Bedside Bar Code Scanning

I work at a small hospital (average daily census of 15). We are not open 24
hours and are in the process of implementing a bedside bar code scanning
system. I am wondering how other hospitals without 24 hour coverage are
handling the medication order input during the off hours of pharmacy.

We currently are using HMS as our pharmacy/patient care system and have
Omnicell for our dispensing cabinets. In order to document the medications
on the MAR all orders must be entered prior to the administration of the
medication. In our situation we have safety features in our patient care
which ask for nursing review and pharmacist verification of all orders. The
problem is that our interface with the dispensing cabinet does not allow it
to distinguish between unreviewed or unverified orders and verified ones.
If we allow someone such as a unit clerk(who had previously transcribed MARs
for nursing) to do the input, the medication will be available to be
dispensed from Omnicell as a profiled active order before nursing or
pharmacy can review the order. Our patient care system would still indicate
that the order had not been reviewed or verified.

Does anyone have any experience with a similar type of situation and what
steps did you take to prevent medication errors at the dispensing cabinet?

Of those who use and electronic MAR how do handle after hours order entry?
Do you have remote order entry, allow nurses to enter orders, allow unit
clerks or other support staff to enter orders?

Do you have competencies specific to this function if it is not a pharmacist
entering the initial order.

Any input will be greatly appreciated.
Thank you,

Brian Ament, Pharm.D., R.Ph.
Pharmacy Manager
Jamestown Hospital
419 5th St. NE
Jamestown, ND 58401
701-952-4797