Automated Dispensing Cabinet Use

Subject to modification by the VTH Director without approval.

Policy

To provide the process for obtaining medications from the automated dispensing cabinet, This policy covers all automated dispensing cabinets (Cubex) in the VTH and VMSC. No medications from an automated dispensing cabinet may be sent home with a patient. The cabinets are only to be used for inpatient medications. Clinicians and technicians acting on the orders of a clinician may retrieve medications from the cabinet.

Guidelines

• All clinicians and technicians are eligible for access to the automated dispensing cabinets once they have passed the applicable training. 
• All medications obtained from the automated dispensing cabinet will have charges automatically transmitted to the Hospital Information System (HIS).
• Technicians removing medications must have a verbal or written order from a doctor or be obtaining medications to administer pursuant to the patient’s current treatment sheet.
• Medications should only be removed as single doses immediately prior to administration. If multiple doses are needed for non-controlled medications, those must be obtained from the medication dispensary and properly labeled.

Procedure (if applicable)

1. When an inpatient medication is needed, a clinician may obtain the medication from the automated dispensing cabinet or direct a technician to obtain the medication. All verbal orders must be followed by written documentation in the patient’s medical record.
2. If a medication is needed on a scheduled basis, and the patient is in ICU, the signed ICU treatment sheet should indicate when doses are due and the appropriate dose and directions. The dose must be marked in mg/kg on the treatment sheet and the concentration of the drug must be included with the drug name if it comes in multiple concentrations. This treatment sheet will serve as a signed order for obtaining these medications.
3. If a medication is needed that is not documented on a treatment sheet, the clinician can give a verbal or written order to a technician to obtain the medication. If a verbal order is given, the technician should repeat the order back to the clinician to verify that they understood correctly. All verbal orders should be followed by written documentation in the patient’s medical record.
4. Prior to administering an injection, the quantity should be verified by a second person that is physically present to make sure the quantity is correct.
5. Each day a pharmacist will follow up on any emails received about failed postings from Cubex to ensure that medications are appropriately transmitted to HIS. The pharmacist will check any records in SANDI with these problems to verify that the charges transferred correctly.
6. Each day a pharmacist will check if there are any patients that need “matched” between the automated dispensing cabinet and HIS records. If so, they will match the records and verify that charges transmitted correctly.
7. If there is a known HIS issue, a pharmacist will check all charges for the time frame where HIS was not working correctly.
8. Any unused controlled substances will need to be wasted properly. See the Wasting Controlled Substances SOP for further information.

Definitions (if applicable)

Matched: The process of connecting records when a patient record in the automated dispensing cabinet doesn’t connect with a patient record in the HIS

Pharmacist: A person holding a pharmacist license in the state of IL

Veterinary Teaching Hospital (VTH): The collective clinical services of the Large Animal Clinic, Midwest Equine, the Small Animal Clinic, and the Veterinary Medicine South Clinic.