The 10 Pyxis Commandments
by Eric Huczko, MD PhD
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1) Check out drugs for only one patient at a time.

2) If a patient has not been entered in Pyxis, then add the patient to Pyxis. Be certain that the last and first names are entered in the correct fields and spelled correctly. Be certain that the SS# is entered correctly. Do not create patient names like: Ima Spaceholder or Ineda Drug to check out drugs for "later." (Yes people do this)

3) Remove more than you need for the case. You will have to return to Pyxis after the case anyway and you can then return unopened vials.

4) Return/waste drugs before checking out drugs for another patient, return/waste drugs after each case, and return/waste drugs when you transfer a case to other anesthesia personnel. Likewise before taking over a case, you have to check out your own drugs. You do not need to do this for short breaks during the case.

5) Return/wastage of drugs is a three-step process. You must account for every vial that you have checked out:

A) First, return unopened vials
B) Next, If you gave all the drugs, you may waste without a witness by using the ALLGIVEN user name and password fields.
C) Last, waste unused drug in syringes by having a witness see you empty the syringe into the container near the Pyxis. The witness will have to enter their user name and password, and then check the anesthesia record and syringe for agreement. The witness then enters this amount of waste into the Pyxis.

6) When you return/waste drugs be certain to choose only the drugs from the list that you have checked out. All of the drugs checked out for a patient will be listed even if multiple people have checked them out.

7) The copy of the anesthesia record must indicate the same usage as that entered in Pyxis. Note on the record when you transfer a case to another provider the amount of drug that you have used. Note the amount used in an infusion and the amount used to make an epidural solution. The drug totals for the case must be entered in the last column of the record.

8) The copy of the anesthesia record must be placed in the blue box immediately after the case. The records must be there at 8 AM when they are picked up.

9) The records are picked up and audited daily. Take a few minutes to make certain that your drugs are completely and accurately accounted for. The pharmacist will contact you for any discrepancy and expect you to write a letter explaining the discrepancy and sign it. It will take much longer, days later, to figure out what happened. Obviously it is easier and faster for you to take a few minutes and put the account in order right after the case.

10) If you have any difficulty in checking out, return/wastage, or accounting of drugs then fill out one of the forms on top of the Pyxis. Explain in enough detail so that the pharmacist can do the accounting. Place it in the blue box.

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