Remote Review of Medicines Administration Charts in Care Homes

Varinder Rai, Regional Medicines Information Manager, London Medicines Information ServiceExample from Clare Collins, Pharmacy Technician Community Services & Intermediate Care , Northumbria Healthcare NHS Foundation TrustPublished
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Overview

Summary

It is usual practice for Care Home Pharmacy Technicians to conduct regular reviews of Medicine Administration (MAR) Charts of Care Home residents, and also when completing medicines reconciliation post discharge. During the COVID pandemic new ways of working were needed to maintain a service provided by Care Home Pharmacy Technicians. A system was developed by a Integrated Care Home Pharmacy Technician at Northumbria Healthcare NHS Foundation Trust using the AccuRx system which enables MAR charts to be remotely viewed and saved in the patients GP record.

Why this example is important

It is important during the COVID pandemic that technicians can continue to provide a service which has been developed over several years and conduct medicines review and reconciliation against the MAR chart for patients newly discharged from hospital. Reviewing the medicines charts with the GP record or discharge medication list, allows discrepancies/concerns to be identified and highlighted to the Care Home, the pharmacist and/or prescriber to ensure safe administration of medicine in Care Homes.

Implementation

What were you hoping to achieve?

We hoped we could mimic the service provided to the Care Home pre-COVID, without physical access to the charts in the Care Home. Virtually viewing the MAR charts and completing the medicines reconciliation with all the patient’s medicines information forms a more holistic approach.

What have you implemented

During COVID-19 pandemic the following steps were implemented to set up remote working:

  • The AccuRx system was identified as being secure and compatible with the GP systems (EMIS & System1). The AccuRx IT system  works alongside the GP system EMIS or Systm One  allowing healthcare professionals involved in patient care to  easily communicate via video call or text messaging
  • Approval was requested for use of the AccuRx system with each practice. The IT or practice manager then has to approve each person individually.
  • The AccuRx system enables a text message to be sent via the patient record in the GP system
  • Care Home staff can then send photos of the MAR charts in response to the text, allowing the pharmacy technician to review the chart.

What have you achieved?

During the pandemic we have achieved continuation of delivery and engagement of the service remotely.

Safe and effective communication and sharing of MAR Charts to support safe and efficient medicines management in the Care Homes.

For example, a patient had been switched from rivaroxaban to dabigatran by the GP several days ago. The MAR had not been updated in the home to reflect the change. It was identified that the resident was receiving both medicines on the MAR chart.

Challenges and tips for adoption

Setting up electronic systems could be timely depending on IT knowledge and skills

Go through the process and outline the steps so other colleagues can follow the procedure

Communicate with the Care Home staff member i.e. nurse or carer to discuss the change

We found many were familiar with the system

Upon receipt of the photos these can be viewed clearly on the GP Screen to reconcile with the repeat medicines.

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