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the newsletter of Manrex Pty ltd ­ weBsterCare · issue no. 110 · feBruary 2009 · © weBsterCare 2009

Medication chart as prescription

by Gerard Stevens

Gerard Stevens saying hello there, Animal news: Matt and Tan have a kitten, named Cindy. 15 weeks old, Cindy is learning to tolerate her new full-time carer family. They are still on trial, but the meat and mince are good. This time round our Webstercare Christmas party had a Las Vegas theme. I dressed up with a shiny flashy coat. All I needed was a bow tie that lit up and span around. There were some great dress-ups, including a Vegas bride. The yellow name tag on the Unit Dose 7 folder has been released. I had good feedback from a nurse at the nursing home where my mother now lives. She told me, `Great idea. Makes it so easy.' Saw Andre Rieu. Must book early and get closer next time. I thought he was taller than that. Beautiful music, though. Jessica says greetings to you all, and woof it up in the New Year. Keep on Webstering.

More and more doctors are even create a life-threatening avoiding working with aged care situation.' homes because they find so It is hard to get more serious many complications writing and than that. If doctors can come in following up prescriptions. In the and write up the chart they will community the patient visits the know they have completed the doctor for scripts. In aged care requirement for the PBS. Once homes the pharmacy follows up the chart is signed, medication doctors for so many scripts which can then be continued for three all run out at different times. months. That will certainly What we need is to streamline relieve the pressure on everybody the system to reduce involved. 93% of doctors the possibility of We did a survey and 94% mistakes. on this--93% pharmacists In my pharmacy of doctors and supported the we service a large 94% pharmacists medication number of aged supported the chart as care homes. There medication chart as prescription. are sometimes prescription. differences between what the Plans doctor writes on the medication The Pharmacy Guild and the chart and the information we Department of Health & Ageing receive on the prescription. Since have been reviewing the current 2004 we have been presenting legislation. They asked for the case for the medication chart submissions, which were due being used as prescription. by the 21st January 2009. We Life threatening What can happen as a result of a doctor not writing the script at the correct time? A quote from a current discussion paper: `The resident may not have enough medications for the course of treatment prescribed which may affect their health condition and

hope that by now they have begun putting plans in place to get this problem straightened out. With the medication chart as prescription we believe that GPs will come back to the aged care area. There is more work to be done, but the future looks positive.

manrex pty ltd ­ WeBSterCare · aBn 63 074 388 088 · 17-19 mOOre Street, leICHHardt nSW 2040 tel: (02) 9563 4900 · Fax: (02) 9563 4955 · Free Call: 1800 244 358 · emaIl: [email protected]

did You Know?

thiS month -- drY eYeS

manrex continuinG education SerieS

Chronic dry eye syndrome is a serious condition that can diminish the quality of life of an older person. It is very common in older people. In a large Australian study conducted over many years, the Blue Mountain Eye Study (2002), symptoms of dry eye were reported in nearly 60% of people over 50. known to be associated with dry eye syndrome. These include many wellknown and frequently prescribed medications such as nonsteroidal anti-inflammatory drugs (NSAIDs), antidepressants and antipsychotics, antihypertensive agents, and anxiolytics and benzodiazepines. gel (hypromellose with carbomer 980), Poly-Tears® (hypromellose with dextran), Tears Naturale® eye drops (hypromellose with dextran), Systane® eye drops (polyethylene glycol 400, propylene glycol), Liquifilm Tears®, PVA Tears®, Vistil® eye drops 1.4% (polyvinyl alcohol), PVA Forte®, Liquifilm Forte®, Vistil Forte® eye drops 3% (polyvinyl alcohol). Preservative-free eye drops are particularly beneficial for the elderly, as a preservative can contribute to corneal damage. A number of these products are available on the PBS for persons with severe dry eye syndrome who are sensitive to preservatives in multi-dose eye drops: Viscotears® eye drops (carbomer 980), TheraTears® eye drops 0.25% (carmellose sodium), Cellufresh® eye drops 0.5% (carmellose sodium), Celluvisc® eye drops 1% (carmellose sodium), TheraTears® gel 1% (carmellose sodium), Bion Tears® eye drops (hypromellose with dextran, Systane® eye drops (polyethylene glycol 400, propylene glycol). Paraffin is available as a lubricating agent as an eye ointment (Poly Visc®, Duratears®, Ircal®, Lacrilube®). Such ointments are generally used only at bedtime, as they can impair visual acuity and blur vision.

Symptoms

The symptoms of dry eye syndrome include: stinging or burning, itchiness (particularly in the corners of the eyes), occasional blurred vision, redness, tired eyes (a feeling like you need to close the eyes), mucus around the eyelids, particularly upon waking, a feeling of grittiness, or the sensation of something foreign in the eye (like an eyelash or a grain of sand). The quality of tears is compromised, so the eye gets more inflamed, causing more blinking and tearing. Symptoms are generally worse in the morning due to less blinking and tear production during sleep. Dry eye disease can lead to damage to the surface of the eye (the cornea), atrophy of the lacrimal glands, and increased eye infections. Eventually, it may cause permanent damage to the eye and impairment of sight.

treatment

There is no cure for dry eye, but the condition can be successfully managed. Treatment options may aim to increase tear production, maintain tear film volume or prevent excess loss of tears. Firstly and most simply, sufferers should be encouraged to blink more often. Blinking stimulates tear production and keeps the eye lubricated. As the condition progresses, most people benefit from eye drops or gels to lubricate the surface of the eye. Many over-the-counter, nonprescription products, known as artificial tears, are available. Eye drops and lubricants can be used as often as necessary to relieve symptoms. Non-prescription eye drops need to be administered at least four times daily. In residents with moderate to severe dry eye, more frequent use of unpreserved lubricants is recommended, with drops or gel during the day followed by ointment at night. Several preparations are available under the Pharmaceutical Benefits Scheme (PBS), but restricted to people with severe dry eye syndrome. They include GelTears® lubricating gel (carbomer 980), Viscotears Liquid® Gel (carbomer 980), Refresh Tears Plus® (carmellose sodium), Refresh Liquigel® eye drops (carmellose sodium), In a Wink Moisturising® eye drops (hypromellose), Genteal® eye drops 0.3% (hypromellose), Methopt® eye drops 0.5% (hypromellose), Genteal®

causes of dry eye

Dry eye syndrome becomes more common as we age, since tear production slows with advancing age. Women are more prone to dry eye syndrome than men, thought to be related to changing hormone levels. Other factors that appear to contribute to dry eyes include air-conditioning or excessive heating and irritants such as cigarette smoke. Eye surgery for cataracts may also cause decreased tear production, and therefore dry eyes. A number of medications are

cautions

Eye drops that contain other ingredients such as vasoconstrictors (eg Visine®) are not recommended for regular use, due to risk of rebound injection of the eye. All eye preparations should be discarded four weeks after opening to minimise the risk of bacterial infections. Bottles should not be shared between residents.

conclusions

Dry eyes are a common source of discomfort in the elderly. Older persons with dry eyes should have a comprehensive review of their medications. Residents should be encouraged to blink more often, consume less caffeine, increase their water intake and stop smoking. While dry eyes do not usually affect vision, left untreated it can. Treatment will not cure the disease however it will improve quality of life and reduce the risk of permanent damage.

Words of Wisdom

I hope to be the kind of person my dog thinks I am. There comes a time when you should stop expecting other people to make a big deal about your birthday. That time is age 11. Confession is good for the soul, but bad for your career. A hen is an egg's way of producing another egg. Time is a great healer, but a terrible beautician.

handlinG ceaSed medication the webStercare waY

Unit Dose 7, safe, easy, suitable for all staff

Customers say Unit Dose 7 is the safest medication management system they have ever used. That is because it gives you so many useful features that make the medication round easy and safe. One type of medication in each blister reduces errors. Staff who are approved to administer medications can do it with confidence. 1. Ceased Medication UD7 Dual Ceased Label When the ceased label is placed over the relevant blister it means that just one medicine is changed. You can keep using the other medications in the pack until the end of the week. This greatly reduces wastage of medications. The ceased label can be applied as soon as the doctor prescribes the change to make sure the

Medical neWs froM all over

medication is not continued. It stops the inconvenience of returning medication to the pharmacy to be re-packed. Cutting down waste of medications means less cost to residents. With the UD7 ceased label you can be sure when a medication has been ceased and should not be administered. 2. Ceased Trigger Label Part of the UD7 Dual Ceased Label is the Ceased Trigger Label for the medicines chart. This is placed on the medication chart beside the ceased medicine. You can see that the chart and the medication pack are both correct. This simple system guarantees that the doctor's instructions are applied right away. Safely and with no wastage of continuing medications.

Regular tea consumption can lead to lower risks of cognitive decline, according to the American Journal of Clinical Nutrition. The researchers conclude that because tea is cheap, non-toxic and widely consumed, it has a great potential in promoting cognitive health and perhaps delaying the onset of dementia. Put the kettle on. Hearing impairment is common in adults with diabetes. Diabetes seems to be an independent risk factor for the condition, according to a study published on the website of Annals of Internal Medicine. Says Kathleen E. Bainbridge, PhD, the study's lead researcher, `The hearing loss we detected did not seem to be caused by other factors such as exposure to loud noises, certain medicines and smoking.' The researchers analysed data from 5,140 adults aged 20 to 69. Hearing impairment was more prevalent among adults with diabetes. The Alzheimer's Association has published a guideline that has been of great help to nurses and carers dealing with Alzheimer's patients. The 10 Absolutes: Never argue; instead, agree. Never reason; instead, distract. Never shame; instead, distract. Never lecture; instead, reassure. Never say `remember', instead `reminisce'. Patients diagnosed with colon cancer who had abundant vitamin D in their blood were less likely to die during a follow-up period than those who were deficient in the vitamin, according to a new study by scientists at Dana-Farber Cancer Institute. The authors note that previous research has shown that higher levels of vitamin D reduce the risk of developing colon and rectal cancer by about 50%. But the effect on outcomes is still not known.

Webster-pak LV

Why has Webstercare been working on a pak that caters for low vision clients? Because by the time they Australia offices recently we noticed that they used a lot of reverse text in their signage. They explained that it is easier for a person with low vision to make out white text against a black background. Christina Hinchliffe, an occupational therapist with Vision Australia, said: `It increases the contrast between the tablets and the background and the lettering is much bigger than the normal pak.' Upper and lower case type also makes it easier to see dosage times and days of the week. This helps people to take their medications as prescribed. They can easily tell whether it has been taken even though they have difficulty seeing. If you have a client with low vision, ask your pharmacist for this new Webster-pak to see the difference it will make. Call Webstercare on 1800 244 358 or email [email protected] for more information and a sample Webster-pak LV.

offSider

reach 40, many people become short-sighted, the eyes are ageing. When we visited the Vision

stress stoppers

Take two after meals with water I had a medical appointment for 8.30, which is 10 o'clock doctor time. I've got a memory like a, like a...what's that thing called? One thing vampire children are taught is, never run with a wooden stake. Why did nature create stock analysts? To make weather forecasters look good. When people tell me a book is a real page turner, I always think, `I know how books work.' I was passing the cemetery there were four pall-bearers walking around with a coffin. Three hours later they were still walking around with it. I thought to myself, `These guys have lost the plot.' My favourite thing since getting married is not having to plan a wedding.

Are you wanting Websterinformation? In need of TLC? Longing for that moment in your busy life when troubles melt away like fairy floss on a hot afternoon? You need Zoe Diplos, the original velvet fist in the velvet glove. Zoe says: In these days of real estate fixation--a few things you don't want to hear from the agent about your new home on settlement day. · I think unexplained crop circles add a unique flair to any garden. · Yes, the last owner did donate the house to the Hell's Angels, but I'm told that the judge has ordered them not to come within 100 metres. · Even if there was a full-scale mudslide, it is unlikely that it would reach as far back as your property. · It is quite common for cockroaches to grow that big even when not in the presence of radioactivity. · Did you know that the punk band Pandemonium hold their practice sessions next door? · It is true that they died in the house, but the police were never actually able to prove it was murder. · You can barely hear the sheet metal factory at night.

SiGnoff

Gerard Stevens signing off the first edition for 2009 with a deep and meaningful thought that I reckon applies to all of us: Smart is when you only believe half of what you hear-- brilliant is when you know which half.

manrex, webStercare, webSterSYStem, unit doSe 7 and webSter-paK are reGiStered trade marKS of manrex p/l webStercare.

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