Pharmacy Touch User Guide SOFTWARE REVISION 1.0

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1 Pharmacy Touch User Guide SOFTWARE REVISION 1.0

2 Contents About this Guide... 3 Introducing Pharmacy Touch... 3 User Inventory... 3 Login and Setup... 4 Fingerprint Reader... 4 Configuring Pharmacy Touch... 5 Logging into Cart Mode the First Time... 6 Pharmacy mode... 7 Changing the Inventory Count or Adding Stock... 8 NDC Manager Shopping List Returning Items to Inventory Cart Mode For Pharmacy Users Viewing the Summary Hiding the Cart Drawing Single Drawer View Cart Mode for Anesthesia Users Select Patient Changing the Count Dispensing a Drug Codonics SLS Integration Multiple Packages of a Single Drug Returning an Unused Drug to the Cart Return Multiple Packages of a Single Drug Wasting a Drug Reconciliation Icons Anesthesia Touch Integration Plexus Information Systems 2

3 About this Guide This guide is intended to provide an overview of the Pharmacy Touch application. It provides a tour of the user interface and describes all the major functions. Because Pharmacy Touch has been customized by Plexus IS for your facility s use, your system may look and operate slightly differently than described. This book presents examples of the user interface to explain the functionality of the system and show representative software options. The way your system operates the way it looks, accepts data, and interfaces with operating room (OR) monitors, and even the way you enter information into the system -- depends on your setup. For information about customizing Pharmacy Touch, consult your implementation team. Introducing Pharmacy Touch Pharmacy Touch provides the ability to track both controlled and non-controlled drugs for both the facility pharmacy and individual carts in the OR or other rooms where these drugs may be dispensed. It is designed to integrate with Anesthesia Touch software. For detail on this, see Anesthesia Touch Integration on page 30. There are two different modes in which the software may run. Pharmacy mode is intended for use within the pharmacy. It displays a list of all drugs dispensed by the pharmacy and the amount in inventory. Additionally, it displays information for each cart in an OR or other room, and provides warning indicators when a cart is low or out of a specific drug. You have the ability to indicate when drugs are pulled from stock to fill a cart, returned to inventory, or add to inventory. Cart mode allows you to track both usage and refilling of individual cart. It supports use by both anesthesiologists and pharmacy personnel. The user interface changes depending on whether a pharmacy user or anesthesiologist (or other anesthesia providers) is logged in. This manual is divided into five sections: Login and Setup Pharmacy Mode Cart Mode for Pharmacy Users Cart Mode for Anesthesia Users Anesthesia Touch Integration User Inventory For pharmacy personnel, one of the main features of this application is to track removal of drugs from the main pharmacy inventory for the purpose of stocking the individual carts. Users have their own personal inventory. In the system. When a user removes drugs from the main inventory, those drugs are placed into the user Plexus Information Systems 3

4 inventory. Then when the drugs are added to the cart, they are removed from the user inventory. A user can also return drugs back to the main inventory, which will also remove the drug from the user inventory. This system also provides a way to indicate a situation in which the drug is no longer in user inventory but not added to a cart or returned to stock (for example, a vial is dropped and broken.) Login and Setup Double-click the Pharmacy Touch icon on your desktop, or select it from your Start menu. Enter your user name and password and click Sign In. Note: Do not give out your password, as it represents your digital signature. Fingerprint Reader Fingerprint reading authentication is set up for a one-touch operation. Before you can use this form of authentication, you must enroll your fingerprints with your system administrator for the system to recognize you. When using this biometric form of authentication, you must place your finger consistently for the device to identify your fingerprint correctly. The finger you use must be the same as the finger print registered in the software for that device. Note: You may register all your fingerprints for biometric identification. For more information, contact your system administrator. Plexus Information Systems 4

5 Configuring Pharmacy Touch If you are starting Pharmacy Touch for the first time, you will need to configure the application. Click Advanced Options to open the Settings window. This window has two tabs. The Servers tab is selected by default. Note: The settings in this window will be determined by your IT Administrator. Enter the information provided by the IT Administrator if it is not already set. Click the Misc. tab. The Is Dispenser Cart check box determines whether Pharmacy Touch will display in Pharmacy mode or Cart Mode. Select the check box to have the software display in Cart Mode. If you are using a barcode scanner, the Barcode Scanner Type drop-down allows you to select your scanner type. Click OK to return to the Login window. Plexus Information Systems 5

6 Logging into Cart Mode the First Time The first time you log into the Cart Mode, a window opens asking you to confirm the location of the individual cart. This window does not appear after that first time, unless the server information is reset in the Options window Plexus Information Systems 6

7 Pharmacy mode After logging in, if running Pharmacy Touch in Pharmacy mode, the main Inventory window opens. These drop-downs filter the list Click to open Shopping List Click to return items to inventory Click a column header to sort the list by that column. Click an alert to view items needed for a cart. Displays date when currently highlighted drug was counted The right side of the window displays a list of inventory. Similar to any other spreadsheet, you can sort the list by clicking on a column header. Clicking once will sort in ascending order and clicking again will sort in descending order. You can filter the inventory list of by selecting the drop-downs. The values in these drop-downs can be configured for your site. In the example below, the first drop-down is used to select between Vault and Noncontrolled drugs, and the second selects an individual shelf in the vault. Plexus Information Systems 7

8 On the left side of the window is a list of each cart placed in an OR or other room is listed. If that cart is low on inventory, an Alert will be displayed in red. Click on the alert to display the list of drugs that need refilling. Changing the Inventory Count or Adding Stock If you click the Count icon, two additional columns appear: Actual Count and Count Comment. If the count showing in the Current Qty column is not accurate, you can correct the amount by entering it into the Actual Count. You can enter a Count Comment to describe the discrepancy if needed. You can enter new values for multiple items in the list. Once you have finished entering the new values, click the Count button at the bottom of the window. The new values will appear in the Current Qty column. Plexus Information Systems 8

9 If you click the Add Stock icon, a total of four columns are added: Actual Count, Qty Added, Final Qty, and Count Comment. If you enter a number into the Qty Added column, the Final Qty column updates automatically, adding the amount you enter to the current amount. Note: It is possible to enter an Actual Count and Qty Added at the same time. The Final Qty will reflect the Actual Count plus Qty Added. Use the Count function to just change the count. Once you have finished entering the inventory being added, click the Add Inventory button at the bottom of the window to update the Current Qty column. Plexus Information Systems 9

10 NDC Manager Click the NDC Manager button in the lower left hand corner of the main window to open the NDC Manager window. The NDC Manager allows you to adjust which formulary drug is associated with an NDC. When the window opens, the left side display a list of all NDC codes in the system that are missing information to identify a formulary drug. Scroll through list and select the desired code. Or, you can type in an NDC manually and click Find NDC, or scan an NDC. This will add that NDC to the list, provided it exists within the Pharmacy Touch database. Once you select an NCD in the left column, the list on the right will populate with all of the different Formulary Drugs that have the same drug as the selected NDC. Select an item from the list on the right this list to populate all of the fields above. For an NDC to be complete, it must have a Drug Name and Total Amount. If the drug has a strength or concentration it must also have that value entered. The Drug Form is optional. If information is missing, the software will indicate what needs to be entered. At this point, if you need to edit the value for that Formulary drug, change the field as needed and then click Update NDC. If you click Clear Selected Formulary Drug, the values will revert to the original values stored in the NDC. Note: The Pharmacy Touch database contains hundreds of thousands of NDCs that are unlikely to be used. To prevent a Anesthesia User from having to enter that information, the system is designed so that when you receive a new NDC, you can scan it and fill in the information. Or, if a new NDC is selected by an anesthesiologist, and it can be matched to multiple drugs, the anesthesiologist will be asked which to select one. This will mark the NDC as scanned in our database and the next time a Anesthesia User opens the NDC manager, the incomplete NDC will be listed. At that point the incomplete information can be entered so the anesthesiologist won't have to make the selection again. Plexus Information Systems 10

11 Shopping List Click the Shopping Bag in the upper right hand corner to open the Shopping List window. From this window, you can view a list of drugs needed for each cart and can then fill those items. On the left side of the window is the same list of carts seen on the main window. As on the main window, each cart which is low on stock will show an alert and you can click the alert to display the list on the left side. However, in this window, there is also a check box next to the cart. If you click this check box, the needed items are displayed in the top half of the right side of the window. The needed items will be organized by drawer name. For example, the screenshot below shows drawers named Fast Moving and Narcotics. For each item within a drawer, location within the drawer and the current quantity in the cart are displayed, along with the amount that is expected to be stocked in the cart. You can view or hide the items in each drawer by clicking Collapse or Expand for that drawer. Click Fill Shopping List to enter the needed amounts for each drug into the shopping list in the bottom right of the window. You can adjust the amounts if needed, by changing the value in the Quantity to Remove column. Note: The application checks your user inventory before automatically removing an item from the main inventory. If you already have an item in your personal inventory, it will not remove it from the main inventory. You can print out a copy of the selected items by clicking Print. Note: You can only print before taking the items because it is expected that if you are printing you will go and collect the items after printing then come back and enter in how many you actually took. Once you have selected all needed drugs, click Take Shopping List to remove those quantities from inventory. Plexus Information Systems 11

12 Returning Items to Inventory Click the shopping cart icon in the upper right hand corner of the window to open the Return Inventory window. Enter the amount of each item that you are physically returning to the pharmacy in the Returning Qty column. The values in this column default to the quantity you have of that item in your "user inventory" The Remaining Qty column is the number of item you are keeping in your user inventory. The Remaining Qty is not automatically calculated if you enter an amount in the Returning Qty column that is less than the total available to be returned. This is because the values may not always add up. For example, if you have 10 of item X and you drop and break one item, you will change Returning Qty to 9 but Remaining Qty will still be 0. Note: If a formulary drug is stored in more than one location, the drop-down in the Return To column will allow you to select the location. Click the Return Items button at the bottom of the window. You return to the main window and the amounts you returned are added to the Current Quantity column. Plexus Information Systems 12

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14 Cart Mode for Pharmacy Users If the Is Dispenser Cart checkbox is selected on the Misc. tab of the Settings window, and your user ID identifies you with a role of Pharmacy personnel, then the software opens up in Cart Mode for Anesthesia Users. Note: The windows in this mode are designed for both a regular display and a touch display. So in the following section, for any place where it says to click on a button or area, you can also tap that button or area if you have a touch screen. Each drug in the cart is shown, along with its location (drawer and bin within the drawer), current quantity, and minimum to full quantity allowed for that drug. The Available Qty column displays the amount of each drug that is currently in your user inventory. On the left hand side of the window is a drawing of a cart. The button above the drawing has several possible states: Cart Status Narc Drawer Status Button Button Function Not Connected N/A Disabled (as shown above) N/A Locked N/A Unlock Cart Will unlock cart Unlocked Locked Unlock Narc Drawer Will unlock narcotics drawer and may ask for users login password depending on timeout settings Unlocked Unlocked/Open Disabled N/A Plexus Information Systems 14

15 When you click on a row in the table to highlight a drug, the cart drawing on the left changes to show the drawer and bin layout for the drawer. The bin containing that drug is highlighted in yellow. These tabs change the view Click to update the database using the amounts you entered for Actual Count and Refill Qty. Drawer and bin of currently selected item are highlighted. Click to show a summary of all your changes. Red indicates item is at or below minimum quantity Note: You can also click on the drawings of the drawer and individual bin to limit the list of drugs. Clicking on the drawer displays on the drugs within that drawer. Clicking on an individual bin shows the individual drug assigned to that bin. Click Clear Drawer Selection to display the complete list of drugs in the cart. Any drugs that are at or below the minimum expected quantity will have the quantity column marked in red. Enter the amount you are adding in the Refill Qty column. The Final Qty column is automatically updated to show the new quantity If the quantity of a drug in the bin is not correct, you can update it by enter a value in the Actual Count column. The Final Qty column is immediately updated to display the revised amount. Plexus Information Systems 15

16 If you then enter an amount in the Refill Qty column, the Final Qty column will add the refill amount to the final quantity. When you click Count/Refill, the Quantity for each item that you selected to refill is immediately updated, and Available Qty is reduced to reflect the amounts remaining in your user inventory. Viewing the Summary If you click Show Summary before clicking Count/Refill, the bottom of the window expands to show you a list of all the items you currently have in your user inventory, along with the refill quantities you have selected for the various items in this cart. If you click Show Summary after clicking Count/Refill, the remaining items in your user inventory are still shown, but the refill quantity for each item is now 0 since they were previously refilled. Hiding the Cart Drawing You can choose to just show a list of drugs in the cart without displaying the graphics on the left side of the window. Just click Hide Cart Diagram, and the window changes, as shown below: Plexus Information Systems 16

17 In this view, two drop-downs are added to the top of the window, which allow you to filter the list by drawer, and bin, the same as when you click the drawer or bin in the drawing. Click Show Cart Diagram to return to the original view. Single Drawer View Click Single Drawer View to view the contents of a single drawer, laid out by bin. As in the regular view, a drug at or below the minimum quantity will have its quantity displayed in red. Click on a bin to change the amounts for that bin: Plexus Information Systems 17

18 In this view, you have the exact same fields as in the regular view, and the functionality is identical for changing the actual comment and entering a refill quantity. Note that each bin will turn green if you enter the Actual Count. Plexus Information Systems 18

19 Cart Mode for Anesthesia Users If the Is Dispenser Cart checkbox is selected on the Misc. tab of the Settings window, and your user ID identifies you with a role of Anesthesia User, then the software opens up in Cart Mode for Anesthesia Users. Once logged in, Pharmacy Touch automatically unlocks the cart, and will connect to the Codonic SLS, if available. Select Patient The Select Patient window allows you to choose a patient for whom you will record amounts of each dispensed drug. If the Anesthesia Touch application is not running, then this window will open after an Anesthesia User logs in. Note: For Anesthesia users, Pharmacy Touch is primarily used in conjunction with the Anesthesia Touch application. The two applications run on separate computers and talk to each other over the network. When you log into Anesthesia Touch and select a patient it, will automatically log you into Pharmacy Touch and select the patient (provided the Pharmacy Touch application is already open). Therefore, the Select Patient window is not used frequently. It is mainly used to set up a case in advance. Some CRNAs and anesthesiologist will set up a handful of syringes that they know they will be using prior to the case. In this situation they will log into pharmacy touch directly to dispense the drugs to the next patient. By default, the By Date tab is enabled and the application displays a list of patients with procedures scheduled for the current day. You can search for previous or future dates, if needed. You can filter the results by medical record number, patent last name, or assigned surgeon. The Search tab allow you to search for a patient by MRN, last name or date of birth. This is useful if a case is rescheduled and the system has not been updated yet. When you select a patient, another dialog opens. Select a visit for the patient. You can also select the date range for the visit. Note: The windows in this mode are designed for both a regular display and a touch display. So in the following section, for any place where it says to click on a button or area, you can also tap that button or area if you have a touch screen. Plexus Information Systems 19

20 Highlight the desired patient and click Select to open the Main Cart Mode window. Note: If Anesthesia Touch is already running the Main Cart mode window opens after the user is logged in. Plexus Information Systems 20

21 This window displays the currently selected patient, a drawing of the cart, and a list of all drugs stored in the cart. The button above the drawing of the cart has several possible states. See the table on page 14 for details. You can filter the list of drugs by clicking on the appropriate drawer in the cart drawing, to display only drugs stored in that drawer. You can also quickly jump to a spot in the list by clicking one of the letters displayed at the right edge of the window. The list will jump to the first drug in the list starting with that letter. The application displays drawer and bin where the drug is stored, along with the quantity currently in the drawer. Once you click on a drug to highlight it, the Count and Dispense buttons are displayed. Plexus Information Systems 21

22 Changing the Count If for some reason, the amount in the drawer does not match the amount shown in the display, you can edit the amount by clicking Count. The bottom center section changes to display the count parameters. Enter the correct amount and click Count. Plexus Information Systems 22

23 The Count parameters close and the quantity for that drug in the list is updated Dispensing a Drug To dispense a single item of the currently selected drug, click the Dispense 1 button. The left side of the window changes to show the dispensed drug, and the quantity listed on the right hand side is reduced by one. To dispense an amount larger than a single item, click Dispense Qty. A dialog similar to the Count dialog displays in the bottom of the center section. Plexus Information Systems 23

24 Once you click Dispense, The drug is added to the left side of the window. Codonics SLS Integration If you are using Codonics SLS, each time a label is printed, one of that drug is automatically dispensed (unless the count of the inventory is 0). When you scan a printed label, the Add Drug dialog will open in Anesthesia Touch (if it is running), filled in with the syringe information. At that point, you must enter the dosage in Anesthesia Touch Multiple Packages of a Single Drug In some cases, there may be more than one package available for a specific drug. If two different packages are dispensed, each one will be shown separately: Plexus Information Systems 24

25 Returning an Unused Drug to the Cart If a drug is taken from the cart and not used, or if the wrong drug was selected when dispensing, you can return it to the cart. Highlight the specific drug from the dispense list on the left side of the window. The buttons in the lower center change to say Waste, Return 1, and Return Qty. Click Return 1 to return a single item to the cart. The quantity automatically decreases on the dispensed side of the window and increases on the available list side of the window. If you click Return Qty, a dialog similar to the Count dialog displays in the bottom of the center section and you can enter multiple items to return. Return Multiple Packages of a Single Drug. If more than one type of package has been dispensed for a single drug, each package type will have its own Return 1 and Return Qty button, as shown below. Plexus Information Systems 25

26 Wasting a Drug If a drug has been wasted, highlight that drug in the Dispensed list and click Waste. A dialog similar to the Count dialog displays in the bottom of the center section. There are two options: you can immediately indicate a drug has been wasted, or you can add it to a list, and then authorize all wasted drugs at the same time. Plexus Information Systems 26

27 Click Waste to immediately indicate the amount of that drug that has been wasted. A window pops up, requiring a witness to enter a user name and password. Once the witness enters that information, click Waste. The pop-up window closes and the wasted amount is now indicated in the left side of the window. If you are wasting several items, you can click Add to List after selecting the drug and entering the amount to be wasted. This prevents the pop-up window from opening. The advantage is that the witness only has to enter a user name and password a single time. Once you click Add to List, a button appears in the lower left corner labeled Pending Wastes. Plexus Information Systems 27

28 At this point, if you have other items to waste, you can select them, and repeat the process to add more to the pending list. If you click Pending Wastes, the list is displayed. If you make a mistake in the amount you are wasting, you can adjust the waste amount or comment by selecting the drug (not in the pending waste list) and clicking Waste again. This will retrieve the pending waste info so you can modify it. Once you have included all the items you want to waste, click Submit Waste. This opens the same pop-up witness window used when wasting a single drug, but now it lists all of the drugs in the pending list. Note: If you are not wasting any narcotics the witness username and password are not required Plexus Information Systems 28

29 Reconciliation Icons Pharmacy Touch performs reconciliation on the amounts of each drug in the cart, as follows: It tracks the amount dispensed, based on the labels printed by the Codonics SLS, or entered manually It tracks the amount given, by interfacing with Anesthesia Touch For drugs given by infusion, it updates the amount given every three minutes. It tracks the amounts entered as Waste If the amount given plus the amount wasted equals the amount dispensed, the amounts are reconciled. If the amount given plus the amount wasted does not equal the amount dispensed, a warning is displayed, as shown below: Controlled substances will always have a reconciliation icon (a warning or a check mark) Non-controlled substances initially will not have an icon. o If there is nothing wasted, no icon will be visible o If there is waste but the drug does not reconcile, the warning icon will be displayed o If there is waste but the drug does reconcile the check mark will be displayed Plexus Information Systems 29

30 Anesthesia Touch Integration Pharmacy Touch is designed to integrate with Anesthesia Touch over the network. As long as Pharmacy Touch and Anesthesia Touch indicate they are in the same location (room) certain actions in Anesthesia touch will affect Pharmacy Touch Patient selection in Anesthesia Touch: When a user signs in to Anesthesia Touch and selects a patient, Pharmacy Touch will sign in the Anesthesia Touch user and select same patient automatically. If a different user is logged into Pharmacy Touch, the Pharmacy Touch application will ask if you want to change users If a different patient is currently selected in Pharmacy Touch, the Pharmacy Touch application will ask if you want to change patients Logging out of Anesthesia Touch: If you are logged into Pharmacy Touch you will be asked if you want to log out regardless of whether the user is the same as the Anesthesia Touch user. Switching Patients: If the wrong patient is selected in Anesthesia Touch, there is a function to migrate all recorded data for that case to the correct patient. This will trigger Pharmacy Touch to move the current data to the correct patient and then change to the correct patient to continue. Giving a drug in Anesthesia Touch: The dispensed medication list in Pharmacy Touch will update it's given amounts. For more on this, see the previous section on Reconciliation. You can also click the Refresh button above the dispensed medication list, to manually update the given amounts. Drug Administration: If a syringe label printed by the Codonics SLS is scanned, the information is passed into Anesthesia Touch, which automatically opens the Add Drug dialog with all available information filled in. Plexus Information Systems 30