Hospice Pharmacist: The 4T Is Even Better Than Expected
An astonishing 95% of daily medications needed for all patients at St. Joseph Hospice in Shreveport, LA are safely contained in one tiny cube that’s not much bigger than their microwave. Kathleen Tabor calls Capsa’s NexsysADC 4T the perfect solution for hospice – both its dimensions and its capacity. Tabor would know; she is pharmacist-in-charge at Partners North Pharmacy, which services all medication needs for the St. Joseph residents, and she oversaw the project that chose and implemented the 4T in early 2020.
“It’s even better than I expected,” Tabor says. “We rarely have to send any medications over. Even off-hours, we find that 99% of the time the needed drug is in the Nexsys cabinet.” In just a few short months, Partners North Pharmacy and the staff at St. Joseph Hospice alike saw obvious advantages to using NexsysADC 4T in a hospice setting.
Benefits of This Compact Automated Dispensing Cabinet:
- Absolute controlled medication security
- Practical capacity – small equals efficient
- Cost savings
- Individual doses as needed, versus 3- to 5-day medication packaging that leads to waste
- Live interface between the offsite servicing pharmacy and the onsite nursing staff
- Ease of use for nurses
Controlled Medication Storage Security is #1
Tabor had security top-of-mind when investigating technology. The St. Joseph formulary includes morphine, Ativan, Dilaudid, Roxanol — serious medications that require the highest level of protection. Traditional manual storage processes that hospice has relied upon for too long are problematic. “You risk a free-for-all when nurses have access to anything in just a locked closet. It’s even looser than long-term care,” Tabor says. “They don’t use the OTA requirement. There’s no paper tracking, no logs of how much is taken or remaining. And the pharmacy has to sift through paper.”
With NexsysADC, all security gaps are plugged. Partners North can track how many doses are given to each patient, which is essential for billing. The frequency of doses also requires fast access throughout the day.
NexsysADC Suits Fluid Nature Of Hospice
Hospice patients’ length of stay is fluid. A servicing pharmacy would waste a tremendous amount of medications by providing 3- or 5-day doses. Dispensing one dose at a time from NexsysADC is highly advantageous for the unique setting. There’s even an unforeseen benefit to NexsysADC: Eliminating courier deliveries. Tabor estimates one courier run during daytime hours is $40 – and after-hours is higher. Now, medications are in the NexsysADC cabinet exactly when needed.
Fewer Keystrokes & Data Entry For Nurses
Utilizing an automated dispensing cabinet at a hospice facility is not commonplace … yet. Manually storing medications in a safe or closet still is the norm. But Tabor sees that changing quickly, especially with a device as compact and low-priced as the 4T, and as easy to learn and operate. Nurses at St. Joseph found the device self-explanatory after one day of training. (Note: Capsa Healthcare offers a full cabinet NexysysADC automated dispensing cabinet with capacity for 400+ SKUs; the 4T countertop cabinet is designed for care facilities with a smaller budget, formulary, or medication room.)
The device is interfaced with FrameworkLTC, so Partners North Pharmacy has continual access to all data and oversight into nurses’ dispensing activities. The pharmacists enter medication orders into the patient profile, and the job for nurses at St. Joseph is simple. In Tabor’s eyes, keystrokes can be the enemy. The more data entry needed in any medical care setting, the potential exists for error (along with more nurses’ manual steps and pharmacist intervention and override).
“The nurses’ patient, their dose, their meds are all on screen. They can’t pick the wrong drug or dose. And with so many patients coming and going, this is an environment where a mistake is conceivable to be made.”