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  • Dealing with the virus in community pharmacies

    Has anyone any thoughts on how to deal with the volume of prescriptions if there are insufficient staff to work in the pharmacy?
    I thought to dispense for 2 hours (no interruptions, so no errors) open for 2 hours (to hand out medication and deal with enquiries). This repeated during the 8 hours we are open.
    Also perhaps not allow direct access to the pharmacy waiting room. Shut the front door and use our side access.

    My concerns are that if we have limited staff the dispensing process is slowed to a halt by having to constantly break off to answer the phone or deal with
    other requests.
    Delivery is not an option we are at capacity, neither is closing (we are professionals).
    How are the Italians managing?

  • #2
    Just received an email from my surgery. They will no longer accept written prescription requests on paper or by repeats on the white slip. All to be online or by phone.
    If schools do shut, then staff will be wanting to stay at home and thus counter staff will be decimated.I would expect a massive swing to hub and spoke for dispensing.
    johnep

    Comment


    • #3
      My plan for Monday after discussing with other pharmacists and in the light of some surgeries closing or removing their receptionists I will try and put in place as much of the following measures as possible:
      1) Remove all leaflets and anything else that can be handled by patients from public area;
      2) Wear gloves for handling money and prescriptions;
      3) Make up bleach solution in bucket according to WHO guidelines for cleaning;
      4) Clean keyboards every half hour using damp paper towel and soap with one person to a keyboard;
      5) Set alarm for staff to wash hands every half hour;
      6) Notice in window asking anyone with dry cough, fever or visited a Category 1 country eg Italy, China to phone surgery or NHS24 and go straight home and stay there till further instructions from NHS;
      7) All doors, handles, light switches, benches, tables to be regularly cleaned
      8) Ask staff to keep to 2 metre distancing from customers and each other where possible and try not to touch face or eyes
      8) Delivery driver to carry sanitizing gel and wipe door bell before ringing leaving medicine on doorstep and watch until patient picks it up;
      9) Anybody in the pharmacy with a cough or fever will have to go home and company will need to send new staff if available. One pharmacist has started checking all staff every morning with a Braun Heat Seeking Thermometer but I don't have one;
      10) I will ask doctors to let as many prescriptions as possible be collected by driver;
      11) No waiting in shop by patients for prescriptions.

      If anyone thinks of any further measures I can take please let me know. Or if you think some measures are not suitable.

      Comment


      • #4
        We are using isopropyl alcohol to wipe surfaces, keyboards and door handles rather than soap.

        Comment


        • #5
          Isopropyl alcohol is difficult to obtain?

          Comment


          • #6
            Standard methylated spirit may be OK? I have got some Vyborova vodka I could use. is it high enough in alcohol?
            johnep

            Comment


            • #7
              Vyborova vodka na zdrowie!
              Doing anything with it out of the intended purpose would invalidate the warranty as well.

              Surgical spirit (can you still get that?)
              I get a few bottles of Alcool from the supermarket first aid section when I'm in France.
              Will use that when the gel runs out.
              47 BC : Julius Cesar : Veni Vidi Vici : I came, I saw I conquered.
              2018 AD : Modern Man : I shopped, I clicked, I collected.
              How times change.

              If you find you have read something that has upset or offended you an anyway please unread it at once.

              Comment


              • #8
                John,

                60% and above is enough

                Comment


                • #9
                  Originally posted by Evelyn87 View Post
                  John,

                  60% and above is enough
                  Could you distil you own...
                  It is for hand cleansing .... Honest it is!
                  47 BC : Julius Cesar : Veni Vidi Vici : I came, I saw I conquered.
                  2018 AD : Modern Man : I shopped, I clicked, I collected.
                  How times change.

                  If you find you have read something that has upset or offended you an anyway please unread it at once.

                  Comment


                  • #10
                    Those sound like good measures to keep everyone as safe as possible. My biggest concern is running out of some of these products. Paper towels maybe hard to obtain as tissue and loo roll have been impossible to order for the shop. Hopefully kitchen roll is still available in the supermarkets.

                    Also I am concerned how me may be expected to implement Matt Hancocks possible future statement that all over 70s self isolate for four months. Perhaps the PSNC could negotiate a delivery fee for over 70 and any self isolating person.

                    Comment


                    • #11
                      After I retired, I did locums until I was 76. So, these days I would be unable to do so. Likewise locum Drs. The latter would make it even more difficult to get an appt.
                      johnep

                      Comment


                      • #12
                        Originally posted by Gordon Mackenzie View Post
                        My plan for Monday after discussing with other pharmacists and in the light of some surgeries closing or removing their receptionists I will try and put in place as much of the following measures as possible:
                        1) Remove all leaflets and anything else that can be handled by patients from public area;
                        2) Wear gloves for handling money and prescriptions;
                        3) Make up bleach solution in bucket according to WHO guidelines for cleaning;
                        4) Clean keyboards every half hour using damp paper towel and soap with one person to a keyboard;
                        5) Set alarm for staff to wash hands every half hour;
                        6) Notice in window asking anyone with dry cough, fever or visited a Category 1 country eg Italy, China to phone surgery or NHS24 and go straight home and stay there till further instructions from NHS;
                        7) All doors, handles, light switches, benches, tables to be regularly cleaned
                        8) Ask staff to keep to 2 metre distancing from customers and each other where possible and try not to touch face or eyes
                        8) Delivery driver to carry sanitizing gel and wipe door bell before ringing leaving medicine on doorstep and watch until patient picks it up;
                        9) Anybody in the pharmacy with a cough or fever will have to go home and company will need to send new staff if available. One pharmacist has started checking all staff every morning with a Braun Heat Seeking Thermometer but I don't have one;
                        10) I will ask doctors to let as many prescriptions as possible be collected by driver;
                        11) No waiting in shop by patients for prescriptions.

                        If anyone thinks of any further measures I can take please let me know. Or if you think some measures are not suitable.
                        A lot of places have stopped accepting cash. You could do that.

                        Asking staff to clean their mobile phones with soap and water every day isn't recommended by the WHO or any government I know of, but is probably a really good idea. It is one of the biggest contact surfaces people will touch in their house and transport and other places all day long. You could even let staff clean their phone at work, on work time to make sure they do it.

                        In Italy it's widely been for people to wear FFP3 masks, but particularly pharmacies and other shops. If you have a particularly clean environment like above, you could implement this as there's not so much risk of putting on a mask and transferring things closer to your mouth/nose/eyes. FFP3 masks do not protect against the virus completely, but standard worn by health workers. Due to using electrostatic forces when they get damp they lose effectiveness. There are also issues around fit and cross contamination. In Italy people have been wearing them for hours a day, they will lose effectiveness, but it's better than nothing. This is for one for the UK but if you're going to do it, do it sooner rather than when 200 or 300 people a day start dying (probs 1-3 weeks' time). In China, if you believe the figures 3300 health workers got the coronavirus, but only 13 died.

                        It's also not just what your staff do at work, it's what they do at home. It's a 24/7 lifestyle for the next year and a half. Most of these measures need implementing at home.

                        Comment


                        • #13
                          Originally posted by Stuart Reeve View Post
                          Has anyone any thoughts on how to deal with the volume of prescriptions if there are insufficient staff to work in the pharmacy?
                          I thought to dispense for 2 hours (no interruptions, so no errors) open for 2 hours (to hand out medication and deal with enquiries). This repeated during the 8 hours we are open.
                          Also perhaps not allow direct access to the pharmacy waiting room. Shut the front door and use our side access.

                          My concerns are that if we have limited staff the dispensing process is slowed to a halt by having to constantly break off to answer the phone or deal with
                          other requests.
                          Delivery is not an option we are at capacity, neither is closing (we are professionals).
                          How are the Italians managing?
                          The Italians aren't coping. Long, long queues. In terms of delivery a lot of this is done by the civil protection volunteers. In the UK this will probably end up being done by volunteers too.

                          I would also ask your staff for advice on closure mechanics and issues. As a pharmacist you will have occasionally dealt with the backlog from a closure, but you likely won't ever have seen one. I worked through quite a few closures as a staff member and some of the pharmacists/managers little idea of the issues caused at the time.

                          I would say the side access is a good idea out of personal experience of this sort of thing.

                          Have a script/policy for the telephone for the lower priority calls or just the sheer timewasters. Agree with all your staff. Your priority isn't to answer the phone.

                          Comment


                          • #14
                            Some good points raised there.

                            Plenty of ventilation.

                            100 hour pharmacies using the hatch so no one entering the pharmacy. Payments being taken by contactless and receipt given.

                            No new dosette requests taken and those on existing MCA's being reviewed and sent in original packaging if patient can manage.

                            Paracetamol being spilt from 100 POM packs, some RPS guidance available.

                            Nominations being more tactful so further scripts being assembled promptly so patient's not stood around waiting.

                            Every customer being screened when first greeted at a distance. Some pharmacies have put tape so customers are not allowed near the counter.

                            Supervision done as unsupervised.

                            Comment


                            • #15
                              Patients should not be allowed to stand around in the Pharmacy. Tell them to come back or wait outside.
                              I have obtained toilet rolls etc from Hospitality Suppliers. At moment they are very grateful for any orders. We have enough paper goods for a year. At a very good price.
                              johnep

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