RxTOOLKIT® now offers barcode medication verification scanning specifically designed for use OUTSIDE of the pharmacy using RxWORKFLOW™.
There are many situations where medications are compounded and mixed by personnel other than the pharmacist, such as: an administering nurse, a physician’s office, or in a retail setting.
Certain situations demand timely bedside mixing: administration of immunization shots (with short stability), vaccines mixed in diluent, contrast media (such as suspensions and radio graphics for patients to drink prior to cat scan.), and IM (intramuscular administration) for when a patient doesn’t have venous access.
Certain drugs demand timely bedside mixing: DHE (used for migraines) is only stable for 15 minutes after mixing, Phenytoin (an anticonvulsant used to treat seizures) is only stable for 20 minutes, and other drugs that are commonly dispensed from the pharmacy in powder form. All of these drugs must be mixed at the bedside, there’s simply not enough time for the pharmacy to mix and then deliver them.
Some antibiotics also must be mixed prior to administration. For example, if an infant is admitted to the NICU with a severe ear infection at 3 am, they need to be stared on antibiotics right away! The pharmacy may not be available at that time, but you still need to dispense and compound an oral suspension of antibiotic stat.
In ALL of these situations, there is currently no mechanism in place to make sure that drugs are mixed safely or correctly.
RxWORKFLOW™ by RxTOOLKIT® doesn’t require any special equipment and can be used with ANY barcode scanner (such as the scanner already on a nursing cart). Because RxTOOLKIT® is a web‐based application, all that you need to get started is an internet connection and a subscription to our site. Then you are ready to use RxWORKFLOW™ at the bedside!
Let’s look at an example:
RxWORKFLOW™ for AMOXicillin / Clavulanate Potassium — Oral Suspension for the NICU.
The process starts with a time out geared specifically towards the administering nurse. We walk them thorough the entire process of reconstituting the antibiotic.
We provide specific recommendations about the process. For example, “the only acceptable diluent is sterile water for irrigation”. This helps to avoid errors common to most healthcare settings, such as mixing with the wrong diluent (rubbing alcohol or saline).
We provide warnings, such as allergy information, dosing recommendations, and a link to the package insert on Gold Standard (comprehensive drug information).
Step 2 (Barcode Verification) goes step‐by‐step through the barcode scanning process:
- Collect all the necessary ingredients and follow the instructions
- Scan the Amoxicillin/Calvulanate Potassium, includes verification of required size and picture of the drug package
- Scan the diluent (Sterile Water for IRRigation) includes verification of required size, picture of the drug package, and graduated cylinder image with correct fill
- If all of the items scan correctly, you unlock STEP 3 then follow the instructions to print the Dispense Label and apply it to the compounded (mixed) drug.
Safety is built right into the label printing process (Step 3):
- Scan to enter Patient MRN (avoiding keystroke errors)
- Enter dose and frequency (the drop down variables for dose size/frequency are programed to offer correct dose volume(s)/frequencies)
- Enter Drug Lot Numbers for the drug and diluent
- Enter expiration dates for drug and diluent
ALL of the information entered during label printing is stored in a scannable barcode on the Patient Administration Label. Only the information necessary for administration is displayed keeping the label uncluttered and easy to read.
Step 4 provides detailed instructions for the reconstitution procedure.
Finally, the administration/reconstitution information is easily documented in the patient’s EMR (electronic medical record), such as Epic, with a simple scan of the label barcode. (Step 5)
Barcode medication verification scanning can enhance patient safety anytime a medication is prepared. RxWORKFLOW™ not only incorporates all of the innovative tools you need to get the job done, but also provides step‐by‐step guidance, competency assessments (an optional feature), and time‐outs to make sure your staff gets it right.
Contact us to learn more about RxTOOLKIT or follow this link to read about the inspiration behind RxWORKFLOW™.