Safety issues/solutions surrounding wrong product strength selected from omnicell?

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Wed, 02/05/2025 - 15:37
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Gregory Mak
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Safety issues/solutions surrounding wrong product strength selected from omnicell?

Good afternoon,

What strategies have organizations implemented to reduce nursing reliance on muscle memory when selecting products from an automated dispensing cabinet? For example, if historically we have 5 mg oxycodone stocked but are now stocking 10 mg oxycodone in addition to accommodate patients on high doses - there is a concern that a nurse may default to muscle memory and pull 2x 10 mg tablets thinking that they are 5 mg tablets. This of course leads to potential overdose as well as discrepancies from diversion monitoring standpoint.

Have organizations implemented anything to circumvent this?

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