Patient was three

Here’s an example of why pharmacists provide a rather valuable service to the public!

Had a script in today for trimethoprim 200mg BD for 3/7’ to a patient with no date of birth on the script. The patient turned out to be a 3 year old and on checking the dose of trimethoprim it was the maximum daily dose for this age and I could have dispensed a syrup since no form was indicated on the script.

But it did immediately go through my mind that the doctor had just signed this script (the patient had picked it up from reception) without realising it was for a child. It was, of course, from the dispensing practice that we don’t have a great relationship with but this one had to be checked out.

Well it turned out that my gut feeling was right and so I modified the dose for the patient and got a new script issued from the surgery.

Survey completed

We have finished collecting our patient surveys and they have been sent off for analysis. It’s taken us two weeks to get this completed.

We found that the majority of patients who were asked were more than happy to complete a survey while they waited for their scripts, etc. We didn’t once need to offer anyone an alternative way of filling in the survey (as you are supposed to do) by e.g. going online. So we will wait to see what our patients think of us!

EPS success!

The PCT came to visit us today to check that we are using the first phase of the EPS system so we valiantly scanned a bar coded script for them. Luckily this one came down from the spine almost immediately (but I have to say that this is still very hit and miss). The owner of the pharmacy will now receive his EPS payment so he’s happy!

In the bag

If you remember, I recently described the week of lost medicines. There was one case where we simply couldn’t resolve the issue with the patient. We had re-dispensed the item and made a note that in future we would always count the items into a bag in front of him.

I had my doubts whether that patient would return but he has on two occasions since and didn’t seem to mind the fact that we took him to one side and counted all his items into a bag.

Abusive language

We’ve had to ban a second patient from using our pharmacy following abusive language in the shop.

It was a teenage boy and stemmed from the fact that I had refused to give him an emergency supply of his salbutamol inhaler following a recent emergency supply for the same thing.

You’ll know from my previous blogs that I’ve had to deal with refusing repeated requests for salbutamol MDIs before.

In this case, I had previously given him an emergency supply with all the appropriate counselling about using his preventers, getting his asthma reviewed, etc and I had made it very clear to him that I wouldn’t be prepared to do the same again.

So of course when he came in again for another emergency supply I got a load of verbal abuse and so we have written to him asking him not to use our services any more (this approach has so far worked from a previous incident).

Another world

We have suddenly entered the world of EPS this week with a system upgrade and bar code scanners for the scripts.

One of our local surgeries is already using bar coded scripts so we now have lots to practice on.

I would echo what I have read in the pharmacy press that there still seems to be a lot of work to do with this system since it seems to be very hit and miss in terms of how long the scanned information takes to come down from the spine (from instantly, to 5-10 minutes, to never appearing at all!).

When it does work it is great to have all the information in front of you straight away without having to select all the individual drugs from the patients’ records.

But I wonder if it will make us less vigilant when scanning the whole of the patient’s record to look out for problems, and we inevitably have to go into each of the selected drugs to change the directions to something that makes sense for the patient.

Anyway, it’s a start!

The price of change

Had a great patient return today of sixteen packs of unopened rosuvastatin tablets 10mg. Any one care to work the price out?

The PCT is busy swapping all patients on atorvastatin 10mg to simvastatin 40mg at another one of the local surgeries so we are busy fielding patient’s questions and making sure that they know about the grapefruit interaction with simvastatin.

Patient survey

We started our patient survey today. As I said before, we are going with the NPA-recommended company that provides the paper based surveys since we felt this would better suite our patients.

I prepared a briefing sheet for the counter staff on how to sell the survey to patients waiting for NHS scripts and Care of the Chemist and off they went. We need to get 150 completed surveys off to the company to analyse so we will see how long it takes.

Missing item

We have had a week of lost script items. We hardly ever get patients ringing up to say that we haven’t given them everything that was on their scripts, but over the holiday period we’ve had four!

Like everyone else we always count the items into a bag and then seal it before handing it out. If a patient then rings in to say that an item isn’t in their bag we explain our procedure to them and ask them to bring the entire bag contents back to the pharmacy so that we can check it over again (our worry always being that if we have counted the items into a bag and a patient is missing something then they may have something else that they shouldn’t have).

This usually means that the patients then go away and have a good look round again before coming back to the pharmacy – and this worked in three out of the four telephone calls this week when patients then rang back to say they had found their ‘lost’ items.

But we just couldn’t get to the bottom of it with our fourth patient and so after exploring all avenues we finally re-dispensed the item to them (what else can you do without making a big song and dance out of it?) with an explanation that strictly speaking we should be reporting the loss of the item to the police, etc.

We have also made a note in this patient’s record that in future we will count the items into the bag in front of them.