Medication Management with AccuShelf
AccuSite/AccuShelf will serve as the primary inventory management for medications and vaccines.
Vaccines:
Should no longer be added into eCW inventory due to the eCW interface. AccuShelf is the “source of truth” for inventory management; updates to physical inventory counts will be made in AccuShelf.
For Medications:
All clinic medications will be added to the AccuShelf.
**Exception** Emergency cart medications will not be added to AccuShelf.
Injectable medications, IUD’s and Nexplanon must also be added to eCW inventory. If/when there is an interface with eCW for medications, this may change.
Updates to physical inventory counts will be made in AccuShelf.
Updates to physical inventory counts of therapeutic injections must also be modified in eCW.
Sample Medication Management page 44 in User Guide
All samples must be added to AccuShelf. Not all sample medications have NDCs or barcodes.
TruMed has a printable list of barcodes: Sample medication barcodes
If you don’t see your sample item(s) on that list, you can still track them with AccuShelf using their custom item barcodes. Scanning one of these barcodes will allow you to create a new sample item to associate with it.
Patient-Owned Medications
All patient-owned medication will be scanned into the AccuShelf system to improve inventory tracking.
When adding to inventory, add a “note” indicating patient’s name, DOB and MRN. (if possible)
Monthly inventory counts and expiration dates:
Count inventory and verify expiration dates.
Update inventory counts if needed on AccuShelf.
Log into AccuSite and navigate to the Inventory tab.
Navigate to “On hand”. Select the appropriate program (e.g. 340b meds, Samples, etc.) and any additional filters needed.
Export report.
The report should include at the minimum:
Generic name and brand name
Lot number
Strength
Expiration or BUD date
Open the downloaded inventory report and add your timestamp.
Upload the report to the clinic’s folder on the Nursing shared drive. Logs
**Some clinics may also print and add to RN binder**
AccuShelf is a medical inventory management system designed to streamline the tracking and organization of medications, vaccines, and supplies. It uses wireless barcode scanning to capture details like expiration dates, lot numbers, and dosages, ensuring accurate inventory control and reducing waste.
The system enhances patient safety by providing real-time alerts for expired or recalled products and confirming medication dosages before administration.
ALL clinic medications, samples, patient-owned medications and vaccines should be added to the kiosks.
AccuShelf Online Resources
eCW Interface: (Vaccines only)
Vaccine order(s) is placed in eCW. Will take several minutes to cross over from eCW to AccuSite.
Log into AccuShelf and follow dispense instructions. Scan vaccines.
Lot number and expiration date will populate back into eCW. Will take several minutes to cross over to eCW from AccuSite.
Complete documentation in eCW. Route/location, payer, VIS, administrator, timestamp
pages 39-44 in User Guide
When transferring medications and/or vaccines to other Neighborhood health centers, a transfer must be recorded in AccuShelf. For medications, staff will no longer need to hand-write a transfer invoice as the transfer in AccuShelf serves as the transfer invoice. You will still need to print out the transfer summary from AccuShelf or AccuSite and file in the appropriate file.
Sending site: Create transfer. Name the transfer with date, time, and the SENDING site or AccuShelf name
Receiving site: Receive transfer.
Medications: transfer invoice NO LONGER needed
Vaccines: Must still complete appropriate VFC/VFA transfer form in addition to transferring in AccuShelf
To view transfers in AccuSite: Select “Enterprise”, then navigate to “Inventory”. Once there, select “Transfers”
Print out transfer summary and file in RN binder under “invoices”.
11._transferring_inventory (540p).mp4
Patient mode should only be used for medications.
Order mode is only used for vaccines.
Only vaccine orders will populate into AccuShelf from eCW.
When not "dispensed", orders will automatically be removed from AccuShelf in 2 days.
When staff bypass Patient or Order modes, the safety checks are bypassed.
PATIENT MODE: pages 14-16 in User Guide
Select a Patient Screen
The first step in a patient mode dispense is to select a patient. The user will be brought to a screen with a table listing all available patients for dispense. Each patient card includes the patient’s last name, first name, MRN, and date of birth. Users can scroll through the list to locate their patient for selection or use the search bar to query on name or MRN. If a patient is new to the practice, a user can add a new patient via the Add Patient button.
Once the user selects a patient or creates a patient, they will be brought to the Scan items to Dispense screen. The patient’s information will appear on a card at the upper left portion of the screen.
Scan to Dispense
When scanning an item for dispense, AccuShelf will check the scan against inventory and one of the following results will occur:
• If the item is in stock and only has 1 program assigned, the item will be added to the dispense list.
• If the item is in stock but has inventory in multiple programs, a popup will appear asking the user to confirm a program.
• If an item has multiple lots and expirations in stock and the user does not scan the soonest to expire item, a notice will appear on the item’s card alerting the user there is stock closer to expiry.
• If the user scans an item that is not in inventory, a prompt will appear onscreen asking if the user would like to load that item into inventory.
If the YES button is selected, the user will be walked through the Load workflow to capture that item in inventory.
Once the user finishes the Load transaction, they will automatically be brought back to where they left off, with the newly loaded item selected for dispense
ORDER MODE: pages 16-18 in User Guide
eCW Interface
There is a bi-directional interface with AccuShelf. Users create the vaccine order for the patient in eCW, selecting the appropriate vaccine and payer (e.g. VFC, private, etc). The vaccine information will be sent back to eCW once the Dispense is complete.
Select Order Screen
The Select Order screen lists the open orders available on the AccuShelf. Users can select the order from the list or search a longer list by entering the patient’s first name, last name, or medical record number (MRN). Alternatively, they can select the calendar icon to search via date of birth.
Orders are sent directly to the AccuShelf from the EHR, but if a recently placed order is not appearing in the Orders list, users can press the Refresh button to display the newest orders.
Open Orders
Open orders will display as selectable rows. Included on the row are the following details:
• First Name
• Last Name
• MRN
• Date of birth
• Program
• List of the ordered vaccines
• Status: the vaccine’s inventory status
Checkmark: the vaccine is in stock
X: the vaccine is out of stock
?: unknown if the vaccine is in stock or out of stock
Cancel button allows users to cancel an open order
All vaccines ordered for a patient will be grouped together, and all will be dispensed at the same time once the order is selected.
Out of Stock Orders
The open order will appear grey and cannot be selected if all vaccines on the order are out of stock. The order will be filled-in and selectable once the vaccine(s) on the order are loaded and back in stock on AccuShelf. The user can also press the Cancel button to cancel the order.
Overrides/Patient Safety Cautions
Overrides/Patient Safety Cautions pages 24-27 User Guide
All cautions need to be reviewed before the product can be dispensed.
Patient Safety Cautions may only be overridden by Nurses, Immunization Coordinators, or Leadership.
In the Override field, document reason for override, initials, and title.
Types of Patient Safety Cautions
Age
Maximum Age Exceeded: A product has a licensed maximum age that is less than the age of the patient.
Minimum Age Not Met: A product has a licensed minimum age that is more than the age of the patient.
Gender: Gender Cautions appear when a patient's gender is different from the product’s licensed guidelines.
Too Close: Too Close Cautions are shown when less than the minimum interval time has elapsed between doses for a product.
Too Many: Too Many Cautions are shown when a patient has already received all doses in a series.
Duplicate: Duplicate Cautions display when select products are the same or crossover within the same disease group, such as a patient dispense that contains one dose of Kinrix® (DTaP + IPV) and one dose of Daptacel® (DTaP). These conditions will result in a Duplicate Caution since both doses include DTaP.
Schedule
Multiple: If a dispense is associated with multiple types of cautions, a Multiple badge is shown on the product. All cautions need to be reviewed before the product can be dispensed.
Address Cautions
Users can address the open patient safety cautions by pressing the Review Cautions button at the bottom of the screen. A popup will appear with details on the patient safety caution and why the product was flagged, and the user will have the option to Override the caution or select Do Not Dispense to remove the product from the Dispense list.
Making sure the unit of measure is correct when dispensing is essential for accurate inventory measurement.
When loading:
The system typically defaults to “package” instead of vial, tablet, etc.
Select the appropriate unit of measure and quantity.
When dispensing:
During the first dispense, manually change the UOM from 'mL' to 'Vial' (or package to tablet, etc.) then complete the transaction.
Select the three dots in the upper left corner.
Choose appropriate unit of measure.
Going forward, the system should default to this selection for this item. CONFIRM before dispensing.Dispensing - unit of measure.mp4
pages 4-7 in User Guide
Neighborhood will use 2 levels of access for AccuShelf: Clinician and Administrator.
Clinician: (regular MAs)
• Dispense- User can dispense inventory items to administer to a patient.
• Return- If a dispensed inventory item is refused by a patient, the user can return the item back
into inventory for future use. Additionally, the user can “waste” a product if it is compromised.
• Inventory- The user can view what products are in inventory and what program the product is
assigned to. The user can remove any inventory currently in the system.
• Reconcile- The user has the ability update inventory counts in the AccuShelf to match the true
on-hand count.
• Transfer- When enabled, the user can authorize a transfer of inventory from their current site
to another site in need of the product.
• Move- For COVID-19 vaccines only, the user can move vaccines stored in an ultra-low or regular
freezer to the refrigerator or room temperature. This will update the BUD of the vials moved as
well as the date of the first move.
• Activity- User can see all activity on the machine over the last 24 hours including the action,
the program, date and time stamp, and the user.
• Temperature- For AccuShelf TM, the user can view 24-hour temperature data of different storage
locations.
Administrator: Nurses, Immunization Coordinators, and Leadership
The user has all the capabilities as the “Loading Clinician” plus the following functions:
• Users- This allows the user to add new and existing users from other sites to the AccuShelf. Additionally, this allows for current user’s information, access level, and fingerprint to be edited or removed.
• Settings- The user can access Ethernet, Wi-Fi, and LTE configuration to change or regain connection.
Procedural meds (Podiatry workflow)
At the start of the shift, the MA will gather the medications needed for the day.
During the shift, the MA will use the logs to document patient information, provider name, date, and what medications the patient received.
At the end of the shift, the MA will log into AccuShelf and navigate to “Dispense” and then “Patient” mode.
For each patient that received a medication, the MA will search for the patient, scan the medication(s) the patient received during their visit, and document the amount received. Once complete, return the completed logs and any remaining medications to the nursing team.