Using TestSafe information when providing pharmacist
services Standard Operating Procedure
Introductory comments
TestSafe data is an important addition to the range of information pharmacists have available to
them to ensure safe and effective use of medicines. However its use is still in its infancy and, as
yet, there are no firm best practice guidelines to guide pharmacists.
This SOP template is provided to help pharmacy proprietors document the initial use of TestSafe
information in their practices and introduce a quality improvement focus to the evolution of their
practice in the TestSafe era. It proposes criteria for the use of TestSafe information as a way of
ensuring pharmacists use the resource when providing care for those patients most likely benefit
initially. This will allow pharmacists to gain experience in the use of TestSafe information in a
relatively systematic fashion and over time to establish the most effective way to use TestSafe in
the pharmacy.
These starting criteria to consider accessing TestSafe are:
When dispensing prescriptions for;
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Or when;
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Patients known or suspected to be receiving prescriptions from multiple prescribers;
Patients who have been hospitalised in the past month;
All patients receiving medicines which require routine lab test surveillance of
therapy;
Patients new to the pharmacy who have a long-term condition; or
Any patient the pharmacist has reason to suspect be obtaining prescription medicines
from several pharmacies.
Consulting with a patient seeking an emergency supply of a prescription medicine.
Providing a Medicine Use Review
Consulting with a patient seeking a Pharmacist Only Medicine if one would normally
check the patient’s dispensary database record as part of the consultation.
Additionally, TestSafe information has a role to play in the delivery of Medicines Use Reviews,
and in consultations for Pharmacist Only Medicines.
To facilitate rapid evolution of the use of TestSafe information we propose a 3 monthly cycle for
reviewing and upgrading this SOP. This would ensure pharmacists reflect and build on their
experience in s systematic way whilst stopping the SOP from becoming inaccurate because
practice has changed over time.
As with the other template SOPs in this pack, it is designed to help you implement TestSafe with
a minimum of work. The process for using the template is straightforward. We suggest:
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4.
Read this template SOP,
Think about any changes you need to make to reflect the procedure you will operate in
your pharmacy
Work through the template making any changes needed
Finalise the SOP.
Using TestSafe Pharmaceutical Data Repository information when providing pharmacist services
«Insert Pharmacy name»
Document information
Date of Preparation:
24/3/09
Version number::
Standard
Operation
Procedure number:
«insert number»
Created by:
«insert name of person»
Authorisation date:
Next Scheduled review
___/___/______
___/10/2010
Authorised by:
Updated staff training date:
«Draft»
Staff training participants:
___/___/______
Standard Operating Procedure: Using TestSafe Pharmaceutical
Data Repository information when providing pharmacist services
Objectives
To ensure the pharmacy’s patients receive a high quality pharmacy service through best use of
data from the TestSafe Pharmaceutical Data Repository.
To ensure pharmacists employed by the pharmacy meet their ethical obligations to optimise
medicines related health outcomes for the patient, work cooperatively with other health providers
to optimise the health outcomes of mutual patients, and act to prevent harm to the patient.
Scope
This Procedure covers:
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Use of TestSafe data in the provision of dispensing services
Working with a TestSafe patient record which contains confidential data
Use of TestSafe data in providing other pharmacist services
The contribution of pharmacist service data to the TestSafe database
Process Stages
1.
Use of TestSafe data in the provision of dispensing services
TestSafe data is an important addition to the range of information pharmacists have available to
them to ensure safe and effective use of medicines. However its use is still in its infancy.
1.
2.
As the pharmacy is learning how best to use TestSafe, this SOP will be reviewed quarterly
and is expected to evolve as the pharmacy’s experience in using TestSafe increases and the
most efficient and effective ways to use the resource are identified.
Until the first review is completed, pharmacists will use their professional judgement and
discretion in using TestSafe data. It is appropriate to consider accessing the TestSafe
database when dispensing prescriptions for these types of patients:
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Using TestSafe Pharmaceutical Data Repository information when providing pharmacist services
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3.
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Patients known or suspected to be receiving prescriptions from multiple prescribers;
Patients who have been hospitalised in the past month;
All patients receiving medicines which require routine lab test surveillance of
therapy;
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Patients new to the pharmacy who have a long-term condition; or
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Any patient the pharmacist has reason to suspect be obtaining prescription medicines
from several pharmacies.
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Patients seeking an emergency supply of a prescription medicine.
When consulting TestSafe data, pharmacists will use the patient’s TestSafe record to
enhance the rigour of the pre-dispensing prescription check. Specifically the pharmacist
will look for:
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Any prescription medicines not recorded in the pharmacy database.
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Any relevant non-prescription medicines not recorded in the pharmacy database.
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Accessible lab test results which have a bearing on the patient’s regimen including the
medicines about to be dispensed.
The pharmacist will take any relevant TestSafe information into account in reaching the
decision to dispense or refer the prescription back to the prescriber. Similarly this
information will be factored into decisions on the content of patient counselling and any
discussion with the prescriber.
After each quarterly review the content of this SOP will either be revised or confirmed for
another quarter. This quarterly review cycle does not preclude an earlier, out-of-cycle
review if experience warrants it.
2.
Working with a TestSafe patient record which contains confidential data
1.
Pharmacists using TestSafe information must remember at all times this resource is a
record of dispensings. There is no certainty the patient is actually taking the medicine.
Pharmacists should be aware that patients may prevent sharing of information via
TestSafe. Pharmacists encountering patients with confidential records should ask the
patient to share the missing information to help the pharmacist ensure the prescription is
suitable and safe for the patient. They will need to use their professional judgement and
discretion in interpreting the information, if any, the patient provides.
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Use of TestSafe data in providing other pharmacist services
TestSafe data has considerable potential to support pharmacist consultations surrounding the use
of non-prescription or prescription medicines and the provision of MUR and other services from
the National Framework of Pharmacist Services.
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When providing an MUR service, the pharmacist will check the patient’s TestSafe database
record and take the information obtained into account in identifying any medicine use
problems and proposed solutions to them.
Interrogation of the TestSafe database will also form a part of follow-up MUR
consultations to ensure a complete assessment of the patient’s progress is made.
The dates of accessing TestSafe data must be recorded in the patient’s MUR record.
The MUR SOP will be updated to reflect these additions to practice.
When providing a pharmacist consultation or responding to a request for a Pharmacist
Only Medicine the pharmacist will consult the patient’s TestSafe record if the pharmacist
would normally review the patient record held on the dispensary system as part of the
consultation.
The pharmacist will factor the information obtained from the TestSafe record into
decisions made about the care of the patient.
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Using TestSafe Pharmaceutical Data Repository information when providing pharmacist services
4.
The contribution of pharmacist service data to the TestSafe database
1.
Submission of information on a patient’s use of Pharmacist Only Medicines to TestSafe
serves 2 purposes:
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It increases the comprehensiveness of the patient record available to pharmacists in
this pharmacy and to other care providers.
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It records a patient consultation associated with a pharmacist accessing TestSafe for a
reason not linked to dispensing a prescription. This will reduce the number of audit
requests for information about the reason for a pharmacist accessing TestSafe
information which is not linked to a dispensing.
In consequence, pharmacists must record any Pharmacist Only Medicine sale for which
they accessed TestSafe during the patient consultation in the dispensary software. When
recording these consultation it is important to record the patient’s NHI number if possible
to ensure the information is transmitted to TestSafe1. If the patient receives prescriptions
from the pharmacy it is likely the patient’s NHI will already be on record. If the
pharmacist accessed TestSafe as part of a consultation for a patient new to the pharmacy,
the patient’s NHI number will be shown on the TestSafe screen. It should be included in
the consultation record.
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Policy decision:
It is desirable for all Pharmacist Only Medicine sales to be recorded in the dispensary database to
maximise the usefulness of patient records and TestSafe information in medication management. It is not
essential to record Pharmacist Only Medicine sales in this way so long as an alternative record which
meets the pharmacist’s legal obligations is maintained in the pharmacy.
Responsibility
The Pharmacy Manager is responsible for maintaining this Standard Operating Procedure.
Review
This SOP will be reviewed by the pharmacy quarterly over the first year of use of the TestSafe
database. It’s content is expected to evolve as the pharmacy’s experience in using TestSafe data
increases and the most efficient and effective ways to use the resource for dispensing and other
services are identified . At the end of the first year of use the review period will be reassessed.
Next scheduled review:
1
July 2010
Dispensary software only transmits information about patients with recorded NHIs to TestSafe.
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