The nomadฉ Community Dosage System
WHAT IS nomadฉ CDS?
The Nomad Community Dosage System has evolved from the proven Nomad MDS system. In the UK it is used by over 8,500 nursing homes, care homes and public hospitals.
THE BENEFITS OF nomadฉ CDS?
FOR THE PHARMACIST:
It adds value to a standard range of services
FOR THE PATIENT:
Reduces/eliminates accidents 48% of drug related hospital admissions of
people over 65 are caused by dosage problems and/or poor compliance.
FOR THE GP:
Patient compliance is improved. Provides a medication base line against which
further treatment can be assessed.
FOR THE CAREGIVER:
Simplifies the process of administration of medication.
SETTING UP NOMAD CDS IN A PHARMACY
There are three stages to set up nomadฉ CDS in a pharmacy;
Coordination of four groups of people will ensure nomadฉ CDS runs smoothly.
Training the staff to run nomad CDS and establishing the best administrative system to run it cost effectively.
The GPs in your area
Gaining their co-operation especially with scripts and in selecting the appropriate patients
If patients have a caregiver who assists with or administers medication they should be briefed on the details of nomadฉ CDS. Such people may well have requested the system in the first place.
Choosing patients who will benefit from using nomadฉ CDS.
Before setting up nomadฉ CDS in your pharmacy, its important that all pharmacy staff understand the system; how it works, its benefits and how to implement and run the system.
It is recommended that GPs in your area should be advised that you are providing this service. There is general acceptance that CDS packs promote medication compliance and few GPs have difficulties with the principles of CDS. GPs assistance in aligning scripts with dispensing is useful.
New patients may mean additional revenue, however, it is
important that existing patients are not excluded and are also given a
reasonable opportunity to be brought onto CDS.
Suitable CDS users are patients with regular scripts of, we suggest, two or more items. The following groups may find benefits in using an CDS pack.:
How many people should be brought onto CDS initially?
Aim to implement CDS over a period of time to avoid
pressure until the pharmacy is in a regular CDS routine.
In most cases the pharmacist will select the people he feels will benefit
most. In some areas
institutional or voluntary services may wish to use a CDS pack for some of their
service-users and will recommend these people to the pharmacist. Once nomadฉ
well established it is likely that District Nurses, Care Assistants etc will
recommend people for nomadฉ CDS.
Services providers will often ask nomadฉ pharmacists for
To ensure the maximum co-operation, every opportunity should be taken to inform caregivers about nomadฉ CDS. It is particularly important that the caregiver of each person who applies for Nomad CDS is informed about it.
There are three stages to go through before the patient receives his/her nomadฉ cassettes:
The pharmacist may request approval from the patients GP. When requesting approval from the GP you will need to suggest the date when you wish to start their patient on Nomad CDS and inform the GP of the script(s) needed to ensure a smooth transition.
With the approval of the GP you will also have received
agreement to the implementation date you suggested. The most convenient date to
select is one which is before the patients current medication runs out.
SETTING UP THE MEDICATION
This is very straightforward. You need to:
PHARMACY OPERATIONAL PROCEDURES AND ADMINISTRATION REQUIREMENTS
Before the dispensing of items commences, the pharmacy will need to set up records that will ensure that packs are completed on due dates and their issue recorded. This aids the smooth running of the service in both the domiciliary setting and the community pharmacy.
Nomad for Windows software, assists in the administration and operation of this service.
It is usual to obtain the consent of the patient or the care giver. A sample form is attached.
SUMMARY OF SETTING UP NOMAD CDS
Check the patient/caregiver knows how to use the system.
It is important that you are notified as soon as possible in the event of any medication changes. You should encourage the GP and patient to let you know prior to a new script being presented. For example, the GP could telephone you from the patients home. The GP should prescribe for the number of days left in the cycle. All trays should be returned to the pharmacist who can then refill the cassette trays with the new medication.
Users should ensure that they have sufficient medication for their holiday periods and liaise with the pharmacist to ensure this.
Users should inform their pharmacist if they go into hospital for any period of time, so that medication is not prepared unnecessarily.
Usually the cassettes remain the property of the pharmacist, (unless otherwise agreed with the patient or caregiver.). It is the pharmacists responsibility to come to an arrangement with the patient.
USING NOMAD CDS OUTSIDE THE HOME
The user can either choose to take their cassette with them, or can remove the appropriate medication and place in a separate container.
RUNNING OUT OF MEDICATION
The usual procedures apply, with the pharmacist being informed as soon as possible.
Insert Trays are single patient use only and should not be cleaned or recycled in anyway. They must not be 'interchanged' between residents. They should only be used for the resident listed on the 'Insert Tray ID Label.
Cassettes may either be washed by hand or in a dishwasher. Do not overheat.
If trays are supplied monthly in a Carripac each tray much have the relevant backing sheet attached or enclosed. 'Enclosed' requires that the track and backing sheet are in a sealed bag (supplied by Nomad) Attached may be by means of a glue stick or similar.
MEDICATION NOT FOUND IN THE CASSETTE
Medication which should not be included in ANY CDS or MDS packs.
* All soluble or effervescent tablets
(3) SurgiChem has consulted with pharmaceutical suppliers
in the UK and they recommend that these pharmaceuticals are not (unless in
their original foil) be placed in ANY MDS packs.
NOMAD COMMUNITY DOSAGE SYSTEM (CDS)
The following forms may be downloaded or used as templates
GP ADVICE FORM
Dear Doctor .. .,
The following patient has requested that medication be dispensed in a nomadฉ CDS pack and has agreed that I should advise you.
Address .. .
I am proposing that he/she should start the on
If in your opinion it is inappropriate for the patient to be supplied medication in a CDS pack or if you require more information please advise.
NOMAD COMMUNITY DOSAGE SYSTEM (CDS)
Please complete appropriate sections.
1/ PATIENT OR CLIENT
Surname .. (Mr / Mrs / Miss /Ms.)
Date of Birth ../ / ..
I would like to have all appropriate medication supplied in
Telephone . Other Phones .. ...
3/ REFERRED BY
Signed .. Date. / / .
PHARMACY USE ONLY; ..
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