LOS ANGELES COUNTY
DEPARTMENT OF MENTAL HEALTH
  Policy 352.22 Pyxis System Access and Responsibility
 
  PROCEDURES
  1. Access
    1. Every employee who uses the Pyxis SystemTM will be required to make two entries before access is authorized.
      1. The two entries are:
        1. Employee ID number, and
        2. Bio-ID (numeric fingerprint)
      2. In addition, each user will have a password to allow access in the event the Bio-ID cannot be activated. If employee forgets their password, they will follow Department of Mental Health (DMH) procedures to reset password.
    2. Access to medications will be limited to authorized trained personnel.
      1. DMH Pharmacy will be responsible for assigning roles to authorized trained personnel.   
  2.  Activation
    1. When a user needs to be activated, a system profile will be generated, consisting of:
      1. An ID (employee number),
      2. An initial password, and
      3. Assigned areas and privileges
        1. Based on the individual’s specific job assignment
    2. Employee will receive training specific to their defined responsibilities.
    3. Temporary Access
      1. Shall be given by authorized users who have permission to grant visitor access to employees.
        1. Only under circumstances when no other trained authorized personnel is on duty to access medications in Pyxis to perform essential operational tasks.
      2. Shall be granted to individuals with the following roles:
        1. Nursing
        2. Psychiatric Technician
        3. Pharmacy
        4. Pharmacy Technicians, and
        5. Physician 
  3. Returning Medications in Pyxis SystemTM
    1. Clinic stock (non-controlled and controlled substances) that are indicated to be returned to internal bin shall be returned to the internal Return Bin only if they are:
      1. unopened,
      2. untampered,
      3. not expired and
      4. fit in the internal bin. 
    2. Samples and patients’ own medications that are unopened, untampered, not expired, shall be returned to stock.
    3. Non-controlled drugs that are opened and not used must be wasted.
    4. Controlled drugs that are opened and not used shall be treated as a lost narcotic and therefore 100% wasted with an authorized witness.
  4. Performing Outdates in Pyxis SystemTM
    1. Authorized personnel shall check expiration dates of medications and applicable medical supplies in Pyxis at least once a month. 
    2. Expired medications (controlled and non-controlled substances) shall be wasted in accordance with DMH Expired Medication and Device Disposal Policy 352.08 and DMH Medication Storage Policy 352.14.
  5. Wasting Medications in Pyxis SystemTM
    1. Authorized personnel shall waste any partially used, contaminated, and/or deteriotated medications in Pyxis in accordance with DMH Expired Medication and Device Disposal Policy 352.08 and DMH Medication Storage Policy 352.14. 
  6. Responsibility
    1. Authorized Personnel shall:
      1. Conduct a controlled substance blind inventory count at end of each shift with authorized user.
      2. Verify that there are no unresolved discrepancies prior to end of business day or change of shift.
        1. If an unresolved discrepancy exists, the Authorized Personnel in charge shall ensure the discrepancy is resolved prior to the staff leaving for the day.
        2. Refer to DMH Controlled Substances Policy 351.01 for discrepancy that  involves controlled substance.
    2. Pharmacy Services shall:
      1. Ensure all authorized users are trained and have access to available resource information regarding use and troubleshooting of system.
  7. Security
    1. Always log off the system after completing a transaction or when walking away from Pyxis machine. 
    2. Pyxis SystemTM shall be kept in a secured medication room. 
  8. Notify Pharmacy
    1. Program Managers or Supervising Psychiatrists shall notify DMH Pharmacy of the following program changes immediately:
      1. Tampering of Pyxis machine
      2. Pyxis machine malfunction or broken parts
      3. Termination or transfer of an authorized user 
  9. Emergency Situations
    1. Power failure/MedStation failure:
      1. Pyxis SystemTM shall be plugged into universal power supply to ensure on-going care access in the event of a power failure.
      2. In the event of a catastrophic power failure or Pyxis SystemTM failure, an internal battery backup at the Pyxis SystemTM provides about 60 seconds of power to automatically initiate a safe shutdown of the station. If the power failure continues
        1. Notify DMH Pharmacy within 5 minutes
      3. In the event IBHIS is inaccessible and most current order cannot be reviewed due to power failure, medication shall not be removed unless a new order is written by prescriber. Such order shall be scanned into IBHIS within 24 hours when IBHIS becomes available. 
  10.  Jammed Drawers
    1. Nurses, psychiatric technicians, and physicians can recover a jammed drawer that fails to open.
    2. The recover drawer alert icon will appear on the Main Menu.
    3. Follow instructions on the screen.
    4. If recovery is not successful, authorized personnel will contact Pyxis Customer Support, 24 hours/day.