Patient Group Direction for the supply of Timodine Cream by community
pharmacists for the management of babies with nappy rash.
Clinical condition
Clinical need which this PGD is intended
to address
Relevant National Guidance
Criteria for inclusion for treatment
Criteria for exclusion for treatment
Action to be followed if patient excluded
Staff characteristics
Qualifications required
Additional requirements
Requirements for continuing training and
education
MAS/PGD04/OCT06/ISSUE004
Treatment of babies with nappy rash.
Joint Formulary 4th Edition. RCHT, PCT, and GPs
within Cornwall and Isles of Scilly. June 2003. The
latest edition of the BNF.
Patient must be registered with a Doctor in the area
(see separate sheet) or be a Temporary Resident
Children from 0 to 3 years with parental/guardian
consent.
The rash appears red, with pinpoint papules or
pustules over the napkin area. Skin folds can be
affected if candidal infection is present.
The child must be present at the consultation.
Allergy to any of the components in Timodine Cream.
Refusal of treatment by parent/guardian.
Children over 3 years of age.
Already applying a dermatological preparation that
contains any of the active ingredients in Timodine
Cream.
Refer to GP for further advice and treatment.
Registered Community Pharmacist
Attendance at a specific training course organised by
Cornwall and Isles of Scilly PCT and the satisfactory
completion of post workshop material for the
treatment of nappy rash and other childhood skin
conditions.
Regular review and update for the treatment of
babies with nappy rash and other childhood skin
conditions.
Patient Group Direction for the supply of Timodine Cream by community
pharmacists for the management of babies with nappy rash.
Treatment
Name of medicine
Method of obtaining supply of medicine
Legal status of medicine
Dose of medicine
Method of administration
Total number of doses to be supplied
Special
precautions
concerning
concurrent medication
Follow up treatment which may be
required
Advice to be given to the patient before
or after treatment
Treatment records to be completed
Audit trail
MAS/PGD04/OCT06/ISSUE004
Timodine Cream (Hydrocortisone 0.5%, nystatin
100,000 units/g, benzalkonium chloride solution
0.2%, dimeticone ‘350’ 10%)
From Pharmacy refrigerator stock, stored between
2 to 8C
POM
Apply three times daily at nappy change for seven
days.
Topical
1 x 30g tube.
Apply Timodine cream to nappy area before using a
barrier cream.
Advise parent/guardian to discuss with Health Visitor
if the nappy rash does not improve or take child to
GP if condition gets worse.
Discontinue treatment if the rash appears worse and
contact GP for advice.
Read the patient information leaflet provided.
Store the cream in the refrigerator between use.
Wash hands at the start and finish of the procedure.
Wash with warm water and pat dry thoroughly
affected napkin area of baby and apply a small
amount of cream to area.
Dress in a clean nappy.
Change nappy as soon as wet or soiled.
If child is running a temperature or unwell advise
parent to make an appointment to see their GP.
Name, address and DOB of patient. Date of supply.
GP name and surgery. Signature of Pharmacist
supplying Timodine Cream. Batch number and expiry
date of product. Completion of relevant checklist.
Completion of prescription charge/exemption form by
parent/guardian.
Entry made on computerised patient medication
records.
Label product with directions for use and “Supplied
under Patient Group Directions”.
2 copies of the above information to be retained.
1 copy retained by Pharmacy for 2 years.
1 copy to be sent to GP within 48 hours of supply of
Timodine Cream for inclusion in patient’s notes.
2 copies of the Audit Form to be made. Retain one
copy in the pharmacy and send one to the
Prescribing Team, Sedgemoor Centre for payment.
Paperwork to be forwarded to office once each
month.
Patient Group Direction for the supply of Timodine Cream by community
pharmacists for the management of babies with nappy rash.
Management
PGD developed by
Authorising Pharmacist
Cornwall and Isles of Scilly Primary Care
Trust, Prescribing Team.
Rosalind Palmer
Prescribing Adviser,
Cornwall and Isles of Scilly Primary Care
Trust.
Signature of Authorising Pharmacist
Date of PGD
Date this PGD becomes due for review
August 2008
Approved by:
Name
Cornwall & Isles of Scilly PCT
Nominated Doctor
Cornwall & Isles of Scilly PCT
Pharmaceutical Adviser
MAS/PGD04/OCT06/ISSUE004
Signature
Customer Details
Name
Address
Check List for Management of Nappy Rash
Yes
No
Yes
No
Patient is present at consultation
Parental consent obtained for child under 16years
Nappy Rash seen.
Criteria for exclusion for treatment checked and none apply.
(See table below)
Consent form completed by Pharmacist & signed.
Parent/guardian to sign form.
PMR completed and Timodine Cream labelled as per PGD
Treatment regimen explained and understood
Advice given should condition not improve.
Follow up advice given
Pharmacist’s Signature
Date.
Criteria for exclusion for treatment
Allergy to any components of Timodine cream
Already applying a dermatological preparation containing
hydrocortisone or nystatin
Child is over 3 years old.
If the parent answers yes to any of the above criteria please refer to GP.
MAS/PGD04/OCT06/ISSUE004