Nomads (guest blog by @zams123)

Thanks to @zams123 for writing this blog

Nomads…also known as venalinks or usually blister pack dosette trays. We have 100 patients on them in our community pharmacy and I check 4 in a go so that’s actually 400 of them over a week!

I have a structured routine of managing the trays upstairs to managing the shop and dispensary downstairs in my pharmacy. However, the more busy the pharmacy gets, the checking process of nomads becomes trickier as it is a time consuming process.

A lot of healthcare professionals such as GP’s and receptionists don’t understand that this is a time consuming process. Especially when there are changes made to medicines. A prescriber will change it at the touch of a button on a computer, whereas the pharmacy staff require performing a surgical operation to the blister pack tray in order to make a change. I have encouraged receptionists and doctors to inform us ASAP if there are any changes made to medicines for tray patients, since recently a lack of communication by a GP resulted in a patient not receiving their medication on time.

It is very sympathetic when a tray patient is admitted to hospital, but this can be very frustrating if the pharmacy is not informed about it. The driver is unneccessarily wasting a trip to the patient’s house to try and deliver the tray. The medication is liable to change whilst the patient is in hospital, so if the pharmacy does not know, the pharmacist will check and seal 4 weeks of trays in advance…this will then lead to medicine wastage and extra manual work will take place to change the tray if any changes made.

Sometimes we aren’t even informed when the patient comes out of hospital until the day the patient runs out of medication. We need to chase up discharge summaries and request new prescriptions that need to be signed by a GP all less than 24 hours.

Checking trays can be physically stressful too. For example, your eyes are focused on every single tablet there is in the tray – this can be more eye straining when all the tablets are white! Basically at the end of the day I come home with red eyes. This process can also be physically stressful if you have to stand up and check – depending on how tall you are and the height of your checking bench, your back can be slouched and aches after a while.

Apologies if I put anyone off checking the trays! I just hope that communication improves between patients, GP’s, receptionists and pharmacists.

6 thoughts on “Nomads (guest blog by @zams123)

  1. Mmmmmm has given me food for thought. I am a hospital pharmacist. I know community pharmacies are not always notified when patients using blister packs have meds changed and are then discharged. Sometimes this is because we do not know the pharmacy. A script comes to dispensary with ‘dossette’ written on but often not the pharmacy details. Patients often do not bring their original supply in with them. If the patient is not in front if you you cannot ask them. Even if the patient is there, they are often confused about which pharmacy they use. However I will revisit this issue next week when I go into work as I agree that communicstion is paramount and have seen cases where patients are readmitted because they have continued to use old blister packs that do not hsve the amended meds in them.
    I agree that dispensing into them is time consuming. I only hope that it is the right patients that are getting them. Blister packs can be invaluable to those that really need them. It must be remembered that once a blister pack is given patients often lose any knowledge about their medicines. I suspect that not all patients receiving blister packs really need them.

  2. I have conducted MURs on some of my tray patients and was very surprised to find that they could identify which medicine every single tablet was and what condition it was for. Therefore, not always does the patient lose any knowledge of their medicines when they are on blister pack trays.

  3. Bless you! I can fully sympathise with the red eyes, checking that many would make me dizzy too I think! I have a patient whose meds get chopped and chnged almost every week, and it is so annoying. Nobody considers the cost and time and effort these changes will mean to a pharmacy. In some cases patients arent even aware that the doctor has made these changes which can be annoying too, because we are left in anawkward position of being the first to inform the patients. In my experience I have had a few hospital pharmacists get in touch with me and even being so kind as to fax me discharge lists when someone has been in hospital. Its much better for us if pharmacists can do this as when its left to a nurse we never get the information we need, or we can never get hold of the nurse we spoke to initially due to shifts patterns etc.

    Great blog 🙂

  4. I couldn’t agree more. I hate it when the ACT is off, im forever checking trays!!!
    Great blog thanks for sharing 🙂

  5. Hi guys I searched this subject as I am a dispenser who does tray. When I have finished them and they go to the pharmacist he merely checks the boxes I have supplied and not the medication to see if the medication is in the tray or whether it is in the right place or matches the tray sheet. I do not think this is right. My locum checks every single tablet. What do I do?

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