Please Note: This is a draft. Before using this material, practices should check the contents and adapt the text to suit their circumstances and style.
STANDARD OPERATING PROCEDURE
MDS Dispensing
This Standard Operating Procedure (SOP) has been designed to follow best practice processes in Care Home dispensing and ensure that all items are dispensed in a prompt, professional, efficient and safe manner.
1) Initial Computer Set-up
§ Enter the full details of each of the care home’s residents
§ in the relevant HOMES section of your computer – Full name, date of birth, G.P., Allergies, Conditions
§ Enter every individual item of medication for the resident detailing-
Medicine name, strength, dosage, administration times, route
§ Include all items, both MDS and non-MDS (external) medicines-
Annotate on your computer items not in MDS/Cassette to print on MAR
chart as a reminder to staff
§ Check that you have no concerns with any entry –
If you have any concerns when entering medication details, contact the Care
Home/Prescriber to resolve before continuing
2) Receipt of Prescriptions
§ Check that all sections of the prescription are completed
Check both front and back where relevant. Check any query with
prescriber/Care Home. Mark X in evidence not seen if necessary
§ Review each prescription item against the computer patient records –
If you have doubts on any item, check with the prescriber/Care Home.
3) Pharmaceutical Assessment
§ Does the prescription meet all legal requirements?
If there are concerns, return to the prescriber for correction
§ Is the dose form appropriate?
Is the form appropriate for MDS packaging if this is to be used. Also, check
there are no Contraindications or Interactions shown
§ Are there any other issues?
Check that there are no Adverse reactions, or misuse issues. Is the drug
suitable for the patient’s condition? Any concerns should be addressed to the
prescriber
4) Labelling & Printing
§ Check the computer dosage agrees with the prescribed supply-
Are the administration times and doses for each prescription item correct.
Does the quantity prescribed agree with the MDS dosage supply (normally
28 days)
§ Check full medication details –
Check that the full medication details are shown on the computer if
necessary (NOTE: A multi-dose system must show the colour, shape and
form of every item used in then MDS system)
§ Check Customer Requirements-
Does the customer need to have Not in MDS/ Not in Cassette instructions
shown on the label/ MAR chart
§ Confirm the Start Date is correct –
§ Does the start date of the prescriptions agree with the computer information on both start day and date
§
§ Print the required labels-
This will be labels required for the MDS system. In the case of unit dose this
will a label for each administration time and for multi-dose a label detailing full
colour, shape, form for every item of medication in the MDS. You will also
have to print labels for every non-MDS item of creams, liquids etc
§ Print the required Medication Administration Charts (MAR) –
Print off a MAR chart for every patient in the Care Home. This must show
every item of prescribed medication and if a PRN item is not re-ordered as
the Home has sufficient carry over stock for the next cycle, it must be
printed showing a ZERO quantity dispensed. The Care Home staff will still
require the item printing so that they can enter the amount of tablets carried
over and then record any administration during the MAR chart cycle.
5) Dispensing and Assembling MDS
Wherever possible the dispensing and checking processes should be carried out by two people. The checking of the dispensing can be carried out by a qualified Accredited Checking Technician (ACT), in which case the initial prescription check and professional review should have carried out by the pharmacist.
§ Select shelf stock early –
Once the labels etc have been printed, pull the stock required for each prescription. This way if you do not have sufficient stock it can be ordered in good time to complete every patient’s dispensing
§ Incomplete stock –
If you have insufficient stock to complete an MDS fully, the patient’s MDS packs should be placed to one side until stock is available to complete the full MDS dispensing for that patient.
§ Is the drug suitable for and MDS pack? –
If it is not suitable (liquids, creams, drops etc) then it must be labelled and
remain in the original container as with conventional dispensing.
NOTE:
There is also a guidance category list produced by the RPSG of types of
drug not compatible with MDS packaging eg; Effervescent tablets, Dispersible
tablets, Buccal tablets, Sublingual tablets, Hygroscopic preparations, Solid
dose Cytotoxic preparations
§ Check Expiry date and stock –
Is the expiry date on the original packaging sufficient to cover the period of
the MDS dispensing? Also is there enough stock to complete the MDS
dispensing from one original pack?
§ Dispense the required quantity into the MDS pack(s)-
Dispense into the MDS unit dose blisters (one blister for each administration
round) or the multi-dose pack (one in each relevant daily administration
time).
§ Date and Initial the “dispensed by” section of your labels
(if appropriate)
§ Assemble onto MDS system –
As each blister card is dispensed for a unit dose system, it should be placed
behind the Patient’s Named Divider Card for each necessary administration
round. In the case of multi-dose packs, there will be either 1,2, 3 or 4
completed weekly packs according to your preferred dispensing schedule
6) Checking for Accuracy
§ Check each patient’s prescription –
Check that the patient’s prescription matches the MAR chart entries. Then
check each prescription against the patient’s MDS pack. In the case of unit
dose, check each prescription to make sure there is a correct blister pack
for each necessary administration time.
§ Check the Patient details –
Check that the patient name details are correct on each label/ MDS pack
and agree with the prescription.
§ Check that the “dispensed by” label section is completed correctly-
Then sign the appropriate checked by section as each MDS pack is completed
if your are using this system.
§ Check that all MDS packs are correctly sealed –
As you check each pack, make sure that it is safely and correctly sealed and
that no tablets are likely to escape from the MDS.
§ Bag all non-MDS items after checking –
As each non-MDS item is checked, bag the item and ensure that each bag has
Has a correct patient label visible.
§ Complete this process for each patient-
Ensure that every item on a patient’s prescription is checked completely.
§ Endorse then file each prescription on completion -
7) MDS Storage and Despatch
§ Place all completed MDS packaging in a safe dedicated area-
On completion of the accuracy checking, place all MDS racks in suitable
packaging carriers for delivery to the Care Home. Ensure that the outer
packaging (boxes etc) are sealed. Store all boxes/MDS carriers etc for a Care
Home together and make sure they are labelled with the name of the Care Home.
§ Place all non-MDS labelled bags in containers-
Place all ancillary dispensing bags in outer containers, labelled with the Care
Home name and store in a dedicated area along with the MDS carriers.
§ Complete a Packing Note –
Prepare a Delivery Note detailing the number of MDS carriers and the
number of conventional dispensing containers to accompany the goods
§ Place a reminder note of Fridge lines etc with the Care Home despatch –
Place a reminder note of Fridge Lines and Controlled Drug dispensing with
the stored despatch goods to ensure they are not left behind when the
goods are delivered to the Home.
On the day of despatch, complete the separate delivery notes for either
Fridge or Controlled drug items and make sure they go with the Care Home’s delivery.
© Practice Services UK Limited.
For use within your practice only. You are not permitted to supply this to any other organisation.
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