Pharmacy Filling

Standard Operating Procedure for providing a dispensing service in support of the Pivotell Medication Dispenser.

 

The purpose of this SOP is to enable a pharmacy to accurately dispense appropriate medicines into the Pivotell automated Medication Dispenser.

1. Electronic medication dispenser(s) delivered to pharmacist by appropriate agency e.g. local authority telecare team. The dispensing cycle start date must be confirmed with the local agency prior to delivery and the exact pharmacy service agreed. The required number of complete Pivotell units and inner trays are then provided for each individual service user by the local authority team. The service relating to collection/delivery of the prescriptions and dispensed units should also be agreed at this time.
2. There are two dispensing cycle options for the Pivotell unit, -
   A 7-day prescription and a 28-day prescription
   
   (a) A seven day prescription
   The pharmacy is provided with two Pivotell units. One unit can then be thoroughly cleaned and air-dried in the pharmacy and the medicines dispensed in preparation for delivery. Meanwhile the second unit is in use in the service user's home. Each dispensed unit will have a tamper evident seal attached. The timings will be set by the pharmacy and the unit will be locked by the pharmacist prior to delivery. (Should the tamper evident seal be damaged, or removed, then the pharmacy cannot be held responsible for the Pivotell contents). 
   
   (b) A 28 day prescription
   The pharmacy is provided with a single Pivotell unit and 8 inner trays and lids. One full 28-day cycle of medication (four inner trays) is dispensed by the pharmacy. The initial delivery will be one inner tray in the locked Pivotell unit and a further three sealed inner trays for weekly changeover by the service user/carer.
   Whilst the Pivotell unit is in use, the pharmacy will clean, then dispense the next cycle's four inner trays. These will be sealed with a tamper evident seal and delivered to /collected by the service user's carer. Once the second cycle of inner trays is in use, the service user/carer must return the empty inner trays from the previous cycle to the pharmacy for cleaning and preparation for the next prescription cycle.
3. When the service is started, the pharmacist receives order form/information, which includes patient and GP details, plus timings required for the electronic dispenser.
   
   NOTE: 24-hour clock timings should always be used to avoid any confusion over dosage times.
      
   At this stage the pharmacist will check the service user's current medication to establish that all the required items can be dispensed into the Pivotell unit. If there are items that cannot be placed in the unit, the pharmacist will contact the local agency providing the service to discuss alternative solutions.
4. The pharmacy, or service user’s representative, collects prescriptions from surgery. The relevant dispensing labels are prepared from the prescription and attached to the paper label carrier.
   
   
   
   NOTE: All dispensing labels must be attached to ensure compliance with RPSGB labelling guidance.
   
   A description of the form, shape, colour and any markings should be written on the label of each medicine, unless it this information has been printed by the computer labelling system.
5. A dispenser familiar with filling multi dose products fills the Pivotell inner trays.
   
   
6. A dispenser following the Pivotell manufacturer instructions sets the timings and alarms required for medication. (See attached)
   
   
7. The tablet inner tray and correct cardboard dosage indicator insert are assembled in the Pivotell.
   
   
8. The label carrier must be securely fixed to the dispensing device body/inner trays to meet RPSGB requirements.
   
   
9. An Accuracy Check by either a pharmacist or an accredited checking technician is performed against the prescription. Both dose timings (where appropriate) and medication are checked.
   On satisfactory completion of the accuracy check, where the complete Pivotell unit is being provided; the pharmacist or technician then locks the unit and applies a tamper evident seal
10. A Clinical Check is performed by a pharmacist.
    
    NOTE: Follow pharmacy SOP for clinical check, the clinical check can be performed at any stage of the dispensing process although it is recommended that, where possible, it is done at the start of the process to resolve any problems before dispensing.
11. The Pivotell dispenser/dispensed inner trays are delivered to the service-user/carer/family member or collected from the pharmacy by the service-user or their representative, as per the agreed service level.
    
    NOTE: All relevant Patient Information Leaflets should be sent with the dispenser
12. If any medication remains in the dispenser on return to the pharmacy, this should be logged on the pharmacy Patient Medication Record and the relevant carer informed according to locally agreed protocol. Any concerns regarding the device having been tampered with, batteries removed etc, should be relayed to the local agency in accordance with the agreed service protocol.
13. Batteries for the device (and a charger unit if two sets of rechargeable batteries are to be used) should be provided by the local agency when the Pivotell unit is initially delivered to the pharmacy.
    Where rechargeable batteries are used, the pharmacy should change the batteries with each dispensing sending out each unit with fully charged batteries.
    
    If non-rechargeable batteries are used, the date the batteries are first installed should be recorded by the pharmacist/dispenser.
    Such batteries must renewed at six monthly intervals at the latest.
    
    
14. THERE WILL BE A SERVICE COST of £20 (+vat) PER SERVICE USER/ MONTH.

 

Appendix 1

Service level agreement

Pharmacy (ADDRESS)

Tel:

Dear Name,
Following our Meeting on Date, I have pleasure in confirming that Store Address will be supplying the medication for your client (Name) in the Pivotell Automatic tablet dispenser from Date.
We agree to provide the following service:
The store will organize prescription collection using the client’s prescription repeat slips (amend depending on specific store repeat service). The family or carer employed by Agency Name will communicate any changes to medication or personnel circumstances to the Store. Your Key Contact for medication queries is Name of store contact, Telephone: ...

1. All patients will be enrolled in our prescription collection service to help manage their prescriptions.
2. The Store will deliver medication directly to the customer’s home address or Agreed location address.  Name will confirm any change to delivery details to the Store.
3. Computer Generated Medication Charts (MAR Charts) will be issued with all dispensed medication*
4. A local daily cut off time of (time) pm was agreed for any emergency or interim items such as antibiotics.
5. Name will collate a list of all client details, address, date of birth, GP, Allergies and a list of all prescribed medication along with details of what time of day it is to be taken.
6. The arrangements for supply of the Pivotell device, trays and batteries (And charger if rechargeable) are as follows:  …

The pharmacy will supply MAR chart training* (* Include if appropriate)
If I can be of any assistance then please don’t hesitate to call me on the number above. I will be delighted to help or answer any questions that you may have.
Yours Sincerely  (store contact)

Appendix 2

Pivotell instructions – See attached

 

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