Catheter & Accessories Formulary 2018 Reference guide for the Prescribing & PECOS ordering of all Indwelling Catheters & Drainage Bags & Accessories Reviewed: January 2018 For Review: January 2021
CONTENTS INDEX PAGE Introduction 3 Prescribing Quantities & Tips 4 SECTION ONE PRESCRIBING INFORMATION Indwelling Catheters and Urinary Sheaths 5 Leg Bags 6 Overnight/2litre bags 7 Fixation Device 7 Bag Holder 7 Catheter Valve 8 Catheter Maintenance Solutions 8 Anaesthetic Gel 8 Nephrostomy Drainage Bags 8 Appendix 1 Exception Form 13 SECTION TWO - PECOS ONLINE ORDERING Introduction 9 Indwelling Catheters 10 Leg Bags 11 Drainage Bags 11 Urinary Sheaths 11 Fixation Device 12 Bag Holder 12 Catheter Valve 12 Catheter Maintenance Solutions 12 Anaesthetic Gel 12 Nephrostomy Drainage Bags 12 Helpful hint 13 Appendix 1 Exception Form 14 The information contained within this booklet is intended for use by healthcare professionals within NHS Fife. At the time of going to print all prices were taken from the Dec 2017 Scottish Drug Tariff & the PECOS online ordering catalogue. 2
INTRODUCTION Continence Formulary This formulary is a joint guide for all healthcare professionals that prescribe/request prescriptions or order through PECOS for patients that require products for bladder dysfunction. This booklet has been designed as a quick reference guide for first line choices which should be used for all new patients and for current patients when a re-assessment of their needs is completed. The formulary will be reviewed on a regular basis and at this point any amendments or additions will be considered. Wherever possible there is a continuity of product use between primary and secondary care which has been achieved by joint working on this formulary. If you are unable to prescribe or order a PRODUCT the EXCEPTION FORM should be completed with reasons for use of non-formulary products (Appendix 1) or alternatively contact the Continence Advisor / Senior Prescribing Support Nurse (SPSN) Team for details of a second choice product. This reference guide has been split into 2 sections:- Section One For healthcare staff prescribing or requesting a prescription. Section Two For healthcare staff ordering through PECOS using the Non Prescription Ordering (NPO) system. This formulary is authorised by Pauline Millar Continence Advisor for NHS Fife, with contribution from the Senior Prescribing Support Nursing Team, Mary Thomson & Karen Whatton. If you need further information please contact: Continence Service: 01592 869924 Mary Thomson & Karen Whatton: Fife UHB.Fifeprescribingsupportnurse@nhs.net 01592 643355 ext: 22068 3
PRESCRIBING QUANTITIES ADVICE This chart is for guidance purposes only AVERAGE 56 day cycle/2 monthly PRESCRIBING QUANTITIES PRODUCT QUANTITY Leg bags 8 1 x 10 box Non sterile single use overnight bags 56 6 x 10 packs Catheter valves 8 2 x 5 packs Urinary sheaths 28 1 x 30 pack AVERAGE ANNUAL PRESCRIBING QUANTITY PRODUCT QUANTITY Long term catheter 6 Bag Holder/Sleeves ( washable & reusable ) 2 x 4 packs G Strap Adult 2 x 5 packs PRESCRIBING TIPS 1. LONG TERM INDWELLING CATHETERS - 2 catheters should be ordered on the first prescription - so that a spare catheter can be kept in the house/care home. Re-order 1 at a time thereafter. 2. SILVER COATED CATHETERS- Should only be prescribed on the advice of the Continence Advisor. DO NOT PRESCRIBE These are very expensive items and not necessary Bard Bio-Cath Comprehensive Care Foley Tray Bard Bardex IC Tray Bard Lubrisil Comprehensive Care Foley Tray Cath-It Insertion/Removal Kit Clinisupplies Prosys Cath Trays VESCPO1 and VESCPO2 ORDER THROUGH PECOS: 192762 Catheterisation Pack Each 0.57 4
INDWELLING CATHETERS PRESCRIBING TIP - When prescribing catheter, add size required to end of code E.g. CODE = DP3201, Size = 12ch, Prescribing Code = DP320112. NB. These catheters are also suitable for Suprapubic use. LONG TERM CATHETER - UP to 12 WEEKS - HYDROGEL RUSCH - AquaFlate SympaCath (Teleflex Medical) DESCRIPTION Hydrogel Coated Latex SIZE/CH 12-18 LENGTH Standard Female CODE DH3101 DH2101 QUANTITY Each COST 6.22 COMMENTS Includes syringe pre-filled with sterile water & empty 10ml syringe for balloon deflation LONG TERM CATHETER - UP to 12 WEEKS - SILICONE RUSCH - AquaFlate Brilliant (Teleflex Medical) DESCRIPTION Silicone SIZE/CH 12-18 LENGTH Standard Female CODE DA3101 DA2101 QUANTITY Each COST 6.11 COMMENTS Includes syringe pre-filled with sterile water & empty 10ml syringe for balloon deflation SHORT /MEDIUM TERM CATHETER - UP to 28 DAYS RUSCH - AquaFlate PTFE (Teleflex Medical) DESCRIPTION PTFE Coated Latex SIZE/CH 12-18 LENGTH Standard Female CODE DP3101 DP2101 QUANTITY Each COST 2.17 COMMENTS Includes syringe pre-filled with sterile water & empty 10ml syringe for balloon deflation SHEATHS SILICONE PENILE SHEATHS SELF ADHERING MACGREGOR HEALTHCARE LTD, QUFORA SIZE 24mm 28mm 31mm 35mm 40mm CODE (standard length) 20111101 20111201 20111301 20111401 20111501 CODE (short length) 20111103 20111203 20111303 20111403 20111503 QUANTITY 30 30 30 30 30 COST 38.38 38.38 38.38 38.38 38.38 COMMENTS Sheaths should be changed daily. Use Qufora leg bags and overnight bags 5
LEG BAGS Included in pack are gloves and elasticated straps. Bags should be changed every 7 days LEG BAGS - 350mls UNOMEDICAL CARELINE TAP T TAP TUBE LENGTH Short Long CODE 45-01 SVCG 45-02 LVCG QUANTITY 10 10 COST 25.69 25.69 LEG BAGS - 500mls UNOMEDICAL CARELINE TAP T TAP LEVER TAP TUBE LENGTH Short Long Short Long CODE 45-05 SVCG 45-06 LVCG 46-05 SVCG 46-06 LVCG QUANTITY 10 10 10 10 COST 25.48 25.48 25.48 25.48 LEG BAGS - 750mls UNOMEDICAL CARELINE TAP T TAP LEVER TAP TUBE LENGTH Short Long Short Long CODE 45-09 SVCG 45-10 LVCG 46-09 SVCG 46-10 LVCG QUANTITY 10 10 10 10 COST 25.48 25.48 26.93 26.93 COMMENTS LEG BAGS FOR SHEATHS - MACGREGOR HEALTHCARE QUFORA STERILE TUBE LENGTH Short Long CODE 12161804 12161504 QUANTITY 10 10 COST 22.40 22.40 6
DRAINAGE BAGS SINGLE USE 2litre OVERNIGHT DRAINAGE BAG UNOMEDICAL CARELINE with NON RETURN VALVE-NRV (E2) CODE 45-40 LBC QUANTITY 10 per pack COST 2.47 COMMENTS 1 Bag change per night STERILE 2litre DRAINAGE BAG - DRAINABLE UNOMEDICAL CARELINE T-TAP with NRV (E4) CODE 45-20-IDC QUANTITY 10 per pack COST 11.92 COMMENTS Bag change every 7 days DRAINAGE BAGS FOR SHEATHS MACGREGOR HEALTHCARE QUFORA Non sterile/non Drainable CODE 13800101 QUANTITY 10 per pack COST 2.05 COMMENTS 1 Bag change per night FIXATION DEVICE FIXATION /RETION DEVICE COLOPLAST CATHETER RETAINING SIMPLA G STRAP ADULT CODE 383001 QUANTITY 5 per pack COST 14.44 COMMENTS Can be washed and reused BAG HOLDER/SLEEVE LEG BAG HOLDERS REUSABLE/WASHABLE PROSYS SIZE Small/24-40cms Medium/36-50cms Large/40-65cms CODE PLS3881 PLS3904 PLS3928 QUANTITY 4 per pack 4 per pack 4 per pack Cost 7.55 7.55 7.55 COMMENTS Can be washed and reused for 3-6 months 7
CATHETER VALVE STERILE CATHETER VALVE FOR USE WITH INDWELLING CATHETER PROSYS CODE PCV3942 QUANTITY 5 per pack COST 9.57 COMMENTS Valves should be changed every 7 days CATHETER MAINTENANCE SOLUTION CATHETER MAINTENANCE SOLUTION BARD OPTIFLO SOLUTION OPTIFLO S - 0.9% NaCl OPTIFLO G -3.23% Citric Acid OPTIFLO R-6% Citric Acid CODE CSS50 CSG50 CSR50 QUANTITY 50mls 50mls 50mls each each each COST 3.39 3.60 3.60 COMMENTS Only use where clinically indicated and supported by local standard operating procedures ANAESTHETIC GEL ANAESTHETIC ANTISEPTIC LUBRICANT CLINIMED INSTILLAGEL VOLUME 6mls 11mls QUANTITY 10 per pack 10 per pack COST 14.05 15.76 COMMENTS Contains lidnocaine and lubricant, takes 5 minutes to take effect NEPHROSTOMY DRAINAGE BAG 500mls STERILE DRAINAGE BAG MANFRED SAUER UK Ltd- NephSys System TAP TWIST LEVER CODE NS721.3730S NS721.3730SE SIZE 30 cm tube 30 cm tube QUANTITY 10 per pack 10 per pack COST 42.03 42.43 COMMENTS Bag change every 5-7 days 8
SECTION TWO PECOS ORDERING This section provides healthcare staff with the codes to place their weekly order through the PECOS ordering system. For use by staff who are ordering stock/stores through the Non Prescribing Ordering (NPO) system. PLEASE NOTE: Not all products that are available for prescribing are available through the PECOS online ordering system. There may be a slight variation from products that are ordered through PECOS compared to prescription. 9
INDWELLING CATHETERS PECOS ORDERING NHS Fife Catheter & Accessories Formulary 2018 LONG TERM CATHETER - UP to 12 WEEKS - HYDROGEL RUSCH - AquaFlate SympaCath DESCRIPTION Hydrogel Coated Latex SIZE/CH 12-18 LENGTH Standard Female CODE/SIZE 003587 12 003549 12 003594 14 003556 14 003600 16 003563 16 003334 18 QUANTITY Each COST 1.90 COMMENTS Includes syringe pre-filled with sterile water & empty 10ml syringe for balloon deflation LONG TERM CATHETER - UP to 12 WEEKS -SILICONE RUSCH - AquaFlate Brilliant DESCRIPTION Silicone SIZE/CH 12-18 LENGTH Standard Female CODE/SIZE 078646 12 018369 12 080236 14 018376 14 018338 16 018383 16 018345 18 018352 20 QUANTITY Each COST 1.40 COMMENTS Includes syringe pre-filled with sterile water & empty 10ml syringe for balloon deflation SHORT /MEDIUM TERM CATHETER - UP to 28 DAYS RUSCH PTFE Coated DESCRIPTION PTFE Coated latex SIZE/CH 12-18 LENGTH Standard Female CODE/SIZE 003419 12 003327 12 003518 14 003501 14 003341 16 003389 16 003525 18 031146 18 QUANTITY Each COST 0.76 COMMENTS Includes syringe pre-filled with sterile water & empty 10ml syringe for balloon deflation 10
LEG BAGS PECOS ORDERING LEG BAGS - 500mls UNOMEDICAL CARELINE TAP LEVER TAP TUBE LENGTH Short Long CODE 220830 220823 QUANTITY Each Each 0.25 0.25 COMMENTS Bag should be changed every 7 days SINGLE USE 2litre NIGHT DRAINAGE BAG UNOMEDICAL CARELINE with NON RETURN VALVE-NRV CODE 136902 QUANTITY 10 per pack COST 1.40 COMMENTS 1 Bag change per night DRAINAGE BAGS PECOS ORDERING STERILE 2litre DRAINAGE BAG - DRAINABLE UNOMEDICAL CARELINE T-TAP with NRV CODE 201266 QUANTITY 10 per pack COST 3.54 COMMENTS Bag change every 7 days URINARY SHEATHS PECOS ORDERING SILICONE PENILE SHEATHS SELF ADHERING CONVEEN OPTIMA SILICONE SIZE 21mm (shorter length) 25mm 30mm 35mm CODE 195855 116522 116539 116546 QUANTITY 5 5 5 5 COST 2.50 2.50 2.50 2.50 COMMENTS Sheaths should be changed daily 11
FIXATION DEVICE PECOS ORDERING NHS Fife Catheter & Accessories Formulary 2018 FIXATION /RETION DEVICE COLOPLAST CATHETER RETAINING G STRAP ADULT CODE 099573 QUANTITY 5 per pack COST 12.30 COMMENTS Can be washed and reused BAG HOLDER/SLEEVE PECOS ORDERING LEG BAG HOLDERS REUSABLE/WASHABLE UNOMEDICAL SIZE Small Medium Large CODE 126385 126378 126361 QUANTITY 4 per pack 4/per pack 4/per pack COST 4.21 4.40 5.28 COMMENTS Can be washed and reused for 3-6 months CATHETER VALVE PECOS ORDERING STERILE CATHETER VALVE FOR USE WITH INDWELLING CATHETER UNOMEDICAL CODE 181636 QUANTITY 5 per pack COST 2.50 COMMENTS Valves should be changed every 7 days CATHETER MAINTENANCE SOLUTION ANAESTHETIC LUBRICATING GEL See Section 1 This still requires to be ordered on prescription. (See pages 8+9) NEPHROSTOMY DRAINGE BAG- PECOS ORDERING 500mls STERILE DRAINAGE BAG MANFRED SAUER UK Ltd- NephSys System TAP TWIST LEVER CODE NS721.3730S NS721.3730SE SIZE 30 cm tube 30 cm tube QUANTITY 10 per pack 10 per pack COST 42.43 42.43 COMMENTS Bag change every 5-7 days 12
USEFUL HINT ON ATTACHING DRAINAGE BAG TO SILICONE CATHETER To maintain the life of the catheter by preventing stretching, insert the leg bag so there are still 2 or 3 notches visible 13
Appendix 1 NHS Fife Catheter & Accessories Formulary 2018 NHS FIFE PRODUCT REQUEST AND EXCEPTION FORM Please complete Part A for all Non Formulary Requests. Please complete Part B for wound care and/or Part C for catheter care products. PART A Person Requesting: Job Title: Work Base: Date of Request: NAME OF NON- FORMULARY PRODUCT PRODUCT SIZE QUANTITY REQUIRED Type of wound: Size of wound: Formulary products already tried: PART B - WOUND Location of Wound: Level of Exudate: Duration of Wound: Reason formulary product not suitable: Suprapubic/Urethral: Formulary Product already tried: PART C - CATHETER Reason formulary product not suitable: For how long? Discussed with specialist: Yes/No TVN Continence Advisor Vascular Podiatrist Plastics Other Name of Specialist: NON FORMULARY PRODUCT REVIEW DATE Once completed please send to Senior Prescribing Support Nurse Team Fife-UHB.Fifeprescribingsupportnurse@nhs.net or Cedar House, Whytemans Brae, Kirkcaldy Completing this form will enable the SPSN to collate non formulary prescribing information and therefore inform future discussions on formularies, training etc. Copies can be obtained from: http://www.fifeadtc.scot.nhs.uk/formulary/woundcare-formulary/woundcarecatheter-product-request-and-exception-form.aspx 14