the multi-scan medication feature............................................48
Formulary equivalencies ......................................................................................50
Creating an equivalency...............................................................................50
Editing an equivalency.................................................................................52
Deleting an equivalency...............................................................................52
Expanding an equivalency............................................................................53
Variable dose........................................................................................................54
Adding a variable dose.................................................................................54
Editing a variable dose .................................................................................57
Deleting a variable dose ...............................................................................57
Combination dose.................................................................................................58
Adding a combination dose..........................................................................58
Editing a combination dose..........................................................................61
Deleting a combination dose........................................................................62
Kits .......................................................................................................................63
Adding a kit..................................................................................................63
Editing a kit ..................................................................................................65
Deleting a kit ................................................................................................66
Users.....................................................................................................................67
Creating templates for user privileges..........................................................67
Adding a user................................................................................................69
Beginning the process and assigning areas to a user .........................69
Assigning privileges from a template ................................................70
Assigning console privileges to a user...............................................71
Assigning station privileges to a user ................................................72

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Assigning medication privileges to a user.........................................76
Filtering the users list ...................................................................................76
Updating information for an existing user or group of users .......................77
Updating information for one user.....................................................77
Updating a user-privilege template....................................................78
Deleting a user..............................................................................................78
Patients .................................................................................................................80
Adding a patient file.....................................................................................80
Using the expanded allergies feature............................................................86
Multiple severities and reactions for one allergy...............................88
Using the enhanced pre-admit hold order ....................................................88
Editing a patient file .....................................................................................89
Discharging a patient....................................................................................89
Filtering the list of patients...........................................................................89
Patient billing reconciliation.........................................................................90
Using the reconcile feature ................................................................91
Areas.....................................................................................................................93
Adding a nursing unit...................................................................................93
Adding an area..............................................................................................95
Adding or removing a nursing unit to or from an area.................................95
Deleting an area............................................................................................96
Deleting a nursing unit .................................................................................96
Clinical data..........................................................................................................97
Predefined Clinical Data Categories (CDCs)...............................................97
Using a CDC response................................................................................102
Adding a multiple-response list .......................................................104
Editing a multiple-response list........................................................105
Deleting a response from a multiple-response list...........................105
Site-specific options...........................................................................................107
Specifying demographic information.........................................................107
Specifying system options..........................................................................107
Configuring an attention notice (bulletin)..................................................109
Activating an optional type of attention notice................................109
Addressing an unsolicited attention notice ......................................111
Report and maintenance options ................................................................111
Selecting report options ...................................................................111
Specifying maintenance options ......................................................113
Running a maintenance task ............................................................115
Customizing the console name ........................................................115
Viewing or modifying a medication warning..................................116
Pharmacy configuration .....................................................................................118
Customizing a security group name ...........................................................118
Adding or changing a medication-classification name ..............................120
Renaming a medication classification..............................................120
Adding a medication classification..................................................121
Deleting a medication classification................................................122

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Adding or modifying a discrepancy-resolution reason ..............................122
Adding a discrepancy-resolution reason..........................................122
Editing a discrepancy-resolution reason..........................................123
Deleting a discrepancy-resolution reason........................................123
Adding, updating, or deleting a formulary or station list ...........................124
Adding an item to a list....................................................................124
Editing a list.....................................................................................125
Deleting an item from a list..............................................................125
Maintaining scan codes......................................................................................126
Adding a scan code.....................................................................................126
Editing a scan code.....................................................................................127
Deleting a scan code...................................................................................127
Using scan code for a quick search ............................................................127
Confirming items........................................................................................129
Communication status........................................................................................131
Viewing specific communication information...........................................131
Changing the refresh rate............................................................................135
Chapter 4—Utilities
Using virtual files edit to define communication ports......................................138
Adding a virtual file....................................................................................138
Editing a virtual file....................................................................................138
Deleting a virtual file..................................................................................139
Renaming a virtual file...............................................................................139
Copying a virtual file..................................................................................140
Updating information globally...........................................................................141
Updating the formulary globally................................................................141
Updating device information globally........................................................144
Updating user information globally............................................................148
Archiving transactions........................................................................................152
Viewing or deleting the list of archive files ...............................................152
Selecting archive data.................................................................................153
Creating or editing archival data for pocket-access transactions.....153
Creating or editing archival data for user transactions ....................155
Creating or editing archival data for document-discrepancy
transactions.......................................................................................155
Creating or editing archival data for temperature-log transactions..156
Copying archive files to media...................................................................157
Scheduling archive maintenance................................................................157
Chapter 5—Inventory
Assigning a medication to a pocket....................................................................160
Select block loading on individual stations................................................165
Replacing or editing a loaded medication..........................................................167
Clearing a pending medication...........................................................................168

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Chapter 6—Reports
Available reports ................................................................................................170
Report descriptions.............................................................................................171
Generating a report.............................................................................................175
Batch reports.......................................................................................................177
Adding a batch report.................................................................................177
Viewing the list of batch reports ................................................................178
Editing a batch report .................................................................................178
Deleting a batch report ...............................................................................179
Enabling or disabling a batch report...........................................................179
Printing a batch report................................................................................179
Appendix A—Troubleshooting
Attention notice (bulletin)..................................................................................182
Can’t communicate attention notice...........................................................182
Same station attention notice ...........................................................183
Different station attention notice......................................................184
Using brain transplant to restore a database.......................................................185
Checking the communication status of a station..............................185
Running a brain transplant...............................................................185
Communication problem with Pyxis Procar ......................................................187
ADT communication problems..........................................................................188
Patient or patient order not displayed at the console..................................188
Patient billing information problems..........................................................189
Report does not include correct data..................................................................190
Facility power outage.........................................................................................191
Console printer not working...............................................................................192
Remote diagnostics.............................................................................................193
User cannot access a medication........................................................................194
Appendix B—Pyxis®Advisor control panel
Accessing Pyxis Advisor in the console.............................................................196
Appendix C—Pyxis Nurse Link on the console
Pyxis Nurse Link overview................................................................................202
Waste process.............................................................................................202
Removed Meds ................................................................................202
All Meds...........................................................................................202
Undocumented Waste......................................................................202
Waste information......................................................................................202
Role-Based queuing....................................................................................203

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Appendix D—Cerner®
Cerner overview.................................................................................................206
Medication location and availability..........................................................206
Linking your accounts................................................................................208
Clinical and operational alerts............................................................................209
Alerts ..........................................................................................................209
Appendix E—Management and Monitoring
Recommendations
Security recommendations.................................................................................212
General recommendations..........................................................................212
Controlled medications...............................................................................213
System configuration recommendations............................................................214
Drawer configuration and medication location..........................................214
Control the station formulary list ...............................................................214
Order entry and verification .......................................................................215
Medication distribution ..............................................................................215
Glossary .............................................................................217
Index ...................................................................................227

Pyxis MedStation 4000 System Console User Guide ix
About this guide
This guide provides information on how to set up, use, and maintain the Pyxis
MedStationTM 4000 system console.
This guide does not cover service and repair procedures. It focuses on the daily
use, minor maintenance, and troubleshooting of the system.
For information about the product that is not covered in this document, call the
Technical Support Center (TSC) for Pyxis®products at 800.727.6102 or
858.617.2000.
Conventions
This guide uses the following conventions:
• The names of document titles, cross-references, and text that requires
emphasis are formatted in italics.
• The names of buttons, menu commands, options, icons, file names, and
folders are formatted in bold.
• User input is formatted in
Courier bold .
• Programming code is formatted in
Courier fixed width .
CAUTION
Caution indicates a potentially hazardous situation which, if not avoided, could
result in minor or moderate injury. Caution is also used to alert against unsafe
practices that could result in unpredictable results or data loss.

About this guide
x Pyxis MedStation 4000 System Console User Guide
Overview of this guide
This guide includes the following information about the console.
•Chapter 1, System overview—Provides an overview of system features and
components, and the system’s network configuration.
•Chapter 2, Console Basics—Explains how to use the console and includes
procedures for logging on and off the system.
•Chapter 3, Setting Up the System—Describes how to set up system
information unique to your hospital, such as station names and options, users,
patients, and the formulary.
•Chapter 4, Utilities—Describes how to use system management functions at
the console.
•Chapter 5, Inventory—Describes how to use the Inventory feature to manage
your hospital’s inventory as it moves from the Pharmacy out to the patient.
•Chapter 6, Reports—Provides reports, report descriptions, procedures for
generating reports, and batch reports information that can help you to monitor
and manage your system.
•Appendix A, Troubleshooting—Provides remedies to potential problems
involving the console and its components.
•Appendix E, Management and Monitoring Recommendations—Provides
security recommendations, system configuration recommendations, and
examples of controlled substance procedures for operating rooms (ORs) and
anesthesiology in hospitals where Pyxis MedStation 4000 system is used.
•Glossary—Defines system terminology.
•Index
NOTE
Notes contain supplementary information or emphasize a point or procedure.

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Chapter 1
System overview
The Pyxis MedStation system automates the distribution, management, and
control of medications. The Pyxis MedStation system includes a network of
secure storage stations located in patient-care areas throughout the facility. Each
station is controlled by its own microprocessor and functions similar to an
automated bank-teller machine. This section includes the following topics:
The total medication solution.................................................................... 2
Unit-dose workflow................................................................................... 3
Pyxis MedStation system components....................................................... 4
Network information .................................................................................6
System communication.............................................................................. 8

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The total medication solution
The Pyxis MedStation system allows a pharmacy to store and track a range of
medications and floor-stock items. Depending on your needs, the Pyxis
MedStation system can manage:
• Controlled medications
•Floorstock
• Pro re natas (PRNs) (profile mode recommended)
• First doses (profile mode recommended)
• Some IV solutions and sets
• Up to 95% of all medications (profile mode only)
The actual amount of medication storage depends on your station configurations
and other factors. The Pyxis MedStation system is flexible and has many
configuration options to accommodate your needs and requirements.

Unit-dose workflow
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Unit-dose workflow
Most pharmacy and nursing managers understand the benefit of having
medications available at all times on the nursing unit. The following flowchart
represents the differences between the traditional unit-dose system and the Pyxis
MedStation system. The Pyxis MedStation system is able to reduce nine identified
points of potential time delays and errors down to a manageable five.
Unit-Dose
Order is written and
pulled from chart by clerk.
Prescription is delivered
to pharmacy.
Pharmacist reviews.
Orders are entered.
Technician
prepares order.
Pharmacist
checks order.
Order is delivered to
floor.
Order is put in
appropriate storage.
Nurse acquires and
administers medication.
Pyxis MedStation System
Order is automatically
transferred to
automated system.
Nurse acquires and
administers medication.
Prescription is written and
delivered to pharmacy.
Pharmacist reviews.
Orders are entered.

Chapter 1—System overview
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Pyxis MedStation system components
The Pyxis MedStation system is custom-configured for your facility’s needs and
for the way you do business. The Pyxis MedStation system components include
the following:
•Console (one or more)—The console is the central controller and
clearinghouse for all stations. Network connections provide the
communications path between the components. The console is usually located
in the pharmacy and stations are located throughout the facility.
The console provides the management interface to enter and collect
information. It performs the following functions:
°Communicates data to and updates activity information in all the stations.
°Maintains copies of all patient, user, formulary, and activity information
used to generate pharmacy reports.
In some facilities, an additional computer, monitor, and keyboard can be
added in a second location as another console access point. This is also known
as a console workstation.
Pyxis®Procar, also a part of the console subsystem, is responsible for
interface communications, including the admissions, discharge, and transfer
(ADT) and billing information and, if you use profile mode, the pharmacy
software system link (patient orders and other pharmacy profile information).
CareFusion representatives configure and install the Pyxis MedStation system
for you.
•Stations (one or more)—The stations are the clients in the setup. They
provide secure and reliable storage for medications of all types. They
communicate with the console, receiving patient, order (profile mode only)
and inventory information, while continuously reporting all medication
transactions. Stations come in a variety of configurations, with a selection of
configurable drawers and doors to meet the needs of the various areas.
•Printer—The console includes a high-speed laser printer for printing reports.
•Optional Component (Pyxis®Connect)—the Pyxis MedStation system
incorporates the Pyxis Connect product. The nurse-monitor station is a tool
used outside the pharmacy, on each unit where a scan station is placed, to
monitor the status of orders in the Pyxis Connect system. The nurse-monitor
station software is usually installed on computers in the nursing unit and used
by nurses to track orders that have been scanned from particular locations.
Nurses can check the status of an order at the same station from which they
attempted to remove a medication. If a nurse discovers that a new drug is not
yet on the patient’s profile, he or she can log on to Pyxis Connect from the
Pyxis MedStation system to check the status of the order.
NOTE
The Pyxis MedStation system communications hardware and software interfaces
are proprietary.

Pyxis MedStation system components
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•Scanner—A scanner capable of reading linear and 2D barcode symbols is
standard equipment on both the station and the console.

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Network information
Pyxis Procar translates patient information from the hospital’s host information
system into a usable format for the Pyxis MedStation system. It serves as a
connection between the console and the hospital’s ADT, billing, and clinical
(patient-profile) pharmacy systems.
The communications link between the console and the stations is interactive. The
console receives patient information from the hospital’s information system
(ADT), correlates it with the correct nursing unit and area, and sends it to the
appropriate stations.
The console communicates with each station after a specified time interval
depending on setup and the amount of activity. Information is automatically
retrieved and subsequently stored when any change in status, such as medication
removal, occurs. The activities are then forwarded to the hospital’s billing system
through Pyxis Procar.
Comprehensive reporting
Many facilities have numerous stations located throughout a variety of patient-
care areas, so comprehensive and accurate reporting is critical to the pharmacist
and system manager.
The console, located in the pharmacy, retains up to 31 days of transaction data for
all stations, including:
• Medication removals and returns
• Wasted medications
• Refill activities
• Discrepancy-resolution information
• Inventory verification
Reports on every aspect of the Pyxis MedStation system—including pocket
accesses, inventory, patient ADT, orders (profile mode only), and formulary—are
available from the console, located in the pharmacy. Data can be sorted and
printed in a variety of reports and kept as a permanent record of medication usage.
NOTE
Some hospital or pharmacy vendors require additional hardware and software to
accomplish this interface. Your CareFusion representative works with you to
determine the requirements for your facility.
NOTE
CareFusion provides long-term data-archive and reporting systems to track
inventory and clinical data. For more information, contact your CareFusion
representative.

Network information
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Each station can generate summary reports of all transactions for that station for
up to the most recent 32 hours.
To store information electronically, or to generate custom reports, you can archive
the console data and import the data into various database and spreadsheet
programs. For specific information on archiving, see Utilities on page 137.

Chapter 1—System overview
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System communication
You can implement a communications system to fit your needs and the layout of
the facility. The configurable communications feature allows communications via
network methods. A CareFusion applications engineer works with you to
integrate the Pyxis MedStation system with your telecommunications system.
The required communications links in the Pyxis MedStation system installation
include:
• A Pyxis Procar that interfaces the console to the hospital or pharmacy
computer for ADT, billing, and patient-profile information.
• A communications component that links the console to the network of
stations.
For station communications, network protocols are used. For interface
communications, the same options apply, depending on the system-interface
method supported by the hospital-system vendor. The preferred method of
network communications is Transmissions Control Protocol/Internet Protocol
(TCP/IP) over Ethernet.
Interface options
While the Pyxis MedStation system can be operated as a stand-alone turnkey
system, significant value and operating efficiencies are added by using various
interfaces with your hospital- and pharmacy-information systems. CareFusion
will collaborate with any hospital-information system vendor to complete these
interfaces.
There are five basic interface options:
•ADT interface—Although ADT information can be manually updated, the
volume of information necessitates the use of a real-time electronic interface.
The ADT interface between the console, located in the pharmacy, and the
hospital’s information system is typically a one-way source of information,
coming from one of several potential ADT sources. These sources include a
printer “splice” interface into an existing line from your information system to
your pharmacy printer, or any of the communications methods discussed in
System communication on page 8. The console receives ADT information,
routing it to the appropriate stations.
•Billing interface—A billing interface eliminates the need to enter individual
billing transactions manually into the billing system. CareFusion can create an
interface that allows you to format and send these transactions directly to your
billing system.
•Pharmacy-profile interface—the Pyxis MedStation system offers an
interface to the pharmacy computer system, which gives providers immediate
point-of-use access to patients’ medications via their medication profiles,
while saving a number of dispensing steps for the pharmacy. Upon medication
removal, information regarding usage and inventory is automatically routed
back to the pharmacy system. This interface can also include real-time

System communication
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formulary and stock-location updates between the pharmacy system and the
Pyxis MedStation system.
•Medication-charting interface—As medications are withdrawn from
stations, all information routinely required for the medication-administration
record is passively collected. The Pyxis MedStation system has the ability to
pass this information electronically to automated nurse-charting systems.
Additional data fields in the Remove and Return processes collect
information such as injection sites, observations, and other medication- and
station-specific data. Configure the information to meet your nurse-charting
vendor specifications.
•Wholesaler interface—CareFusion has the ability to pass medication usage
information directly to your wholesaler. A separate computer connected to the
console interfaces with the wholesaler’s computer. More information
regarding the wholesaler interface is available from your CareFusion
representative and your wholesaler.

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