May 18, 2020

Installing Cabinets Through Remote Support

Carré Crews CPhT, BS
Technician Manager/Omnicell Administrator, Pharmacy
PIH Health Hospital-Whittier

Rapid Response Cabinets – Q&A

1. For what purpose did you purchase the new Rapid Response Cabinets?

We needed to expand an ICU care area to accommodate the influx of suspected COVID-19 patients needing critical care. We also purchased cabinets for two medication rooms on a previously closed nursing unit so we could place post-op patients away from the usual Medical-Surgical unit and in the building where the COVID cohort care areas were located.

2. In what treatment areas are you using your new cabinets?

ICU and medical-surgical care units. The ICU area had only six active rooms which was increased to another 18 ICU beds in less than one week. The second area was a vacated floor used previously for pediatric care that was converted into an adult care medical telemetry unit.

3. Did you reallocate/reconfigure existing cabinets for use in COVID-19 treatment areas?

We repurposed a table top G4 Omnicell inside the tent used to triage and assess possible COVID patients outside the ED in our covered ambulance bay. The table top was stocked with a specific formulary designed by the lead ED physician and clinical pharmacist for the immediate needs for COVID-like symptoms. Our hospital also created a cohort section inside the ED for the treatment of “rule out” COVID patients. The existing Omnicell in this space was reconfigured with the necessary medications for these specific patient types.

4. What types of users (job functions) are accessing your new cabinets?

Policy allows only users who are licensed to handle medications. We do not use cabinets for supplies.  Users include nurses, respiratory therapists, pharmacy techs, and pharmacists.

5. The Rapid Response Cabinets have standard configurations intended for quick setup and near-immediate use with limited training. Was this your experience? 

Our internal support team is very experienced with Omnicell cabinets. However, we previously only had one of the newest XT Omnicell cabinets in our hospital. All our cabinets are the older G4 models. We had never set-up and configured XT cabinets without onsite Omnicell support.

The remote support technician, Nathan, was very knowledgeable and available for our questions (even on a Saturday). We were impressed with the documentation Omnicell has prepared to assist customers with the Rapid Response Cabinet set-up. The instructions were very detailed. Nathan walked us through the documents when needed and kept us informed with project updates. Our team installed hardware onto the cabinets, configured bins and shelves, and stocked medications into four two-cell cabinets in less than a week.

6. What types of medications are you storing in the new cabinets? 

Our usual ICU/med-surg/telemetry formulary meds, plus the specific medications our infectious disease physician and ID pharmacist deemed appropriate as a treatment option for COVID positive patients. 

7. Are you managing shortage drugs stored in cabinets any differently (e.g., reclassifying shortage drugs as controlled)?

We have reclassified the highly publicized COVID treatment medications as controlled items for high accountability by all end users. These included azithromycin, hydroxychloroquine and lopinavir/ritonavir tablets.

Our automation specialist technician created specialty reports in the OmniCenter to assist with managing about 10 medications to watch per shift for dispensing practices. This encompasses the narcotic and sedation IV drips made in our sterile preparation area, and the IV medications in high demand for our critical ventilator patients (e.g., propofol, dexmedetomidine, norepinephrine). One report sends an email report to all staffing sterile prep pharmacists twice daily with the PAR levels and quantity on hand amounts of these essential IV drips. The report helps them assess the correct quantity to prepare for the next 12-hour batch, in addition to saving personnel entry to the isolation floor.

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The views and opinions expressed in this blog are those of the authors and do not necessarily reflect the official policy or position of any other agency, organization, employer or company. Assumptions made in the analysis are not reflective of the position of any entity other than the author(s). These views are always subject to change, revision, and rethinking at any time and may not be held in perpetuity.