Catheter, Stoma & Skincare Formulary

Transcription

1 Contents: Catheter, Stoma & Skincare Formulary Version 11 October 2017 Catheter products Stoma accessories Skin care products Community nurses/district nurses: Items not listed in this formulary are non-formulary. If needed for a particular patient, an exception reporting form should be completed (available on SCH website). Catheters Initial catheterisation: the catheters listed in this formulary can be ordered by community nurses through NHS Supply Chain for initial use only. Long term catheter use: a prescription should be requested from GP practice. Stoma and skin care products Stoma products: request a prescription from GP practice. Skin care products: (excluding stoma skin care products) patients to be advised to purchase skin care products GP practice staff Wherever possible formulary items should be prescribed. If a non-formulary item is required, an exception reporting form should be completed (available on WSCCG & IESCCG website)

2 Catheter Products Appliance Product details Gauge/ CH size 1. Long-term catheters (use for up to 12 weeks) Bard Biocath Aquamatic Hydrogel Coated Bard All Silicone Male10ml Prefilled Female10ml Prefilled Cost per pack (pack size) (1) (1) Comments 1 st choice Male10ml (1) 2 nd choice or patients with latex Female10ml (1) allergy Bard Biocath Hydrogel Paediatric (1) Paediatric only Coated 5ml 2. Single-use pre-lubricated intermittent catheters (single use) Coloplast Speedicath Wellspect Healthcare LoFric Primo Rochester Hydrosil Gripper Male (30) Female (30) Paediatric (30) Male (30) Female 20cm (30) Paediatric (30) Male (30) Paediatric (30) Rochester Hydrosil Rose Female (30) 3. Catheter maintenance solutions Sodium chloride 0.9% OptiFlo S Bard 3.30 (50ml) Uro-Tainer NaCl 0.9% Solution G OptiFlo G (Suby G) Uro-Tainer Twin (Suby G) Braun Bard Braun 4. Catheter valves (change every 7 days) 3.45 (50ml sachet) 3.50 (50ml sachet) 4.72 (2 x 30ml sachets) Flip-Flo catheter valve Bard BFF (5) 5. Belly bag (use for up to 28 days) B litre (1) For short term use by healthcare professionals For patient selfcatheterisation For patients requiring a more flexible catheter Used to unblock a catheter For patients prone to encrustation. Used as regular maintenance to prevent blockage For patients where a leg bag cannot be connected Usual quantity to order 1 catheter every 4-12 weeks Approx. 4 packs per month if using regularly 3-4 times/day When required. Should not be on repeat prescription 4 valves per Month 1-2 bags per month

3 Appliance Leg Drainage Bags Product details Gauge/ CH size Cost per pack (pack size) Comments Usual quantity to order Qufora Leg Bags Use for 7-10 days Bard Uriplan leg bag Use for 5-7 days For use only in exceptional circumstances e.g. paediatric use 500ml 500ml 500ml 750ml 750ml 750ml 350ml Direct inlet,5cm Short tube 10 cm Long Tube 30cm Direct inlet,5cm Short tube 10cm Long tube 30cm Direct Inlet 30cm tube (10) To maintain a closed system overnight leave the leg bag connected and connect a night bag to the leg bag. All Qufora leg bags can be drained at degrees, which is an advantage for people with poor manual hand dexterity. All long tube leg bags have spare connectors, but cutting tubing for adjustment is not recommended To maintain a closed system overnight leave the leg bag connected and connect a night bag to the leg bag Approx. 1 box every 2-3 month Approx. 1 box every other month 7. Night drainage bags Qufora single use 2 litre 90cm tube 2.05 (10) Qufora drainage bag with 120cm 2 litre with tap outlet inlet tube 8. Incontinence sheaths (use for 1 3 days) Rochester Medical Ltd Clear Advantage Silicone sheath 9. Accessories Leg bag holders Bard Ltd Urisleeve G-strap Simpla G-Strap 9.57(10) Small 23mm (30) Medium 28mm (30) Standard 31mm (30) Large 35mm (30) Extra large 40mm (30) Small 24-39cm 8.00 (4) Medium 36-55cm 8.00 (4) Large 40-70cm 8.00 (4) Adult (5) Abdominal (5) First choice Single use Change every 7-10 days. Washable 3 boxes per month 1 box every 2-3 months 1 box (may not be required every month)

4 Stoma Accessories Product Quantity Price Comments Usual quantity to order 1. Barrier films (used with each bag/flange change) 3m Health Care Cavilon No Sting Barrier Film Pump Spray Peel-Easy no sting Wipes Salts Barrier Film Wipes (formerly peri-prep) 2nd 2. Skin fillers Hollister Adapt Paste Dansac Soft Paste Oakmed Paste 2 nd 3. Sore Skin Accessories 28ml Used on skin that is broken, sore or weepy to promote healing. For selected patients only (diabetics, palliative patients and difficult stomas) 60g g g 7.69 Orabase paste s103 30g 2.16 Coloplast Brava Powder Orahesive Powder 25g g 2.50 OstoSEAL Protective Powder 50g 4.92 Ilex Skin Protectant 2 nd 57g Discharge solidifying agents Opus AbsorbaGel 150g Used as a sealant for creases and crevices Used to heal around stoma For wet skin, short term use 1 box/bottle per month 1-3 per month Not for regular use 1-3 per month Opus Deogel 200ml 8.05 Opus Deogel Sachets 2 nd Respond Ostosorb 5. Flange extenders 50 sachets 150 sachets Absorbs effluent Mainly for ileostomies Higher Quantity Option 1 per month Salts Flange Extender with Aloe Coloplast Brava Elastic Tape Dansac X-tra Strips Extends adhesion of bag. Especially if patient has a hernia 1-2 boxes per month Ostomart Astoa

5 Product Quantity Price Comments Usual quantity to order 6. Moudable washers Salts Barrier Rings Thins Salts Barrier Rings Standard Used on problem Hollister Adapt Barrier Rings stomas An adhesive 48mm sealant to fill Pelican Cohesive Slims creases/crevices around Small 2 nd stoma Pelican Cohesive Seals Small 2 nd Dansac TRE Seal 30mm 2 nd Adhesive Removers (Sprays/Wipes) (used with each bag/flange change) 1-3 box per month Stocare Spray 50ml 6.00 Opus Lift Plus with Citrus 50ml 6.40 Dansac Easy Spray Adhesive Remover Spray 2 nd Respond Ostomart Ostopeel 2 nd 50ml sachets 9.04 Used each time stoma bag is changed Sprays are more cost effective than wipes 1-3 cans per month (depending on frequency of bag changes) Stocare Wipes 30 wipes 8.60 Salts Wipeaway Plus 2 nd 30 wipes 9.33 Restrictions Stoma support garments and clothing - Level 3 Following specialist recommendation only (Level 1 and 2 garments are OTC items) Deodourants, cleansers and soaps are not clinically necessary and prescribing of these products will not be supported in Suffolk. Please refer to CCG Website for Ostomy Accessories List - Prescribing Indictor for further prescribing guidance Contacts: Ipswich & East: Suffolk GP Federation Community Stoma Nurses: Debbie Cooper , Sarah Skingley West Suffolk Community Stoma Nurse: Bernadette Ambrose Ipswich Hospital Trust Stoma Nurses Sharon Stopher, Sally Power West Suffolk Hospital Stoma Nurses Katie Lloyd, Ann Hubble

6 Skincare (OTC) = Item is available for patients to purchase over the counter Product 1. Soap Substitute Emulsifying ointment (OTC) Zero AQS cream (OTC) Dermol 500 Lotion (OTC) 2. Emollients (Leave on preparations) Only if infection present or frequent complication Where required in Primary Care for patients with chronic skin conditions e.g. psoriasis or eczema, prescribe larger tubs i.e. 450/500G only. Where use is intermittent, smaller packs are required or simply dry skin - these are available to purchase. Lanolin based products e.g. E45 or Exocream are not routinely recommended for chronic skin conditions due to allergy risk Epimax (OTC) lsomol gel (OTC) Zeroderm ointment White soft paraffin 50% / liquid paraffin 50% ointment (OTC) Emollin spray Ultrabase cream (OTC) Dermol cream (OTC) Aveeno cream and lotion (OTC) 3, Emollients with urea imuderm (OTC) Balneum Plus cream (OTC) Eucerin Intensive lotion Calmurid cream (OTC) Dermatonics Once Heel Balm cream This is equivalent to Diprobase Cream. Can be used as a soap substitute. Low fire risk This is equivalent to Doublebase. Low fire risk. This is equivalent to Hydromol ointment (lanolin free) and Epaderm ointment. High fire risk High fire risk Usually only on advice from specialist where: Sore and inflamed skin so unable to spread cream/lotion Where access to the affected site is difficult High fire risk Low fire risk Only if infection present or is a frequent complication Usually only on advice from specialist Restricted to paediatric use where they are unable to tolerate other emollients; ACBS borderline substancefor patients with endogenous and exogenous eczema, xeroderma, ichthyosis and senile pruritus associated with dry skin only Equivalent to Balnuem cream Usually only on advice from specialist Usually only on advice from specialist Usually only on advice from specialist Inpatient use only on advice from specialist

7 4. Emollient bath and shower preparations Soap substitutes available OTC include ZeroAQS, Dermol 600 bath emollient may be used if recommended by a specialist for infected atopic eczema for 14 days Aveeno bath oil may be recommended by a specialist where there is an issue with paraffin based products There is a lack of good evidence to support the prescribing of these items. These should only be prescribed at the request of secondary care in exceptional circumstances. Patients should be encouraged to wash with soap substitutes Usually only on advice from specialist Restricted to paediatric use where they are unable to tolerate other emollients; ACBS borderline substance- for patients with endogenous and exogenous eczema, xeroderma, ichthyosis and senile pruritus associated with dry skin 5. Barrier Preparations Conotrane cream (OTC) Sudocrem (OTC) Proshield Plus skin protective cream & spray Clinimed LBF Barrier film applicators: 1ml and 2ml film applicators Barrier film 30ml spray Primary Care only- use 1st line Second line use only (Contrane tried and failed) For severe moisture excoriation 6. Pressure sore prevention 10x10x0.3 cm x10x1.2 cm x20x0.3 cm Aderma Pads 30x5x0.3 cm x2.5x0.3 cm 5.38 Heel Standard Heel Extra Large Sacrum/Ankle Wrap x2.5x0.3 cm x5x0.3 cm 6.32 Kerrapro 10x10x1.2M cm x10x0.3 cm 4.20 Devon Positioning Products Heel Sacrum/Ankle Foot & Heel protector (pair) 4.80 Devon Utility Pad 8.45 Not for use as seating pressure relief

8 Silk Garments Product Size Price DermaSilk: Infant Facial Mask Child Teen Size Adult Size months months months Body Suit 9-12 months months months months years Briefs 3-6 years years years years Shirt Roll Neck 7-8 years years Adult Small XXL Shirt Round Neck Adult (Male) Small XXL Adult (Female) Small XXL Tubular Sleeves (pair) 33cm long cm long months months months months Leggings (pair) months months months years Adult (Male) Small XXL Adult (Female) Small XXL Small Child Medium Child Gloves (pair) Small Adult Medium Adult Large Adult years Pyjamas (set) 5-6 years years years Heel-Less Undersocks (per 2 pairs) Standard Length Longer Length Child Child Child Undersocks (per 2 pairs) Adult 5½ - 6½ Adult 7-8½ Adult 9-10½ Adult

9 Process for Reviewing Formulary Products IS THE PRODUCT ON FORMULARY? NO YES DOES THE PRODUCT NEED TO BE ADDED? DOES THE PRODUCT NEED TO BE REMOVED? YES NO YES NO COMPLETE THE EXCEPTION REPORTING FORM SECTIONS 1 & 3 COMPLETE SECTIONS 1 & 3 OF EXCEPTION REPORTING FORM COMPLETE SECTIONS 1 & 2 OF EXCEPTION REPORTING FORM NO ACTION REQUIRED ATTACH TWO COMPARATIVE CONTROLLED STUDIES/BEST SUPPORTING EVIDENCE SEND TO JAN MURTON, CHILTON WAY, STOWMARKET OR TO JANET.MURTON@SUFFOLKCH.NHS.UK FORMS WILL BE DISCUSSED AT TISSUE INTEGRITY & APPLIANCE GROUP (TIAG) MEETING (HELD EVERY 3 MONTHS) A DECISION WILL BE MADE AT TIAG MEETING DECISIONS WILL BE AVAILABLE ON THE SCH INTRANET