UNIVERSITY OF KENTUCKY HOSPITAL CHANDLER MEDICAL CENTER

POLICY NUMBER: PH-18-05 FIRST ISSUED: 10/02 CURRENT AS OF: 9/08

Department of Pharmacy Policy

SUBJECT: SEE ALSO:
Computer Down Time Procedures (Unplanned)
PH-18-04: Computer Down Time procedures (planned)

http://www.hosp.uky.edu/pharmacy/departpolicy/PH18-05.pdf
PH-05-00: Pyxis Rx 3500 System http://www.hosp.uky.edu/policy/pharmacy/PH05-00.pdf

Sunrise Clinical Manager Clinician Downtime Instructions http://careweb/ICISdocs/Downtime_Resources/icis_downtime_resources.htm

PURPOSE:

The following guidelines and procedures have been developed in the event of unplanned computer related down time.

Computer Downtime Plan

1) In the event of computer downtime, each Pharmacy area should maintain a supply of select pre-printed blank labels for IV, Med, Syringe (oral and IV), Oral Specials (and custom labels if any areaspecific). 2) Pyxis will be placed on Critical override during computer down time that extends greater than 30 minutes. Existing orders will still appear on the patient's pyxis profile; however, during the down time, no new orders will crossover to pyxis. Critical override allows nurses to obtain drugs for new orders (see PH 05-10 Override for Pyxis Meds). 3) Prior to administration of a medication that has been removed by the override function, a second nurse or appropriate licensed practitioner should verify the order and the medication. Medications removed without a pharmacists review (via override) should be reviewed for appropriateness prior to administration. a. Drug, dose, frequency, and route of administration b. Therapeutic duplication c. Real or potential allergies or sensitivities d. Real or potential interactions between the prescription and other medications, food, and laboratory values e. Other contraindications f. Variation from organizational criteria for use g. Other relevant medication related issues or concerns. Critical override status will be communicated to the nursing staff via: i) fliers posted on the pyxis machines ii) email communication to patient care managers 4) New orders a) Pharmacist should process new orders manually. i) Review new order for appropriateness, dose, duplicate/allergy, etc using the patients SCM profile. ii) Record the dose and quantity of items dispensed on a Dispensing log. Once the pharmacy computer system is restored, this log will be used to reconcile doses to be billed. iii) Pyxis inventory can be reviewed on the pyxis console, if the pyxis server is up. b) Determine if the WORx_train system can be used. If so, create computer generated labels utilizing the generic Name___ patient. Generate two labels to facilitate documentation of the dispening log. c) If the WORx_train system cannot be used, handwrite labels.

i)

ii)

IV - use preprinted IV labels to facilitate appropriate label format. (1) Blank Labels using NAME patient (2) Pediatric Specialty Fluid labels (3) Existing Chemotherapy labels needed (4) CVVHD if any new ones get started they will need 12 labels/patient (5) PCA Drips Meds baggie label with patient name & location

5) When the Computer systems are back up: A backup of WORx is generated every 12 hours (04:00am and 16:00 pm). Once the computer system is restored, the backup tape will be used to populate the systems orders. The orders will be current as of the time of the last backup. a) Once the pharmacy computer system (WORx) is back up, the orders entered since the SCMWORx interface went down will begin to stream through. The start time should be the time of SCM entry. The system will automatically calculate the number of doses that were dispensed during the down time. b) Once the Computer systems are back up and orders are entered in, Pyxis will be taken off the critical override. The vended transactions will flow across and update the WORx billing report.

If the pharmacy computer system does not come back up prior to the time of the next print cycles, the batches must be generated manually. Each of the pharmacy areas should generate their own list using the SCM patient profiles.

Approved:__________________________ Authorized:_________________________________ Kimberley B. Hite, MS, PharmD John A. Armitstead, MS Associate Director of Pharmacy Services, Inpatient Director, Pharmacy Services