Pivotell Ltd

Suggested Standard Operating Procedure for Pharmacists for the provision of a

dispensing service in support of the Pivotell Medication Dispenser (Mark 3)

Mark 3 SOP v5 300911

2.

The purpose of this SOP is to enable a pharmacy to accurately dispense appropriate medicines into the Pivotell Automatic Medication Dispenser (Mark 3)

1. Pivotell automatic medication dispenser(s) will be delivered to the pharmacist by the user’s family member, carer or an appropriate agency e.g. local authority social care team.

2. The dispensing cycle start date must be confirmed with the family member, doctor or local agency prior to delivery and the exact pharmacy service agreed.

3. The required number of complete Pivotell units and inner trays are then provided for each individual service user.

4. The service relating to collection/delivery of the prescriptions and dispensed units should also be agreed at this time.

5. Dispensing options-

5.1 7 day prescription

It is suggested that the pharmacy is provided with two Pivotell units. One unit can then be thoroughly cleaned and air-dried in the pharmacy and the medicinedispensed in preparation for delivery. The second unit is in use in the service user’s home.

Each dispensed unit will have a tamper evident seal attached. The timings will be set by the pharmacy and the unit will be locked by the pharmacist prior to delivery. (Should the tamper evident seal be damaged, or removed, then the pharmacy cannot be held responsible for the Pivotell dispenser contents).

5.2 28 day prescription

The pharmacy is provided with a single Pivotell unit and re-usable or disposable medication trays. The number of trays provided depends on the user’s daily dosage:Daily doses No. of trays and lids (Re-usable or disposable)4 8 3 6 2 41 2

One full 28-day cycle of medication (4/ 3 / 2 or 1 medication trays) is dispensed by the pharmacy. The initial delivery will be one inner tray in the locked Pivotell unit and a further 3 ( 4 x daily), 2 (3 x daily) or 1 (2 x daily) sealed re-usable or disposable inner trays. These will be changed over weekly by the service user/carer.

Whilst the Pivotell dispenser is in use, the pharmacy should then dispense the next cycle’s inner trays. These will be sealed with a tamper evident seal and delivered to /collected by the service user’s carer in time for the next medication cycle.

Once the second cycle of inner trays is in use, re-usable trays from the previous cycle should be returned to the pharmacy by the service user/carer for cleaning and preparation for the next prescription cycle.

Disposable Trays – please see separate Disposable Tray System Notes for Pharmacist for the handling and labelling procedure.

Note** Trays may be cleaned in a dishwasher or suitable sterilising solution.

3.

6. When the service is started, the pharmacist will receive order form/information, which includes patient and GP details, plus timings required for the dispenser. NOTE: 24-hour clock timings should always be used to avoid any confusion over dosage times.

At this stage the pharmacist should check the service user’s current medication to establish that all the required items can be dispensed into the dispenser. If there are items that cannot be placed in the unit, the pharmacist should contact the family member, carer or local agency providing the service to discuss alternative solutions.

7.. The pharmacy, or service user’s representative, should collect the user’s prescriptions from surgery. The relevant dispensing labels are prepared from the prescription and attached to the prescription booklet. (See prescription booklet and plastic retaining case below -Figure 1):

NOTE: All dispensing labels must be attached the label carrier to ensure compliancewith Royal Pharmaceutical Society of Great Britain labelling guidance.

A description of the form, shape, colour and any markings should be written on the label of each medicine, unless it this information has been printed by a computer labelling system.

8. The pharmacy dispenser, familiar with filling multi dose products, fills the dispenser’s inner tray having positioned the correct time card on the tray (1 x daily / 2 x daily/ 3 x daily / 4 x daily- see photo below with 4 x daily medication time card in place). Note – for 5 or more medication times daily, the times should be hand written on the blanktime disc provided.

Figure 1

4.

9. The pharmacy dispenser sets the timing and alarms required for medication (follow the Pivotell Instruction Book instructions).

10. The pill tray is placed in position in the dispenser so that the compartment marked solid red is positioned in the dispenser opening of the dispenser (see figure 3below)

11. In the case of pill trays filled seperately for positioning later in a dispenser at aservice user’s home, the relevant time disc should be placed on the tray, andthe tray loaded with pills as in para.11 above. The prescription label should be placed on top of the tray and the lid then clipped on (see figure 4 below)

Figure 2 Figure 3

Figure 4

5.

12. In order to meet Royal Pharmaceutical Society of Great Britain requirements on

labelling the pharmacy label carrier must be attached to the dispenser body using

the re-posable adhesive sticker provided on the back of the label carrier. The clear

plastic label cover should then be clipped on to the dispenser to protect the label..

13. An Accuracy Check by either a pharmacist or an accredited checking technician shouldbe performed against the prescription. Both dose timings (where appropriate) andmedication are checked. On satisfactory completion of the accuracy check, where the complete Pivotell unit isbeing provided; the pharmacist or technician should then lock the unit and apply a tamperevident seal.Where the medication tray is being provided the lid and tray should be sealed with a tamper evident seal.

14. A Clinical Check should be performed by a pharmacist.NOTE: Follow pharmacy SOP for clinical check, the clinical check can be performed atany stage of the dispensing process although it is recommended that, where possible, it isdone at the start of the process to resolve any problems before dispensing.

15. The dispenser/dispensed inner trays are then delivered to the service- user/carer/family

member or collected from the pharmacy by the service-user or their representative, as per the agreed service.. NOTE: All relevant Patient Information Leaflets should be sent with thedispenser.

16. If any medication remains in the dispenser on return to the pharmacy, this should be

logged on the pharmacy Patient Medication Record and the relevant carer informed

according to locally agreed protocol. Any concerns regarding the device having been

tampered with, batteries removed etc, should be relayed to the family member, carer or

local agency in accordance with the agreed service protocol.

6.

17. BATTERIES

Batteries ( 4 x AA Alkaline) are supplied with the dispenser when new.Batteries will last in normal use for at least 12 months. Battery life can bechecked using the following procedure:

1. Insert batteries in the dispenser.2. Immediately watch the LCD display for the indication BATLEV.3. At full charge a reading of 1600 (or more) will be shown.4. At a reading of 1325 the battery warning indicator will initiate5. At a reading of 1275 the unit will not operate.

Note: Rechargeable batteries should not be used as they have an inferior life span.

The date the batteries are first installed should be recorded by the pharmacist /dispenser and such batteries should be renewed at six monthly intervals at the latest.

Pivotell LtdP.O. Box 108

Saffron WaldenCB11 4PE

Tel. 01799 550979sales@pivotell.co.ukwww.pivotell.co.uk