Monitored Dosage

TouchStore Rx defines a Monitored Dosage dispense as a Monitored Dosage Dispense encapsulates all the practice administration required to be completed prior to the delivery of the patient's medication for the next week / month.

- Assign a Patient to a Monitored Dosage System

To Assign a Patient to a Monitored Dosage System:

  • Select the patient to assign to a Dosage system
  • Click the Edit button or press (KEYBOARD: F3) to open the Patient Maintenance screen

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  • Click Dosage System or press (KEYBOARD: ALT + S) to open the Dosage System tab

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  • Click the Monitored Dosage option at the top of the Dosage System

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  • Select the Dosage System from the dropdown box.
  • The Round Times need to be configured.
  • Enter a Round Description and a round time.

The round time descriptions will be printed on the Cassette forms and appear on the Drug Dispense panel when entering round time information for items being dispensed

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  • If there is a Dosage System already present that you would like to edit, select the Dosage System and press edit ( altering this will alter this dosage system for all patients attached to this dosage system )
  • Add the name of the Dosage System to the Name field ( Should be kept meaningful, so either the packaging type and dispensing period, or a brand name for the blistering )
  • Round Times are the default times at which patients will take their medication. Upon assigning a patient to a Home/Dosage system, these round times will appear on their F3 screen under Dosage system tab ( From F3 users can adjust or insert new Round times per patient if their round times are different than the default times).Maximum of 6 Round times.

Period:

  • Daily - a cycle per day, this is never used.
  • Weekly - a cycle per 7 days. Drugs are dispensed every 7 days
  • Monthly - a cycle per 28 days. Drugs are dispensed every 28 days

Number of Cycles

  • Number of Cycles = 1 & Period = Monthly ( 28 days )
  • Number of Cycles = 4 & Period = Monthly ( 28 days split into 4 weeks )
  • Number of Cycles = 2 & Period = Monthly ( 28 days split fortnightly )
  • Number of Cycles = 1 & Period = Weekly ( You will not get phasing fees with this setup )

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Print Paperwork

  • If customers are using paperwork, this should be ticked

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Short Course Monthly

  • The default for Short Course is 7 days. If you tick the Short Course Monthly option this will be changed to a full 28 days, this may be desired if the Dosage System is one cycle over one month.

Auto Phase

  • Turn on if using a Monthly 1 Cycle, or Monthly 4 cycle system. The allocation will automatically phase each item as it is dispensed, with the Exception of Separate items. For Nursing Homes or the DP scheme, the auto phase should be unticked as they cannot claim for phasing fees.

Show Product Links

Enabled:

  • When Product Links is enabled, when inserting or repeating an item, if there are Product Links associated with this product, the Product Substitution screen will appear allowing you to choose your Preferred Brand or other allowed Alternatives

Disabled:

  • When Product Links is disabled, when inserting or repeating an item, if there are Product Links associated with this product, the Product Substitution window will NOT appear and the inserted/repeated item will be added to the current dispensing as normal

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Default Phased Reason

  • If you have Auto Phase ticked, this option needs to be chosen. Chose the reason for phasing to this patient. E.G “Patient cannot manage”

Paperwork

  • Chose which paperwork you would like printed when dispensing to a patient on this dosage system. Copies - The number of copies to print of that paperwork and tick auto print. ( When dispensing you can enter zero and it will not print ).

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  • Press OK to save the Dosage System

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  • Chose the new Monitored Dosage System from the drop down and once you press ok the Round Times this will auto populate for this patient

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  • Click OK or press (KEYBOARD: F12 or ALT + O) to confirm the edits and close the Patient Maintenance screen.

- Insert a Dispense for a Monitored Dosage Patient

Please ensure that the patient you wish to enter the dosage dispense for has been assigned to a Dosage System.

Please ensure that the patient has a Cycle started.

To Insert a Dosage Dispense for a Monitored Dosage Patient:

  • Click on Modules and select the "MDS" tab,

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  • The MDS Module window will open
  • Click on the "monitored Dosage" button

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  • Select the patient to dispense to
  • The PMR Console will open. Please note:
  • The title of the PMR Console window will read, "PMR Console - Monitored Dosage".
    • If the PMR Console window title reads, "PMR Console - Ad-Hoc dispense session", this means you have not selected the patient using the Monitored Dosage filter on the Patient Search screen and as a result TouchStore Rx Rx is NOT in Dosage dispense mode.
    • Any dispense entered to a dosage patient in Ad-hoc mode will NOT be included in their Monitored Dosage cycle
  • Click New script or press (KEYBOARD: ALT + I) , the Dispensing MDS Drug Panel will open
  • Select the drug to be dispensed. The Round configuration window will open.
  • The Start Date specifies the start date for the Nursing Home Cycle for this dispense.
  • The Finish Date for the drug is only used by Nursing Home setups. User can indicate when a patient will stop taking (course is Finished) and the system will not repeat that item upon repeat of the next cycle.
  • The Commencement Date is used to indicate when the patient first started taking this drug. Filled in once by staff and printed on the Kardex. Only required by a few Nursing Homes.
  • Tick Separate to indicate that an item is separate, not blistered, delivered outside of the standard packaging. A Drug Label will print for this item in all setups.
  • An Irregular item, in the context of our Dosage config screen, means it will not confer with our mathematical check. i.e. one Ventolin inhaler cannot be divided over 7 or 28 days. Separate items are usually Irregular. We have coded a link between Separate and Irregular, so ticking Separate will also tick Irregular.
  • Use PRN Chart to indicate that this item must appear on the patients PRN Chart.
  • Fill out the relevant Round Times e.g. Morning, Lunch, Tea etc. These rounds are populated from the Rounds specified when creating the Dosage System the patient is using.
  • Click OK or press (KEYBOARD: ALT + O) to save the Drug and Round information.
  • Enter the Dosage instructions. Tip! You may want to create a set of Dosage codes for your round times. E.g. 8A -8 AM 20 - 8 PM etc..
  • Additional information can be captured on the MDS tab on the right hand side of the Current Dispense Screen.
  • Colour, Shape and Letting: Nursing Homes require additional tablet identification. The Colour, the Shape and the Letting (if any) of the tablet can be recorded here. It's worth noteing, that once you have entered this information for a drug once, it is automatically retained for any future dispensing.
  • If all items have been entered for this patient, Click OK or press (KEYBOARD: ALT + O)
  • The Confirm Dispense screen will appear
  • Review all details for the items dispensed and be sure that the correct number of form numbers will be generated when this dispense is completed later. For more information on how to use the Confirm Dispense screen to make edits to one or more items, please see The Confirm Dispense Screen
  • Click Complete or press (KEYBOARD: ALT + M) , the Confirm dispense screen will now close and the Patient search screen will appear. The dosage dispense for the selected patient is now complete.

The patient search filter retains the previous settings for you to select the next Monitored Dosage patient to insert a Dosage dispense.

MDS TAB

The MDS Tab gives details for a drug that was put through on an MDS patient.

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Top Section

  • Start Date - The starting date of when the patients will be administered the drug for the current MDS Cycle.
  • Finish Date - The last date of when the patient will be administered the drug for the current MDS Cycle.
  • Comm Date - The Commencement date of the drug, when the patient first started getting the drug.
  • Not Required -
  • Short Course - A function to enter dispensing info where the patient will not be administered the drug every day during the current MDS Cycle. (Click here for more info on Short Course)

Middle Section

  • Colour - The Colour of the drug. Select a Colour using the dropdown. You can add a new Colour by double-clicking on the drop down and then use the Window that appears.
  • Shape - The Shape of the drug. Select a Shape using the dropdown. You can add a new Shape by double-clicking on the drop down and then use the Window that appears.
  • Lettering - The Lettering that appears on the drug. Simply type in the letters that appear on the drug in the field provided.
  • Separate - This box will be ticked if, upon on insert of the drug, the item was marked as Separate. This field, when ticked, indicates that the item e.g. GAVISCON ORAL SUSP 500ML will not be placed in blister packaging and will be provided separately.
  • Irregular - Tick this box if the drug is going to be an irregular dispense, not administered every day or has an irregular overall Qty being dispensed. This can be used in conjunction with the Short Course function.
  • PRN Chart - Ticking this option will place the item on the PRN Chart Paperwork

Bottom Section

This area contains the rounds of the dosage system.

  • Morning
  • Noon
  • Evening
  • Night

Beside each round is a field that will include the qty of the drug the patient will be administered at that round time during the MDS Cycle.

- Start a patient's Monitored Dosage cycle:

  • From the PMR Console, Press (KEYBOARD: ALT + O ) and Press (KEYBOARD: ALT + 6) to open the MDS section, or select modules and MDS.

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  • Enter your PIN number
  • Select the Monitored Dosage option (step only required if there are two or more Dosage systems in operation)
  • Highlight the patient you want to start a cycle for and click Select or press (KEYBOARD: ALT + S)
  • Click Start Cycle or press (KEYBOARD: ALT + S)

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The Start Date for the next cycle will be displayed, click Ok or press (KEYBOARD: ALT + O) to accept the Start Date.

You can change this date if required, but it is strongly recommended that the Start date suggested is accepted in all cases

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The next Monitored Dosage cycle has been started for the selected patient.

- Repeat Items for the Next Monitored Dosage Cycle:

  • From the PMR Console, Press (KEYBOARD: ALT + O ) and Press (KEYBOARD: ALT + 6) to open the MDS section, or select modules and MDS.

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  • Enter your PIN number
  • Select the Monitored Dosage option (step only required if there are two or more Dosage systems in operation)

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  • Highlight the patient you want to repeat items for
  • Click Repeat Script for or press (KEYBOARD: ALT + R)
  • The MDS module patient select screen will appear, will all patients pre-selected

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Click Repeat or press (KEYBOARD: ALT + R)

  • A progress bar, positioned at the top of the MDS Patient selection screen, will indicate progress through the Repeat process
  • A confirmation message will be displayed when the process has been completed

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  • Click Ok or press (KEYBOARD: ALT + O)
  • The MDS patient selection screen will close

All items have been repeated for the selected patient.

At this point, any required edits required by the Patient, Doctor or Carer should be made to the patients record.

- Print Label / Cassette Sheets for a Monitored Dosage Patient for Their Next Cycle:

  • From the PMR Console, Press (KEYBOARD: ALT + O ) and Press (KEYBOARD: ALT + 6) to open the MDS section, or select modules and MDS.

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  • Enter your PIN number
  • Select the Monitored Dosage option (step only required if there are two or more Dosage systems in operation)

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  • Highlight the patient you want to repeat items for
  • Click the Print Sheets button or press (KEYBOARD: ALT + P)
  • The MDS module patient select screen will appear, will all patients pre-selected

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  • Click Print or press (KEYBOARD: ALT + P)
  • The Print Paperwork screen will open. Specify the number of copies of each type of Paperwork you would like to print and click Print or press (KEYBOARD: ALT + P)
  • A progress bar, positioned at the top of the MDS Patient selection screen, will indicate progress through the Print process

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  • A confirmation message will be displayed when the process has been completed
  • Click Ok or press (KEYBOARD: ALT + O)

The MDS patient selection screen will close

All required Drug label or Cassette sheets are now printed.

At this point all medications should be filled into their Blisters / Cassettes and confirm that all information is correct.

This is the best point in the Practice administration process to correct dispensing or administration errors.

Please take extra care at this point that all information is correct, as correcting errors after time point is more time consuming.

- Print MAR Sheets for a Monitored Dosage Patient for Their Next Cycle:

  • From the PMR Console, Press (KEYBOARD: ALT + O ) and Press (KEYBOARD: ALT + 6) to open the MDS section, or select modules and MDS.

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  • Enter your PIN number
  • Select the Monitored Dosage option (step only required if there are two or more Dosage systems in operation)

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  • Highlight the patient you want to repeat items for
  • Click Print MAR Sheets or press (KEYBOARD: ALT + S)
  • The MDS module patient select screen will appear, will all patients pre-selected

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  • Click the Print button or press (KEYBOARD: ALT + P)
  • The Print Paperwork screen will open.
  • Specify the number of copies of each type of Paperwork you would like to print and click the Print button or press (KEYBOARD: ALT + P).
  • A progress bar, positioned at the top of the MDS Patient selection screen, will indicate progress through the Print process
  • A confirmation message will be displayed when the process has been completed
  • Click Ok or press (KEYBOARD: ALT + O)
  • The MDS patient selection screen will close

All required MAR sheets are now printed.

- Complete scripts for a patient's Monitored Dosage cycle:

  • From the PMR Console, Press (KEYBOARD: ALT + O ) and Press (KEYBOARD: ALT + 6) to open the MDS section, or select modules and MDS.

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  • Enter your PIN number
  • Select the Monitored Dosage option (step only required if there are two or more Dosage systems in operation)

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  • Highlight the patient you want to repeat items for
  • Click Complete Scripts or press (KEYBOARD: ALT + M)
  • The MDS module patient select screen will appear, will all patients pre-selected

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  • Click Complete Scripts or press (KEYBOARD: ALT + M)
  • A progress bar, positioned at the top of the MDS Patient selection screen, will indicate progress through the Complete process

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  • A confirmation message will be displayed when the process has been completed
  • Click Ok or press (KEYBOARD: ALT + O)
  • The MDS patient selection screen will close
  • Click Finish Cycle or press (KEYBOARD: ALT + F) to close off the Cycle for the completed Start Date.

This completes the Monitored Dosage cycle.

All items have been ordered, scripts repeated, labels or cassette sheets printed, MAR sheets printed and any required form numbers have been generated.

The Blister packs or Cassette boxes can now be supplied to the patient.

- Cancel a Monitored Dosage Cycle:

  • From the PMR Console, Press (KEYBOARD: ALT + O ) and Press (KEYBOARD: ALT + 6) to open the MDS section, or select modules and MDS.

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  • Enter your PIN number
  • Select the Monitored Dosage option (step only required if there are two or more Dosage systems in operation)

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  • Click Cancel Cycle or press (KEYBOARD: ALT + L)

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  • Click Yes or press (KEYBOARD: ALT + Y) to the confirmation message

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  • Click No or press (KEYBOARD: ALT + N) to the confirmation message

The Cycle has now been cancelled.