A new medication management system known as Pyxis has been launched in the Princess Alexandra Hospital theatre complex, improving medication safety for thousands of patients receiving surgery each year.
In a move that has proved to be the most significant change in anaesthetic management at the hospital in two decades, the installation of Pyxis offers improvements in efficiency and record keeping - but most importantly, safety for staff and patients.
A Pyxis is a controlled drug cabinet that is immediately available to the staff within each theatre ensuring added safeguards and tracking of medications alongside the immediate availability of medication for each patient.
Pharmacist Team Leader Perioperative, Victoria (Tori) Burfield has praised the multiple benefits of the closed loop system from the pharmacy perspective, particularly the risks related to Schedule 8 drugs.
“A lot of the medications in theatre are Schedule 8 which need significant safeguards in place to protect staff – this was the reason for the original set-up all those years ago having a single point of access to sign out those medications,” Tori said.
“Every morning staff would line up for 20 minutes to sign their drugs out to their patients. You would then take those drugs to the relevant theatres which could be 200 metres away and you wouldn’t have ready access to any more of those medications if the need arose.
“By having them at the point of care in theatre improves the safe journey of each patient, the journey of the medications to that patient, and the accountability for the drugs along that journey,” she said.
Anaesthetics Fellow, Dr Alex Smithers said safety is the priority with several risk factors removed by accessing the required medications at the point of care.
“There is a decreased risk of medication error using the Pyxis because of added cognitive safety steps when signing out the medications from the system, and there is no need to leave the patient who needs those meds in order to collect from the central medication store,” Alex said.
The opportunity to engage throughout the department during planning resulted in changes to the layout of the cabinet to reduce look-alike drug errors, adding a safety layer to the electronic drug log which removes the need for a handwritten drug keeping book for reduced interpretation errors.
Nurse Unit Manager of Anaesthetic Care Unit, Chris Grantham was instrumental in introducing Pyxis to PAH Theatres – championing the system as a safe solution to get the supply of medications to the point of administration.
He said that while changes as significant as this are not regular, identifying issues and forging a path to change the management model involves the considered investment of the whole team.
“It has been a collaborative effort from anaesthetics, nursing and pharmacy over a long period and there are many who were part of that vision in the beginning who are not here for go-live, but their commitment and critical appraisal along the way has been essential to the success of the rollout.”
The partnership effort also involved PAH Corporate Services, Information Technology, Security - who assist with geofencing the machines - and all the people in the background who have contributed to the smooth implementation of the Pyxis system throughout 21 theatres in one day.