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nomad© Software Users Manual  -  April 2005   

Patient Management - Operational
(Using Nomad)

Patients (including community patients) are grouped in carehomes.
To enter patient data into the system you must have set up a carehome(s). 

Adding a New Patient

From the main window select ‘Patient’ and a window similar to the one below will appear;
It will however not show any patients names.

To add a patient select ‘Add’ in the select patient window (F5) shown above. A window similar to the one below will appear where you can select the patient entered into your dispensing system. Type some or all of the patient’s surname / firstname / address then select ‘Search’ and the dispensing system’s database will be searched for matching patient’s. To select a patient either double click on the patient’s name or press the numerical key corresponding to the number next to the patient’s name.

Adding all Patient’s in a Carehome

Only enter the address then select ‘Search’ and a list of patient’s at that address will be displayed. Select ‘Add All’ to add all the listed patients to the carehome.

Selecting a Patient

From the main window select ‘Patient’ and a window similar to the one below will appear.

To select a particular patient enter some or all of their surname into the ‘Patient Search’ edit box. 

For example if you type ‘rob’ only the patients whose surnames match ‘rob’ will be displayed in the list (eg Robson, Robinson, Robertson, etc).

Note: The patient search is not case sensitive - which means that you don’t need to use upper and lower case.

To narrow the search to a particular Carehome, select ‘Carehome’ and a window similar to the one above will appear where you can select the Carehome.

The ‘Next’ and ‘Previous’ buttons refer to the next and previous patient in the currently selected Carehome – ie the Carehome that the currently highlighted patient is in.

To make the patient selection either press the key corresponding to the number next to the patient or press the <Enter> key and the selected patient will be highlighted with a purple background. Use the up/down arrow keys to navigate the list of patients and press <Enter> again to make the selection.

If the option ‘Show medication profile after selecting patient’ in the options window is checked, the patient’s medication profile will appear automatically after selecting the patient.

Editing a Patient’s Details

Select a patient as described above and using the arrow keys to highlight the patient’s name in the list of patients. Select ‘Edit’ and a window similar to the one shown below will appear where you can edit the patient’s details. 

Note that the only details that can be edited are whether or not the date of birth is known, whether or not to generate compliance entries (see the section ‘Compliance’ for details), the doctor, and allergies. Any other changes must be made through your dispensing system.

Removing a Patient

Select a patient as described above and using the arrow keys to highlight the patient’s name in the list of patients. Select ‘Remove’ and a window confirming the removal of the patient will appear. If you answer ‘Yes’ to this the patient will be removed from the system.

Note: Once removed from the system, the only way to recover the patient’s data is to restore from a backup.

The Patient Medication Profile

The patient medication profile lists the medications that the patient is currently using. This is where you add, edit, and remove medications appearing on a backing sheet. The window has been designed to resemble a backing sheet. The system automatically checks the dispensing systems database for any new or altered scripts. Any new or altered scripts will appear with a red background.

To open a patient’s medication profile first select the patient as described in the preceding section, then select ‘Nomad’ in the main window. A window similar to the one shown below will appear.

Navigate around the above window using the left, right, up and down arrow keys, and the <Page Up> and <Page Down> keys.

Note that medications that do not physically go into the Nomad cassette have a (flask!!) beside the drug name.

        PRNs (best practice requires these be put in a separate pack) Highlight medication and F1. To remove, highlight F1.

Medications that are not prescribed have a (symbol!!) beside their drug name.

Medications that have been entered through Nomad (ie not through the dispensing system) have a (symbol!!) beside their drug name.

Selecting another Patient

To open the medication profile of another patient without going back to the main window press ‘F4’ and the select patient window will appear. A patient is selected in the same way as described in the section ‘Selecting a Patient’.

 

Loading Scripts from the Dispensing System

When a patient is first added to Nomad, the program will load the scripts dispensed to that patient within the last 60 days. If a drug has been entered more than once in that period (as in the case of repeats) then only the latest script will be displayed. If a script for the same drug is entered into the dispensing system after a backing sheet has been printed, then the system will update the details (script number, entry date, directions) of the drug on the backing sheet to synchronise with the details of the latest script when the ‘Nomad’ function is selected in the main window.

If you need to show scripts entered earlier than 60 days, select ‘Load’ and a window similar to the one below will appear. Set the date for which you want Nomad to load scripts entered since that date. For example in the window below, the date has been set to January 1, 1999, so all scripts entered into the dispensing system since January 1, 1999 will be displayed.

Note: You will rarely need to use this function.

 

Adding a New medication

Prescribed medications should be entered through your dispensing system, however there may be an occasion where you wish an item to appear on the Nomad cassette which is not entered through the dispensing system (OTC items and vitamins, for example). The purpose of the ‘New Med’ function is to enable you to do this. This function, designed for the stand-alone version of Nomad, has been made available in this integrated version.

Select ‘New Med’ and a window similar to the one shown below will appear.

Selecting a Medication

Type in part of the medication name optionally followed by the strength then press the <Enter> key and a window similar to the one on the next page will appear. Use the up and down arrow keys and the <Page Up> and <Page Down> keys to navigate the list of medications. When the desired medication has been highlighted press the <Enter> key and the medication will be selected. Alternatively press the number key corresponding to the number next to the medication’s name.

The bottle next to the drug name means that the name is a generic. To select a brandname, navigate to the generic name using the up/down arrow keys then press <Enter>. The list will now change to a list of brandnames matching the generic.

To return to the select medication window select ‘Select Drug’ at any time.

 

Adding a New Medication to the Drug Database

If a medication is not listed it may be added by selecting the ‘New Med’ button in the above window. A window similar to the one below will appear where you can enter the medication’s details.

Quick Code

The quick code is an arbitrary code set by the user and is used to uniquely identify a drug to speed drug searches. For example the quick code in the above window you could set the quick code as ‘PAM1’, so typing ‘PAM1’ into the drug search text-box will select this drug without showing the select drug window.

 

Entering the Medication’s Details

Use the up and down arrow keys to navigate the ‘Display’ group of radio buttons. If the medication has not been prescribed (a vitamin supplement for example) then check the ‘Not Prescribed’ check-box. The patient’s doctor will already be in the ‘Prescriber’ text box. If a different prescriber has prescribed the medication, type in part of the prescriber’s name then press <Enter> and the select doctor window will appear. Use the up and down arrow keys to navigate this window then press the <Enter> key to select the medication.

 

Entering the Directions

Type the sigs into the ‘Directions’ text box. They will be decoded as you type. You can access the list of sigs (and warnings) by selecting the ‘Sigs’ button. To enter the warnings associated with the drug enter the warning numbers into the ‘Warnings’ text box.

 

Entering the Quantities

Enter the duration in days that this script covers into the ‘Duration (Days)’ text box. This is useful if a script has been prescribed with directions similar to ‘Take One a day for 30 days’.

If the script has been prescribed with a specified quantity then the number of days in the ‘Duration (Days)’ text box will be adjusted automatically when the daily ‘Dosages’ and ‘Script Quantity’ are entered. The following diagrams show more clearly how to enter the quantities.

Note: The ‘Weekly quantity’ is the quantity that will be printed on the backing sheet. There is usually no need to adjust the automatically calculated quantity, however for some medications which do no go into the Nomad cassette you may wish to override the computed quantity. For example if 5ml per day is to be taken of a syrup, the automatically computed quantity will be 35ml, however the label on the bottle may be 400ml so you may wish to set this to be 400ml to match the quantity printed on the bottle.

Note: The ‘Script Quantity’ can be entered as the number of packs (if the packsize of the medication has been set). Enter the quantity as ‘1p’ for 1 pack, ‘2p’ for 2 packs, etc.

 

Medicines that do not go in the Nomad Cassette

If the medicine is a cream, ointment, syrup, etc, or a PRN it does not physically go in the cassette although it will be printed on the backing and MAR sheets. To set the medication as a ‘non-cassette’ medication put a check beside the ‘Not in Cassette’ check-box. It will appear on the backing and MAR sheets with ‘Not in Cassette’ beside the drug name.

 

Setting the Start and Stop dates

If you want to specify start and stop dates for the medication put a check in the ‘Start’ and ‘Stop’ check-boxes. When they are checked a text box will become visible where you can enter the actual date. The date must me in the format ‘dd/mm/yyyy’, eg ‘07/09/1999’. Quantities printed on the backing and MAR sheets will use these dates (if they have been specified) to computed the quantities.

Note: It is possible to set the stop date before the start date. You may wish to do this for some combinations of medicines which cannot be taken concurrently. For example if the patient is regularly on medicine 1, and has to take a short course of medicine 2 which cannot be taken concurrently with medicine 1, then set the start and stop dates for medicine 2 and edit medicine 2 (see the section ‘Editing Medications’ for details on how to edit medications on the backing sheet) so that the stop date is the day before the start date of medicine 1 and the (re)start date is the day after medicine 1’s stop date.

 

Editing the Medication’s Details in the Drug Database

Once the medication has been selected you can edit the details at any time by selecting ‘Edit Med’.

 

Previewing the Backing Sheet

Select ‘Preview’ and a window will appear showing the backing sheet as it will appear when printed.

Note: The preview shows how it will appear when printed by a laser or an ink-jet printer. The output from a dot matrix printer will look different due to the limitations inherent in dot matrix printers.

 

Changing Cassette/Non-Cassette Medications

Use the up and down arrow keys to navigate to the medication you want to change. Select ‘Cassette’ to toggle the bottle icon next to the drug name. A bottle icon indicates that the medication is a non-cassette medication.

 

Removing Medications

Use the up and down arrow keys to navigate to the medication you want to delete. Select ‘Remove’ and a window will appear confirming the removal of the medication. If you answer ‘Yes’ to this window the medication will be removed.

Note: Only medication entered through Nomad (ie not through the dispensing system) can be removed with this function. To prevent scripts entered through the dispensing system use the ‘Non-Printing’ function

Non-Printing

Non-Printing

To prevent scripts entered through the dispensing system use the ‘Non-Printing’ function. A window will appear listing the patient’s medications. Use the up/down arrows to navigate the list and put a check beside the names of the medications you wish to appear on the backing and MAR sheets. Any medication that does not have a check beside it’s name will not be printed on the backing and MAR sheets.

 

Accessing the Patient’s Details

Accessing the Patient’s Details

The patient’s details (name, address, doctor) can be viewed/edited by selecting ‘Details’.

 

Setting the Dosage Times

If default dosage times (‘bfast’, ‘lunch’, ‘dinner’, ‘bed’, etc) for the carehome have been specified they will appear on the patient’s medication profile. If you wish to change these times select ‘Times’ and a window similar to the one below will appear. Use the up and down arrow keys to navigate the list. Press <Enter> when the desired times have been highlighted. Select ‘New Times’ to add a set of new times to the list and ‘Remove’ to delete a set of times from the list.

Editing a Medication

To edit the medication use the up and down arrow keys to navigate to the medication then press the <Enter> key. A window similar to the one below will appear. This is where you change the ‘display properties’ of the medication.

Note: This function changes the way the medication is displayed on the backing sheet and all though it allows you to change the directions, warnings, start and stop dates etc.

PLEASE NOTE. These changes are not made to the original script in the dispensing system.

Variable Dose Medications

If the medication has a reducing dosage, an alternating dosage, or has directions similar to ‘ONE every Monday and Thursday’, its quantity will change on a daily basis. To enter the details select ‘Vary Dose’ and a window similar to the one shown below will appear. For each of the six dosage time periods the dosage may be varied on a 28 day cycle.

Navigate the window using the up, down, left, and right arrow keys. If no stop date is given the cycle repeats without user intervention. So if the patient is on a long-term medication that has an alternating dosage, do not specify a stop date and no changes to the varying dosage window will be necessary.

If the medication is already a varying dose medication and you want to change it back to a non-varying dose medication select ‘Clear’.

 

Printing Backing and MAR (Signing) Sheets

If the option ’Show print window after changing patient medications’ has been selected in the options window then a window similar to the one below will appear after the patient medication profile window has been closed. To open this window manually select ‘Print’ from the main window.

 

Selecting What to Print

Put a check in the check-box beside the item you wish to print in the ‘Print’ box.

 

Selecting Weekly or Monthly Printing

Put a check in the check-box next to either ‘Weekly’ or ‘Monthly’. The 11 inch and A4 MAR sheets are monthly so this option has no effect on the way they are printed. If ‘Weekly’ is selected then a single backing or 8 inch MAR sheet is printed. If ‘Monthly’ is selected four backing or 8 inch MAR sheets will be printed with their start dates 7 days apart.

 

Selecting which Patients to Print

You can print all the patients in the carehome at once, the currently selected patient, or select a group of patients in the carehome to print. Put a check in the check-box beside the appropriate selection. You can open the window to see a list of patients to select for printing be selecting ‘Select’. Use the up, down, left, and right arrow keys to navigate the list of patients, and use the <Space Bar> to check (or uncheck) the box beside each patient’s name. Any patient who has a tick in the check-box beside their name will be printed.

 

Selecting the Start Date

The ‘Starting Date’ is the date of the first day that that the cassette is to be used. Select the month in the ‘Month’ drop down list, the day in the ‘Day’ calendar (navigate using the up, down, left, and right arrow keys), and the year in the ‘Year’ text box.

 

Printing

When all options have been set select ‘Print’.

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Care Medical Ltd. 0800 333 808 / Email sales@caremed.co.nz  nomad© is a registered trademark of SurgiChem Ltd. United Kingdom.