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AcuDose Cabinet Hardware Malfunctions and Downtime Policy (14.1)

AcuDose Cabinet Hardware Malfunctions and Downtime Policy (14.1) - Policies, Clinical, UWHC Clinical, Department Specific, Pharmacy, Acudose

14.1





Effective Date:
December 2002



Chapter: Acudose

Chapter:

Policy or Procedure:
14.1


04/14

Page: 1
of 4

Title: AcuDose Cabinet Hardware
Malfunctions and Downtime Policy

I. PURPOSE: To outline the procedures to handle situations when the AcuDose cabinets are
not operational and/or malfunctioning.

II. POLICY: When technical problems develop for an AcuDose cabinet, the user (Nurse,
Pharmacist and/or Technician) will call the Aesynt Help Desk. When an AcuDose cabinet is
not operational the following systems will be implemented. For unplanned cabinet downtime
(non-catastrophic) or planned cabinet downtime, AcuDose Zones will be set on adjacent
cabinets to allow for continued dispensing of medications. Nursing staff from the affected
areas will be granted temporary access to the adjacent location in order to dispense
medications. For an unplanned catastrophic downtime, manual downtime systems will be
deployed.

III. FORMS: To be utilized only in the event of a catastrophic failure in which all or multiple
cabinets are not operational.
A. AcuDose Catastrophic Override Checklist – See Appendix 14.1a
B. Controlled Substance AcuDose Downtime Dispensing Form – See Appendix 14.1b
C. Non-Controlled Substance AcuDose Downtime Dispensing Form – See Appendix
14.1c
D. Procedure to create zones during AcuDose downtime – See Appendix 14.1d
E. AcuDose Zone Groups – See Appendix 14.1e

IV. DEFINITIONS:
A. Non-catastrophic- Event in which one or a limited number of cabinets are not
operational or a situation in which one or more high use drawers within a cabinet is
not functioning.
B. Catastrophic- Event in which all or multiple cabinets are not operational.
C. AcuDose zone– Allows user to access an adjacent AcuDose cabinet for dispensing
medications.
D. Manual Override- Refers to AcuDose medication dispensing when a catastrophic
event occurs. The locking mechanism for the cabinet drawers and pockets will be
released using override keys. Full manual access to medications will be granted.
E. Profile Dispense – Access granted to patient specific orders.
F. Inventory Dispense – Access granted for all medications available in that cabinet.

V. PROCEDURE:
A. If technical problems develop the nurse or pharmacy staff will call the Aesynt Help
Desk at 1-800-700-8737. The Help Desk will resolve most issues.





Effective Date:
December 2002



Chapter: Acudose

Chapter:

Policy or Procedure:
14.1


04/14

Page: 2
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Title: AcuDose Cabinet Hardware
Malfunctions and Downtime Policy

B. If the UWHC Help Desk is called regarding the technical problem, they should
contact the Medication Management team member on call who will triage the
problem to the appropriate individual(s) including the Aesynt Help Desk. The
UWHC Help Desk may choose to notify users of AcuDose downtime(s) via the
“banner” communication feature on user desktops.
C. If the Aesynt Help Desk is unable to resolve the issue, the nurse or pharmacy staff
will also contact the central pharmacy by calling 3-1272 to inform them of the issue.
1. The AcuDose technician or Central Pharmacy staff will contact the Aesynt
Help Desk to determine how long the cabinet(s) will be down.
2. If after 60 minutes, an acceptable timeframe can not be provided as to when
cabinet activity will be restored, the AcuDose technician or Central Pharmacy
staff will request that an AcuDose service representative be paged and sent on-
site to UWHC.
D. Loss of connectivity to the Hospital Network
1. Cabinet will remain operational, but will not be receiving new orders and
patient information. If this occurs the cabinet will display “NOT RECEIVING
ORDERS”. Nursing staff can continue to dispense medications that were
available on the patient profile before the loss of connectivity occurred. If a
new medication order is needed, the nursing staff will inform the unit
pharmacist to request the medication(s) be delivered to the unit.
E. Cabinet malfunction related to a specific pocket(s)
1. AcuDose technician may reassign drug to an available pocket.
2. Unit pharmacy staff may also call the Central Pharmacy to dispense drug as
needed.
F. Cabinet malfunction related to a specific drawer(s)
1. AcuDose technician will print inventory specific to the drawer and give to unit
pharmacist. Unit pharmacy staff will call the Central Pharmacy to dispense
drug as needed.
2. If a drug in drawer is determined to be high use the AcuDose technician may
temporarily reassign the drug to an available pocket in another drawer.
3. For Profile Dispense cabinets - if the entire drawer is determined to be high
use the AcuDose technician may set up a “zone” on an adjacent unit (see
section g below).
4. For Inventory Dispense cabinets – if the entire drawer is determined to be high
use, the Nursing Staff may access another cabinet in close proximity to
dispense medications.





Effective Date:
December 2002



Chapter: Acudose

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Title: AcuDose Cabinet Hardware
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G. Entire cabinet malfunction
1. Non-catastrophic event for Profile Dispense cabinets- the AcuDose technician
will activate the AcuDose downtime zones in order for nurses to profile
dispense both controlled and non-controlled substances until the AcuDose
cabinet(s) is (are) back online. Each AcuDose cabinet will have a downtime
cabinet defined in the event of a downtime.
a. Implement AcuDose Zoning Downtime Procedures (Appendix D).
b. List of specific zone assignments and descriptions (Appendix E).
2. Non-catastrophic event for Inventory Dispense cabinets – if the entire cabinet
is down, the Nursing Staff may access another cabinet in close proximity to
dispense medications.
3. Until the cabinet(s) is (are) placed on an AcuDose downtime zone nursing
personnel will page their decentral pharmacist for any “stat” Non-Narcotic
PRN medication needs. For the hours of 2300-0700 call the Central Pharmacy
at 3-1272.
4. For “stat” controlled substances nursing personnel will call the AcuDose
technician at (9)279-7463, or the Central Pharmacy at 3-1272 between the
hours of 2300-0700.
5. Setting Temporary Nurse Access for “zoned cabinet”.
a. Nursing staff will be granted temporary access to the “zoned cabinet”
by the Clinical Nurse Manger, Care Team Leader or the Nursing
Supervisor on call. See policy 14.04 (AcuDose-Rx® Controlled
Access Cabinets) section 1.6 on granting temporary user access.
6. Following recovery the AcuDose technician will remove the zone on the
cabinet(s) and return the cabinet(s) to its previous setting.
H. Catastrophic downtime
1. AcuDose cabinets will be placed on “manual override” (Appendix A).
a. AcuDose keys, which are maintained in the locked box on the wall
box to the NarcStation, are used to place cabinets on “manual
override”. The keys for this locked box are located in the SPA
narcotic drawer. Each cabinet has 2 keys; both keys are needed to
place a cabinet on “manual override”.
b. All AcuDose keys must be signed out and signed back in using the
AcuDose Key Book located in NarcStation. Either the narcotic
technician (days) or the SPA pharmacist (evenings/nights)
coordinates all keys being signed out of the NacrStation.





Effective Date:
December 2002



Chapter: Acudose

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Title: AcuDose Cabinet Hardware
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c. The AcuDose technician will obtain the necessary documentation
forms (Appendices A, B and C) from NarcStation located in Central
Pharmacy.
d. The checklist in Appendix A will be used to coordinate the
downtime
e. Appendix B and C will be delivered to the appropriate unit(s) to
manually document medications dispensed during the downtime.
2. Recovery Procedures for Manual Override Mode
a. Once the cabinet is operational, the nursing staff is responsible for
performing a dispense transaction without physically removing the
drug. This must occur for all medications dispensed and
administered to patients during the downtime. This ensures that the
inventory in the cabinet is accurate and will prevent the creation of
narcotic discrepancies.
b. All dispenses must be performed prior to returning the medication
log to the AcuDose technician and before the cabinet inventory is
evaluated by the AcuDose technician.
c. The AcuDose technician is responsible for forwarding the
documentation Appendices A, B and C to the NarcStation.
d. All documentation will be audited by the NarcStation technician
following the implementation of the recovery procedures.

VI. REFERENCES AND RELATED POLICES, PROCEDURES
A. Policy 14.4 - AcuDose-Rx® Controlled Access Cabinets
VII. COORDINATION
A. AUTHORED BY:
1. Phil Brummond, Administrative Resident
2. Jessica Mahoney, Pharmacy Manager, Patient Care Services and Operations
3. Brad Ludwig, Assistant Director of Pharmacy
B. REVIEWED BY:
1. Pharmacy Operations
2. Nursing/Pharmacy Committee
C. COMMITTEE APPROVAL BY:
1. Pharmacy Operations Committee

Approved By: ____________________________
Director of Pharmacy Services

Date: ____________