Dispensing from ADS Cabinets (Ch 9)
If your hospital is "cart-less", what drugs are on the EFY for the PHR: ADS Load Pharmacy?
Every product and package that SHOULD always be dispensed from an ADS cabinet (almost every unit dose medication and package that you carry, because almost all unit-dose meds come from the cabinets)
If your hospital uses carts to dispense unit dose meds, what drugs are on the EFY for the PHR: ADS Load Pharmacy?
Every product and package that SHOULD always be dispensed from an ADS cabinet (example: only narcotics)
Where is the ADS Load Pharmacy?
A fake dispense location that doesn't physically exist, but has a PHR record and EFY associated
Describe what happens when an order has a dispense location of ADS Load Pharmacy
A label will print at central pharmacy notifying the techs to go to that unit and load the drug
What is the "Load/Unload" interface message between Epic/ADS? Where is it sent? What happens when it is sent?
A message from ADS to Epic when a medication is loaded or unloaded from a particular ADS; this updates the EFY med list for that ADS cabinet within Epic
What is the "Dispense" interface message between Epic/ADS? Where is it sent? What happens when it is sent?
A message sent from ADS to Epic when a nurse pulls/vends a medicine from the cabinet; this causes a dispense action to be recorded in Epic
What is the "Verified Order" interface message between Epic/ADS? Where is it sent? What happens when it is sent?
A message sent from Epic to ADS system when an order if verified; this updates the patient's profile.
What does it mean if the ADS cabinets are "Non-profiled"? An example of where this might be useful?
All meds in the entire cabinet show up and a list of all the patients that this ADS serves; surgical area, where an order might not be placed within Epic for the drug you need to give your patient
Describe what happens when a medication is loaded into an ADS cabinet
An interface message is sent from ADS console to Epic --> EFY for that PHR is updated --> Dispense locations for all patients on that unit who take that drug are updated
Where does the ADS Load label print?
At the central pharmacy
What is the name of the central location that controls info @ all ADS cabinets?
Console
Describe how an order that needs to be loaded into a cabinet appears on the MAR
Dispense from: ADS Load Pharmacy; a label will print notifying the techs to go to that unit to load the drug
True/False: EFY are updated based on the amount of medication in an ADS pocket
False
True/False: The ADS Load Label will tell you which ADS needs to be loaded
False (it says ADS ID: unknown)
True/False: When a drug is out of stock at an ADS, the MAR for patient's taking that medication will update with the next appropriate dispense location
False - Epic does not track inventory this way
True/False: If your ADS cabinet is set as "Profiled", when you pull up a patient's name, you will only see what's in the ADS cabinet available to them, not their entire MAR (which may or may not have all the drugs in that cabinet)
False - it is configurable/recommended to do it this way though
A nurse just took the last acetaminophen-codeine tablet out of the 1 East ADS, so the pocket is empty. True/False: Epic will choose the ADS LOAD PHARMACY as the dispense location for a new order for acetaminophen-codeine tablets.
False - it will not change dispense location - Why? because this drug is still "Loaded" into a pocket here
True/False: Orders from an ADS cabinet generate "dispense" actions when they are verified
False - they generate a "dispense" action when it is pulled/vended by the nurse
True/False: A setting in Epic determines which ADS cabinets are profiled and non-profiled
False - this is a setting in the ADS system
True/False: If your ADS cabinet is set as "Profiled", Epic updates the profile when an order is signed
False - updates when the order is Verified
Describe why an order would have a dispense location of ADS Load Pharmacy
If this drug is meant to be dispensed from a cabinet, but the drug is not loaded on the cabinets that service that patient
Define Load vs Stocking the ADS cabinet
Load = telling the ADS cabinet to assign a pocket to XYZ drug and this spot is reserved for that drug only -- this causes the EFY to update to include XYZ; Stocking = refilling the pocket with tablets that are assigned to that pocket
What are the 2 main interfaces messages that the Console sends to Epic?
Load/Unload messages (to update the EFY at that PHR location); Dispense messages (when the nurse pulls the drug out, alerts Epic to record a dispense action)
Describe what happens when a dose is pulled from the ADS cabinet
Message sent to Epic from ADS console --> MAR is updated to show med has been given
Describe the purpose of an ADS "load label"
Notifies the techs to go to that unit and load the drug
If the dispense location is ADS Load, how does the dispense location appear on the MAR?
Pharmacy to load in ADS
How does pharmacy know what pockets in an ADS need to be restocked?
Run a report from the ADS system console
Define ADS Patient profile
The profiles of patients that this particular ADS cabinet services; Cindy's profile will show all the meds that she currently has active orders for AND that are Loaded in that ADS cabinet (or everything on her MAR if set up that way)
True/False: Epic will dispense an order from an ADS cabinet if there is a pocket assigned for that medication, even if the pocket is empty
True
True/False: If an order has been signed but NOT rph verified, it will NOT appear on the patient's ADS profile
True
True/False: If your ADS cabinet is set as "Non-profiled", a nurse can pull any medication stored in that station
True
True/False: The ADS Load Label will tell you which unit/room/bed needs to have the drug loaded in their ADS
True
True/False: When the ADS is loaded, the Dispense Location (on MAR) updates
True
True/False: Setting in the ADS system determine which cabinets display which patient profiles
True - NOT Epic settings
True/False: Multiple ADS cabinets can display an individual patient's profile
True - might be 2 cabinets on 3rd Floor West
True/False: You can configure Epic to identify orders that should be dispensed from ADS, but aren't currently LOADED
True - this is called ADS Load Pharmacy
True/False: When a drug is unloaded from an ADS, the MAR for patient's taking that medication will update with the next appropriate dispense location
True - this will occur automatically because an interface message will be sent
What are the 2 main interface messages that Epic sends to the Console?
Verified orders (allows the nurse to now get the drug from the cabinet); ADT (admissions/discharge/transfers) which causes the pt's chart to appear in the correct ADS systems
Describe what orders will be added to a patient's ADS profile
Verified orders of drugs that are loaded into that cabinet (on it's EFY)
Define ADS Unload
When a drug is unassigned to a pocket, updates the EFY for that ADS/PHR
What is the "ADT" interface message between Epic/ADS? Where is it sent? What happens when it is sent?
When a patient is admitted/discharged/transferred, a message from Epic to ADS system; causes the ADS to create/update the patient's profile with the correct unit/room, which causes the profile to appear on the correct ADS cabinet
Describe when the EFY for an ADS cabinet will update
When a tech loads/unloads medications from the pockets in that cabinet, an interface message is sent from ADS console to Epic
When is an order added to a patient's ADS profile?
When the order is verified by rph
What does it mean if the ADS cabinets are "Profiled"?
When you select the patient's name, the list displays only that patient's medications, and only what's in that ADS cabinet that they could have; the nurse is only able to pull specific meds
A physician orders a morphine 5mg/mL syringe for his patient. Epic picks a dispense location of ADS LOAD PHARMACY. Why? What will this order show as the dispense location on the MAR?
Why? because its a narcotic and the hospital wants this to be dispensed from an ADS cabinet - however, it is currently not loaded at the ADS that services this patient; Location shown on MAR? Pharmacy to load in ADS