Nursing Homes
TouchStore Rx defines a Nursing Home Cycle as follows:
A Nursing Home Cycle encapsulates all the practice administration required to be completed prior to the delivery of all patient medications to the selected Nursing Home for the next week / month.
- Add a Nursing Home to TouchStore Rx:
- Select the first patient to be linked to the Nursing Home
- Click F3 to open the Patient Maintenance screen
- Click Dosage System or press (KEYBOARD: ALT + S)to open the Dosage System tab
- Select Nursing Homes
- To View, Edit or Insert a Nursing Home Double click the Nursing Home dropdown box.
- The Maintain Nursing Home screen will appear
- Click Insert or press (KEYBOARD: ALT + I) to Insert a new Nursing Home
- Enter the name address and any other contact details you have
- The Pre-Order Supplier allows you to select the Pending list you want your Nursing Home pre-orders to appear on. It is STRONGLY recommended that you create a new instance of your preferred supplier for this purpose. Pre-Orders allow to you to order all items required for the next Nursing Home Cycle before you process the prescription. This allows for much greater control of your stock as your Nursing Home supplies can be stored separately from your normal Pharmacy stocks.
- Select the Dosage system in use by this Nursing Home from the Dosage Systems dropdown box.
- Enter the default Rounds times available for this Nursing Home. The description entered for each Round appears as the round description on the Drug Dispense panel, is printed on the MAR sheets and on the Cassette sheets.
- From this point the Nursing Home entry will depend on the Dosage system selected.
Select a Report type you have 2 options.
- Days Displayed Horizontally - Allows signature of administering nurse per round, per patient. Most secure.
- Days Displayed Vertically - Allows signature of administering nurse per round, per day only. Less secure.
- Insert a new Dosage System:
TouchStore recommends to always insert a new Dosage System when creating a new Nursing Home and initial the Dosage System name with the initials of the Nursing Home.
This will prevent setting changes for one home affecting another.
- Select the first patient to be linked to the Nursing Home
- Hit F3 to open the Patient Maintenance screen
- Click Dosage System or press (KEYBOARD: ALT + S) to open the Dosage System tab
- Select Monitored Dosage
- To View, Edit or Insert a Dosage System double click the Dosage System dropdown box
- The Maintain Dosage System screen will appear
- Click Insert or press (KEYBOARD: ALT + I)
- The Dosage window will open
- Enter the Dosage System Name. E.g. Weekly Cassette LL. This means that the Dosage System is for a weekly period, Cassette packaging and is for a Nursing Home with the initials LL, Laragh Lodge
Set Dosage Period; Daily, Weekly or Monthly
Daily
- Nursing Homes should never be setup on a Daily Dosage System. This would mean the Nursing Home cycle is one day in duration.
Weekly
- This means the Nursing Home cycle is seven days in duration. You prepare your Nursing Home delivery each week.
Monthly
- This means the Nursing Home cycle is 28 days in duration. You prepare your Nursing Home delivery once a month.
- Enter the Round Time and Description e.g. 09:00, Morning for each round of medication. These 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. Users can adjust or insert new Round times per patient if their round times are different. There is a maximum of 6 Round times.
- File Location is only used when the user has a packaging robot system e.g. TOSHO/HDMEDI.
Number of Cycles.
- A weekly system with only 1 week supplied at a time = 1 Cycle = 7 days
- A monthly system with only 1 month supplied at a time = 1 Cycle = 28 days
- A monthly system but supplying 4 weeks at a time = 4 Cycles. = 7 x 4 = 28 days
- A monthly system but supplying a fortnight at a time = 2 Cycles = 2 x 14 days
- Default Phased Reason specifies what Phased Reason to apply to MDS dispenses. This information is sent to the PCRS when sending End-of-month Claims.
- Under Select Paperwork click into the Grid and select the type of Paperwork you would like to use e.g. MAR Sheet, Cassette Lid, MDS Kardex etc.
- Click Ok or press (KEYBOARD: ALT + O) to save the Dosage System and return to the Dosage System maintenance screen
- Configure the Number of Labels to Print
There are two settings that control the number of drugs labels that will be printed for each patient assigned to a Nursing Home with a Blister pack Dosage System.
When in the Dosage System Maintenance Screen:
Setting one, Cards Per: (setting 2 is NOT Ticked)
Week:
- If this option is selected, TouchStore Rx Rx assumes you are filling Blister packs on a monthly basis and fill all required medication for a week for each patient in one pack. Four label will always be printed per drug with this option.
Day:
- If this option is selected, TouchStore Rx Rx assumes you are filling Blister packs on a monthly basis and fill all required medication for a day for each patient in one pack. Seven label will always be printed per drug with this option.
Round:
- If this option is selected, TouchStore Rx assumes you are filling Blister packs on a weekly basis and fill all drugs in one pack for each patient. One Label will always be printed per drug with this option.
Setting Two, Separate Label Per Round:
When Ticked, this check box indicates that you fill a separate Blister pack for each round that the patient receives medication, effecting the number of labels required.
Each of the options for setting one are re-explained below:
Week:
- As above, the system assumes you require four labels per drug, but also makes a calculation for the number of times the drug is taken. So if the patient takes a drug once in the morning and once in the afternoon, eight labels will be printed.
- If patient is on one drug, then four Label will be printed.
- If patient is on two drugs, then eight label will be printed.
- If patient is on three drugs, then twelve label will be printed. etc.
Day:
- This is an unlikely scenario but the system will allow it to be configured. As above the system assumes you require seven labels, but also makes a calculation for the number of times the Patient required the drug in a day. So if the patient takes a drug twice a day, the system will print 14 labels.
- If patient is on one drug, then seven Label will be printed.
- If patient is on two drugs, then fourteen label will be printed.
- If patient is on three drugs, then twenty one label will be printed. etc.
Round:
- As above, TouchStore Rx will print one label per patient but also makes a calculation on the number of drugs taken so if patient is on two drugs 2 labels are printed, three drugs, three labels etc.
- If patient is on one drug, then one Label will be printed.
- If patient is on two drugs, then two label will be printed.
- If patient is on three drugs, then three label will be printed. etc.
The Test Button:
Click Test or press (KEYBOARD: ALT + T), a demonstration of the number of labels that would be printed with the current configuration is displayed.
It is HIGHLY recommended that you try a number of configurations, clicking the Test button with each setup tried to confirm that you are happy that the correct number of labels will be printed.
- Insert a Dispense for a Nursing Home Patient
Please ensure that the patient you wish to enter the dosage dispense for has been assigned to the Nursing Home in which they are resident.
Please ensure that the Nursing Home assigned to the selected patient has a Cycle started.
To Insert a Dosage Dispense for a Nursing Home Patient:
- Click Search or press (KEYBOARD: ALT + A) and select "Nursing Home patient" from the patient search Filter
- Select the Nursing Home in which the patient is resident
- This step is not required if your practice only dispenses to one Nursing Home or the Home required has been set as default. Assign a default Nursing Home in the Configuration module, on the Application tab - Dispensing sub-tab
- Select the patient to dispense to
- The PMR Console will open.
Please note: The title of the PMR Console window will read, "PMR Console - Nursing Home Patient:.." and the name of the assigned Nursing Home.
- If the PMR Console window title reads, "PMR Console - Ad-Hoc dispense session", this means you have not selected the patient using the Nursing Home filter on the Patient Search screen and as a result TouchStore Rx is NOT in Dosage dispense mode.
- Any dispense entered to a dosage patient in Ad-hoc mode will NOT be included in their Nursing Home cycle's
- 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. The 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..
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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 noting, that once you have entered this information for a drug once, it is automatically retained for any future dispensing.
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Click Next or press (KEYBOARD: ALT + N to enter the next item.
- If all items have been entered for this patient, click Complete or press (KEYBOARD: ALT + M)
- The Select Cycle and Paperwork screen will appear.
- Specify which paperwork you wish to print with this dispense.
- Click Print or press (KEYBOARD: ALT + P) to print paperwork.
- Assign a Patient to a Nursing Home
To Assign a Patient to the Nursing Home of Which They Are a Resident:
- Select the first patient to be linked to the Nursing Home
- Hit F3 to open the Patient Maintenance screen
- Click Dosage System or press (KEYBOARD: ALT + S) to open the Dosage System tab
- Select the Nursing Home Tab
- Select the Nursing Home within which the patient is resident from the Nursing Home dropdown box. If you have not yet configured the Nursing Home within which the patient is resident
- If the Nursing Home assign ward numbers or use remote sites to house residents, that location can be entered in the Patient Location text box. The patient location information is printed on Cassette and MAR sheets to make identification easier for Nursing Home staff
- Enter the Patent ID number used within the Nursing Home if any
- The Round Times will be populated with the default round time of the Nursing Home. These can be adjusted, as required per patient, to include additional, fewer or different times from the defaults. 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
- Click Ok or press (KEYBOARD:F12 OR ALT + O) to confirm the edits and close the Patient Maintenance screen.
- Start a Nursing Home Cycle:
- From the PMR Console, Hit Modules -> MDS
- Enter your PIN number
- Select the Nursing Home being processed and click Select or press (KEYBOARD: ALT + S) (step only required if there are two or more Dosage systems in operation)
- Click Start Cycle or press (KEYBOARD: ALT + S)
- 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
- Click Close or press (KEYBOARD: ALT + C) to close the MDS module - Patient processing functions
- Click Close or press (KEYBOARD: ALT + C) - Nursing Home selection screen (step only required if there are two or more Dosage systems in operation)
The next Nursing Home cycle has been started for the selected Nursing Home.
- Pre-Order Items for All Patient for the Next Nursing Home Cycle:
A Pre-Order Supplier must be assigned for the selected Nursing Home for this function to be available.
- From the PMR Console, Hit Modules -> MDS
- Enter your PIN number
- Select the Nursing Home being processed and click Select or press (KEYBOARD: ALT + S) (step only required if there are two or more Dosage systems in operation)
- Click Pre-Order or press (KEYBOARD: ALT + O)
- The MDS module patient select screen will appear, will all patients pre-selected
- Click Pre-Order or press (KEYBOARD: ALT + O)
- A progress bar, positioned at the top of the MDS Patient selection screen, will indicate progress through the Pre-Order 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
The Pre-Order for the selected cycle has been created.
Open the Orders module for the Nursing Home Pre-Order supplier to verify the order before sending.
- Repeat Items for All Patients for the Next Nursing Home Cycle:
- From the PMR Console, Hit Modules -> MDS
- Enter your PIN number
- Select the Nursing Home being processed and click Select or press (KEYBOARD: ALT + S) (step only required if there are two or more Dosage systems in operation)
- Click Repeat Script For or press (KEYBOARD: ALT + R)
- The MDS module patient select screen will appear, will all patients pre-selected
- 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
- Click Ok or press (KEYBOARD: ALT + O)
- The MDS patient selection screen will close
All patients now have an open dispense session with each item on their previous cycle repeated. At this point, any required edits required by the Nursing Home should be made to the patient's record.
- Print label / Cassette sheets for all patients for the next Nursing Home cycle:
- From the PMR Console, Hit Modules -> MDS
- Enter your PIN number
- Select the Nursing Home being processed and click Select or press (KEYBOARD: ALT + S) (step only required if there are two or more Dosage systems in operation)
- Click Print Sheets or press (KEYBOARD: ALT + P)
- The MDS module patient select screen will appear, will all patients pre-selected
- Click Print Sheets 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 Sheets 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 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 Nursing Home 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 and Order Forms for All Patients for the Next Nursing Home Cycle:
- From the PMR Console, Hit Modules -> MDS
- Enter your PIN number
- Select the Nursing Home being processed and click Select or press (KEYBOARD: ALT + S) (step only required if there are two or more Dosage systems in operation)
- Click Print MAR Sheets or press (KEYBOARD: ALT + S)
- The MDS module patient select screen will appear, will all patients pre-selected
- 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
- 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.
If the selected Nursing Home has the Print Patient Update Forms setting turned on, Order forms will also be printed directly after each set of MAR sheets printed per patient.
TouchStore Rx is now ready to process the next Cycle.