ONBOARDING MANUAL - Bayshore HealthCare · 2020. 1. 29. · Onboarding Manual Nov 12 2019 4 Online Catalogue Bayshore Specialty Rx created an Online Picture Catalogue with all Infusion

Onboarding Manual Nov 12 2019

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ONBOARDING MANUAL What you need to know about Bayshore Specialty Rx and the Mississauga Halton LHIN


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INDEX

TOPIC PAGE

Bayshore Specialty Rx Contact Information 3

Online Catalogue 4

MS & IV Formulary 6

IV Manual 7

Rental Equipment 8

Equipment Ordering Guidelines 9

Hydration/Chemo Orders 14

Refills/Dispensing Opioids 15

Symptom Management Kit/Medical Assistance in Dying (MAiD) 16

Deliveries/Delivery of Narcotics and Controlled Substances 17

Medication and Supply Backorders/Recalls 18

Equipment Troubleshooting/Exchanges 19

Equipment and Biomedical Waste Pickups 22

Lost/Damaged Equipment 24

Product Complaints 25 Private Patients 26


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Bayshore Specialty Rx Contact Information

Main Pharmacy Location: 233 Alden Road, Markham, ON, L3R 3W6

Main Telephone Number: 1-888-313-6988

(24 hours/day; 7 days/week)

Main Fax Number: 1-888-287-8577

Hours of Operation:

Monday - Sunday 8:30am - 9:00pm

After Hours: Monday - Sunday 9:00pm - 8:30am

(Same telephone number, to be used for urgent

issues only. You will be required to leave a voice

message for either the On-call Pharmacist or

Logistics personnel and someone will get back to

you shortly).

Back up Pharmacy: 21-1601 River Road E, Kitchener, Ontario, N2A 3Y4

DEPARTMENT EXTENSION TYPES OF INQUIRIES

Customer Service x36351 General inquiries, order status, changes in delivery date/time, complaints/issues

Delivery x36355 Missed/failed deliveries, delivery status

Intake x36353 New/Initial orders, fax receipts, order adjustments

Pharmacists x36350 Medication issues, TPN, verbal orders

Pharmacy Assistants x36356 Equipment malfunctions/troubleshooting, refill orders, IV supply support

Equipment Management Team x36352 Equipment and bio-waste pickups. *Nurses/Patients to contact LHIN directly for pick up requests as BSRx only picks up once approval is received by the LHIN

Stephanie Robertson, RN Clinical Quality Resource Coordinator

x36213

IV, Medical and Feeding supplies questions/support, questions regarding the Formulary, clinical support, etc.

Julena Edwards, RN Clinical Quality Resource Coordinator

x36432


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Online Catalogue

Bayshore Specialty Rx created an Online Picture Catalogue with all Infusion and Medical Supply products listed on the

Mississauga Halton LHIN Formulary.

The Catalogue is available as a web link that can also be converted into a printable PDF version.

To maximize the features available and ensure you are always accessing the most up-to-date information,

we recommend users accessing the tool via the online link.

https://www.bsrxonline.ca/MHOnlineCatalogue

The Catalogue contains the following features:

1. PRODUCT SEARCH: products can be searched by any of the following fields; Product Description, LHIN Item Code,

Manufacturer, Manufacturer Code, key word, etc.

2. PRODUCT CATEGORIES: the Catalogue is broken down by Categories and Sub-categories which match the

Mississauga Halton LHIN Formulary. If you are using this feature to perform your search you must first select

a Category and then a relevant Sub-category to get a listing of items.

3. SORT OPTION: once you have selected a Sub-category you can sort by LHIN Item Code, Product Description,

Manufacturer Name, and Manufacturer Code.

4. IMAGES: click on the thumbnail for a larger version of the image.

5. PRINT OPTION: by clicking Print Complete Catalogue you are able to print a listing of all formulary items with

images.

6. KITS: Kits are divided between the Infusion Supplies Category and the Medical Supplies Category. Click on

Kit Contents to get a complete listing of items listed in the Kit.

7. WOUND CARE PRODUCT PICKER: a resource tool based on the Wounds Canada Product Picker guide. It reviews

Product Categories, Descriptions, Indications for Use and the Formulary Codes for products available in each of

the Categories.

https://www.bsrxonline.ca/MHOnlineCatalogue


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Each product card contains the following information:

Product Description Manufacturer

LHIN Item Code Manufacturer Code

Unit of Purchase BSRx Item Code

1

2

5

3

4


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To see the complete list of Kit Contents click on the Kit Contents button

MS & IV Formulary

Apart from the Online Catalogue there is also a complete Formulary of all items available for ordering. This is a great

resource to use as information is easy to look up and similar items are grouped together.

It would be helpful to have a copy on your tablet or a printed version with you at all times.

*Please note this document does get updated from time-to-time as changes are made to supplies.

This document is posted on the MH LHIN Portal which your Nursing Supervisor has access to.

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IV Manual

The IV Manual is a great resource that provides information for all Contract Stakeholders (LHIN, SPOs, BSRx).

It contains information regarding Initial Ordering Guidelines, Supplies, Kits, ODB Coverage, Line Maintenance and

Flushing Protocols, Deliveries, Equipment, etc.

The IV Manual can be found on the Mississauga Halton LHIN Online Portal.


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Rental Equipment

Bayshore provides the following Infusion Equipment for Mississauga Halton LHIN.

CADD Solis VIP Pump

EnteraLite Infinity Feeding

Pump

Kangaroo Joey Feeding

Pump

IV Pole

In order for Bayshore to provide Rental equipment, Patients must meet the following criteria:

Have an active telephone number

Have a permanent home address

Do not reside in a Correctional Facility, Shelter or Vehicle

Do not have a history of damaging or losing equipment

If any of these situations apply, Bayshore is happy to suggest an alternative method of Infusion.

Each piece of equipment sent by Bayshore Specialty Rx has a unique barcode identifier, referred to as a ‘BEQ’

number. This barcode is scanned into their tracking system so they are able to track the equipment back to a specific

Patient.

B= Bayshore, EQ= Equipment


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Equipment Ordering Guidelines

Prior to contract start, the Mississauga Halton LHIN and Bayshore Specialty Rx worked in collaboration to determine

guidelines as to what equipment and supplies would be provided upon initial order for a Patient’s therapy depending

on dose frequency, duration of therapy and the IV access device.

Below are the general guidelines that cover the most typical ordering patterns.

*Exceptions may apply. For additional information please refer to the IV Manual.

Item Initial CADD Solis VIP PCA Pump

Orders

Initial CADD Solis VIP Pump Orders

Initial Baxter

Elastomeric Pump

Orders

Initial Gravity Orders

Infusion Device

CADD Solis VIP Pump

CADD Solis VIP Pump

Elastomeric Pump N/A

Carrying Case

Large Pouch Pouch (S, M, L) N/A N/A

Accessories Key, Bolus Cord as required

N/A N/A N/A

Educational Material Home Infusion Information Guide, CADD Pump Quick

Guide

Home Infusion Information Guide, CADD Pump Quick

Guide

Patient Guide, Self-Care Booklet, Home

Infusion Pick Up Information Sheet

Home Infusion Client Guide

Administration Set

CADD Extension Set 60” Male-Male Luer

Lock

Tubing 1.2 Micron N/A Tubing Continu-Flo

Medication Container Cassette Air-free Bag Infuser Bag

Kits Line Kit & Accessory Kit

Line Kit & Accessory Kit



Hanging Device IV Pole & adapter as required

IV Pole & adapter as required

N/A IV Hook < 1L, IV pole & adapter >1L


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IV THERAPY VIA CADD SOLIS VIP PUMP

LHIN Code: 9080

LHIN Description: CADD Solis VIP Pump with Rechargeable Battery

Patients will receive the pump and accessories required to operate.

LHIN Code: 9055

LHIN Description: TPN/Feeding Pole Adjustable with Wheels

Bayshore will send the Pole for infusions greater than 1L and for TPN as

required.

If a Pole is ordered by LHIN or Nurse directly for use with a CADD Solis

VIP Pump, a request for the CADD Pole Mount Bracket and Adapter

must be indicated on the form as there is no LHIN code for these items.

LHIN Code: N/A

LHIN Description: CADD Pole mount bracket and adapter

Bayshore will send these items ONLY when a Pole is required with the

CADD Solis VIP Pump.

LHIN Code: IVMC26

LHIN Description: IV Hook

An IV Hook will be sent for all initial Gravity Infusions (prescription sent

to Bayshore) that are not placed in an Elastomeric Pump.

The IV Hook will stay in the home as this is not a rental item.

An IV Hook may also be ordered by a Nurse or Care Coordinator for

Gravity Feeds instead of an IV Pole.

LHIN Code: N/A

LHIN Description: CADD Bolus Cord

If the Patient is on PCA therapy, and is unable to use the bolus button

on the pump, the Nurse can request a Bolus Cord by indicating it on the

appropriate form as no LHIN code exists for this item.

LHIN Code: N/A

LHIN Description: Pump Pouch

Bayshore will automatically send a Pouch with all CADD Solis VIP

Pumps. Backpacks will be sent for large volume therapies such as TPN.


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IV THERAPY VIA BAXTER ELASTOMERIC PUMP

LHIN Code: N/A

LHIN Description: Baxter Elastomeric Pump

Bayshore will send pre-filled Elastomeric Pumps to all eligible patients as per the guidelines agreed upon between the LHIN and Pharmacy.

PATIENTS RECEIVING TREATMENT IN HOME PATIENTS RECEIVING TREATMENT IN CLINIC

Peripheral IV 7 Day Treatment:

1. Medication is in the Elastomeric Pump

2. Peripheral Line Start Kit (IVKIT65) x 1

3. IV Accessory Kit (IVSET02) x 1

4. 3mL Prefilled Saline Syringes x 14

Please note that the two 9” Extension Sets (IVSET09) in

the Peripheral Line Start Kit has been replaced with 1 of

the 17” Extension Set (IVSET18).

Peripheral IV 7 Day Treatment:


Please note that no supplies are sent for Clinic Patients.

All supplies required should be in the Clinic stock.

Central Line IV 7 Day Treatment:


2. Central Line Dressing Kit x 1

3. IV Accessory Kit x 1

4. 10mL Prefilled Saline Syringes x 14

5. 17” One-Link Extension Set x 2

The 17” Extension Sets are sent separately as there are

NO Extension Sets in the Central Line Dressing Kit.

Central Line IV 7 Day Treatment:


Please note that no supplies are sent for Clinic Patients.

All supplies required should be in the Clinic stock.


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ENTERALITE INFINITY FEEDING PUMP AND SETS

LHIN Code: 9075

LHIN Description: Enteralite Infinity Feeding Pump

When ordering this code the Patient will receive the Pump, Charger and

Pole Mount as IV poles are needed with Feeding Pumps.

For older children you can request a Backpack by indicating on the

appropriate forms as no LHIN code exists for this item.

AVAILABLE FEEDING SETS

LHIN Code: IVEN080

LHIN Description:

Enteralite Infinity Feeding Bag

and Set 500mL

LHIN Code: IVEN081

LHIN Description:

Enteralite Infinity Feeding Bag

and Set 1200mL

KANGAROO JOEY FEEDING PUMP AND SETS

LHIN Code: 9086

LHIN Description: Kangaroo Joey Feeding Pump

When ordering this code the Patient will receive the Pump, Charger and

Pole Mount as IV Poles are needed with Feeding Pumps.

AVAILABLE FEEDING SETS

LHIN Code: IVEN051

LHIN Description:

Kangaroo Joey Feeding Bag

and Set Non-Sterile 500mL

LHIN Code: IVEN053

LHIN Description:

Kangaroo Joey Feeding Bag

and Set Non-Sterile 1000 mL

GRAVITY SET

LHIN Code: IVEN071

LHIN Description: Gravity Feeding Bag and Set 1000mL

If you are running feeds by gravity this set is what should be ordered as

the other feeding pump sets will not work for gravity infusions.

IV Hook (IVMC26) can be added if needed (this will stay in the home)

instead of an IV Pole which is a rental item.

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When to order Enteralite Feeding Pump vs. Kangaroo Joey Feeding Pump

ENTERALITE INFINITY FEEDING

PUMP

KANGAROO JOEY FEEDING PUMP GRAVITY FEEDS

For any child: 0 to 18 years

old with Enteral Feeding:

G Tube or NG Tube that is

running via Pump

(this is the Pump used at

SickKids that Patients are

familiar with)

IV Pole (9055) should be

ordered as well

For older children you can

request a Backpack by

indicating on the appropriate

forms as no LHIN code exists

for this item.

For any Patient: 19+ years

old with Enteral Feeding:

G Tube or NG Tube that is

running via Pump

IV Pole (9055) should be

ordered as well

For Gravity Feeds, order

Gravity Feeding Bag and Set

(IVEN071)

IV Hook (IVMC26) can be

added if needed (this will

stay in the home)

An IV Pole is NOT needed

**Please note for any subsequent orders for infusion, medical or feeding supplies are the responsibility of the

Nurse to order through the LHIN for the Patient.


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Hydration/Chemo Orders

Hydration Patients

Bayshore considers all Hydration orders as medication that requires a Prescription (or MR) to be checked by a

Pharmacist prior to delivery. For this reason, Hydration cannot be ordered as a supply item on a Purchase Order.

The only EXCEPTION is if the fluids are for Irrigation use which should be indicated on the PO.

All Hydration infusions will be infused via the CADD Solis VIP Pump therefore Bayshore removes air out of the bag

prior to sending the order.

Hydration Patients may have medication free periods between therapy cycles. During this break in therapy, the LHIN

is to initiate an Equipment pick up via End Rental. A new pump will be sent prior to the next dose.

Chemotherapy Patients

Not all Patients who receive Chemotherapy are receiving the medication from Bayshore Pharmacy. It is possible that

the Patient may be supplied with Chemo from the hospital and is using a Bayshore pump to administer the

medication. In these cases, the Pharmacy does not have the values required to program the pump. Bayshore will be

able to assist the Nurse with the functions of the pump and setting the values once Nurse acquires them from the

hospital.

Chemo disconnect supplies are NOT automatically sent by Bayshore and are only sent when requested by the LHIN.

Nurses can confirm with the LHIN if this was requested prior to phoning Bayshore.

Most Chemotherapy Patient’s will have medication free periods between therapy cycles. It is best that the pump is

picked up after each cycle so that it can be properly maintained, programmed and checked by a Pharmacist to ensure

Patient safety and accurate dosing.

Pumps Exposed to Radiation

On occasion the CADD Solis VIP Pump may be exposed to therapeutic levels of ionizing radiation.

Please note that this may cause permanent damage to the pump’s electronic circuitry.

It is recommended to disconnect the pump from the Patient while they undergo therapeutic radiation sessions. If the

pump must remain with the Patient during this treatment, it should be protected from radiation as best as possible.

Exposure to radiation may affect the pump’s ability to function adequately, which must be confirmed following

exposure.

In the event of exposure to radiation, please allow the pump’s self-checks to run by shutting down and restarting

the pump. As per the Manufacturer’s recommendation, the Preventative Maintenance process should be followed

to verify performance and functionality of exposed pumps.

To assist in identifying these pumps, Nurses are advised to notify Bayshore Specialty Pharmacy when pumps are

exposed to radiation by calling 1-888-313-6988 ext. 36352 to speak with a member of our Equipment Management


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Team. The LHIN should also be notified that the pump has been exposed to radiation so this information can be

included on the End Rental for Bayshore.

Refills

Refills of medications administered routinely will be automatically scheduled and delivered according to the

specifications of the Patient’s medication. The Pharmacist will decide how many doses to be sent based on stability,

volume and storage conditions. For example for a short stability medication Patient might receive 3 days at a time.

There is no need to call Bayshore requesting a refill unless it is a PRN medication which does require a phone call

from the Nurse to initiate the delivery. Requests for PRN medication refills should be submitted at least 24 hours in

advance of required delivery date to avoid any therapy interruptions.

Bayshore will only send supplies for Initial/Extension orders ONLY, for additional supplies, these must be ordered

through the LHIN.

Dispensing Opioids

In 2018, Health Canada introduced new regulations to provide better information for Patients on the safe use of

Opioid medications.

Opioids are prescribed to manage serious pain uncontrolled by other treatments. The risks associated with opioid use include the potential to lead to dependence, addiction and overdose. Health Canada wants to ensure that all Patients are aware of these risks and receive relevant and consistent information prior to use.

A mandatory label is applied to all opioid medication dispensed by Bayshore Pharmacy. Each prescription is also

accompanied by a handout with further information about the potential risks.

Please note: Bayshore requires 24 hours to

prepare and deliver a Medication refill.


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Symptom Management Kit

Symptom Management Kits are available for palliative Patients who require access to medication and supplies

needed in urgent pallative care situations in the home.

The Kit includes enough medication and supplies to manage the Patients symptoms for up to 48 hours to allow time

for the necessary prescriptions to be ordered and processed.

Bayshore Specialty Rx added a security seal to the Symptom

Management Kit as an added precaution for the Nurse. This is

meant to act as a flag for any unauthorized access of the

medications prior to the Nurses accessing the kit. If the seal is

broken, the Nurse is to follow their Nursing agency’s protocol

immediately for this situation.

It is the responsibility of the Nurse to monitor and track the usage

of the medication inside the box and should they suspect any

tampering, report it immediately to their Nursing Manager, the

LHIN and Bayshore Specialty Rx.

Please note the Medication Box is a reusable black box that the

Pharmacy requires to be returned after Patient use.

Medical Assistance in Dying (MAiD)

Upon request from the LHIN, Bayshore will provide medication and supplies required to support Medical Assistance

in Dying. Bayshore requires a minimum of 48 hours for processing MAiD orders.

Due to the sensitive nature of this procedure, Bayshore will dispense a primary medication and supply kit, along with

an identical backup kit of each in case the physician requires additional medication or supplies.

The kits will be labelled as followed:

Medication Kit 1

Medication Kit 2

Supplies Kit 1

Supplies Kit 2

Bayshore Specialty Rx will only schedule a pick up of the unused medication/supplies if requested by the LHIN.


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Deliveries

Once an order is received from the LHIN, it is processed by the Pharmacy depending on date/time of order due and

delivery priority. It is Bayshore’s policy to call each Patient prior to delivery to arrange for a delivery window (2-3

hours) that the Patient or Caregiver will be home to accept the delivery. Please note that all deliveries require a

person over the age of 18 to sign for it and in cases of delivery of Narcotics proper ID must be shown and

documented.

Should no one be home to accept the delivery in the prearranged time frame, the driver will leave a Door Hanger

advising that delivery was attempted and instructions to call the Pharmacy to arrange for an alternate time.

Please note that Bayshore CANNOT adjust a delivery time/location based on a request from the Nurse. Any delivery

requirements must be communicated to the Pharmacy from the LHIN.

Delivery of Narcotics and Controlled Substances

In 2011, the Ministry of Health and Long-Term Care put into place a new regulation to protect individuals from any

harm caused by misused prescription narcotics and controlled substances. When delivering these medications a valid

ID must be provided and a record must be kept on file at the Pharmacy.

Bayshore Pharmacy requires the following when delivering narcotics and controlled substances:

Recipient to show the driver a valid ID (Ontario Health Card, Valid Driver’s Licence, Birth Certificate, etc.)

Driver to document the ID information on the Packing Slip

Signature of Recipient

All Delivery Slips are stored in a secured area in the Pharmacy; the recipient’s privacy is protected and is not shared

with any outside parties.

If a Patient/Caregiver refuses to have their ID number recorded, Bayshore will still deliver the medication as long as

the ID is shown to the driver, a name and signature is obtained and the driver documents that the recording of the ID

number was refused.

Should Patients/Caregivers require additional information they can be directed to the Ministry’s website:

ontario.ca/narcoticstrategy


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Medication and Supply Backorders

Bayshore Specialty Rx strives to have sufficient

quantity of supplies, equipment and medication on

hand in order to service all Patients. Occasionally,

supplies/equipment/ medication will go on

backorder from the Manufacturer and so Bayshore

will provide an equivalent product in fit, form and

function. Should an exact equivalent be unavailable,

Bayshore Pharmacy will notify the LHIN and Service

Providers.

Please note that all Backorder Substitution Notices

are posted on the Mississauga Halton LHIN portal

for Nursing Managers to forward to their staff.

Recalls

In cases of medication and/or supply Recalls, the Pharmacy will issue a notice to the LHIN and Service Providers

within 24 hours of receiving the notice indicating the product/lot numbers of affected item(s).

The severity of the Recall and the Action Plan will be discussed with the LHIN on case-by-case basis and will be shared

with Service Providers.


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Equipment Troubleshooting/Exchanges

Mississauga Halton LHIN and Bayshore Pharmacy chose to provide the most advanced Smart Pump, the CADD Solis

VIP Pump, on the current market to their Patients. Although the technology of this pump is superior, like any other

electronic device it can malfunction from time to time.

If there are any issues/alarms with the pump, the Nurse is to inform the Pharmacy immediately. It is important that

the Nurse is in the home so that the Pharmacy can troubleshoot the pump to avoid doing unnecessary exchanges. If

the issue is not resolved over the phone, Bayshore Pharmacy will arrange for an equipment exchange.

*Please note pump exchanges after hours are NOT programmed by the Pharmacy. Nurses are encouraged to

contact the on-call Pharmacist while programming the pump for assistance and confirmation.

Preventative Maintenance

BSRx ensures that Preventative maintenance (PM) is performed on

Equipment utilized in the delivery of care and service to Patients a regular

basis (every 6 months), consistent with Manufacturer’s recommendations

and with Contractual requirements.

When a pump is due for service while in the care of a Patient, a Bayshore

Team Member will contact the Patient and arrange for a pick up of the

pump and schedule a new pump to be delivered to avoid disruption of

therapy. The pump requiring service will then be returned to the facility to

be inspected and tested for any malfunctions.

BSRx maintains a database of maintenance activities performed on Equipment which includes cleaning and

preventative maintenance

Equipment Care

Should the equipment

required an additional

label please do not use

anything other than

masking tape. Masking

tape does not leave a

residue like other

adhesives thus making it

easier to remove

and clean the equipment.


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Helpful Tips/Tricks

Pump Not Charging

A common issue that the Pharmacy receives is that the pump is not charging. This could be the result of the AC

Adapter (Charger) not being attached properly and therefore causing the pump not to charge.

Please ensure Patients are following the below instructions when charging the pump:

STEP 1: The AC Adapter plugs into the 7V port on the side of the pump. Please ensure you are NOT attaching it to the bottom port as this is for the

Bolus Cord.

STEP 2: To disconnect the power cord, grasp the metal collar of the plug as close to the pump as possible and slide back. The power cord will then

release from the pump. The cord must be put in straight and taken out

straight. DO NOT twist or rotate the power cord.

Note: Do not pull the power cord from the

pump by tugging on the back cord.

Please do not wrap the power cord around the AC Adaptor; doing so could cause damage to the AC Adapter unit.

Instead, the cord should be wrapped loosely and secured with an elastic band when required.

In the event that the charger is not working or in cases of power outages, AA

Batteries can be used. We encourage Nurses to explain to Patient’s that it would

be helpful to always keep 4 AA Batteries on hand in cases of emergency

especially for palliative Patients on PCA pump.

For additional information/training regarding the CADD Solis Pump please contact a Pharmacy Team Member who

will be happy to assist you or visit Smith’s Medical website

http://www.smiths-medical.com/catalog/ambulatory-pumps-sets/cadd-ambulatory-infusion-pumps/cadd-solis-

vip/cadd-solis-vip-ambulatory.html

http://www.smiths-medical.com/catalog/ambulatory-pumps-sets/cadd-ambulatory-infusion-pumps/cadd-solis-vip/cadd-solis-vip-ambulatory.htmlhttp://www.smiths-medical.com/catalog/ambulatory-pumps-sets/cadd-ambulatory-infusion-pumps/cadd-solis-vip/cadd-solis-vip-ambulatory.html


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Take medication out 2 hours prior

Air Bubbles

To avoid introducing any air bubbles in the bag, please follow the below tips:

Bag spikes should be fully inserted into the bag. Bevel up should be the practice just like you would place an IV

catheter into a vein.

Make sure the medication bag is taken out of fridge 2 hours prior to infusion

(unless otherwise indicated). Chilled solutions may run too fast, too slow or may

cause air bubbles to form as the cold solution warms.

Prime all air out of the tubing using the pump priming

feature, NOT manually.

Ensure the tubing and filter is hanging straight down when priming so the filter is properly

saturated with fluid. The filter can also be inverted.

Consider tapping the filter gently to ensure no air is trapped.

CHECK YOUR BATTERY!

Open the battery door → take out the battery → put the battery back in → close the battery door

Error Messages

Patients may experience error messages on the screen of the pump with continuous beeping.

To clear this alarm, open the battery door, remove battery and AC Adaptor. Close the battery door and turn the

pump back on. If the error message does not repeat, the Pharmacy may suggest continued use of the pump. If the

error is persistent, the pump must be exchanged for service.


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Equipment and Biomedical Waste Pickups

In order to ensure the safety of Nurses, Patients, Caregivers and Bayshore staff, we ask that Nurses review the proper

procedure for disposal of sharps with their Patients to avoid any injuries such as needle-stick, cuts or punctures.

We also ask that the Nurse completing the final visit re-iterates to the Patient that the equipment and accessories are

property of Bayshore and must be returned in good condition once therapy is complete.

Process for pickups should be as follows:

STEP 1: Patients should be informing their Nurse when their sharps container is full to arrange for disposal and delivery of a new container if required.

STEP 2: Nurses must inform the LHIN when the Patient is done therapy, the equipment is no longer required and when a bio-waste pickup is required.

*To avoid delays and potential for lost equipment, please contact the LHIN directly

and NOT Bayshore.

STEP 3: The Care Coordinator generates and submits the necessary paperwork for the Pharmacy to complete the task.

STEP 4: Once BSRx has received the notification from the LHIN, the Patient/Caregiver will be contacted to make arrangements for a pickup date and time frame.

*Please do NOT inform Patients of dates/times that Bayshore will be picking up. Bayshore will

contact the Patient to arrange a suitable time ONLY once they receive authorization from the LHIN.

Please note the following:

Bayshore has up to 3 days to perform the pickup unless specified as urgent in which case the pickup will be

completed the same day

Pickups are arranged within a 3-4 hour time frame, ranging from 9am-9pm, 7 days/week

A receipt is provided to the Patient/Caregiver for the equipment once the pickup has been competed

For equipment returned at the hospital please ensure it is returned to the LHIN Office for Bayshore pickup.


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Please note the Baxter Elastomeric pump is to be disposed of in the regular garbage and NOT recycling.

In accordance with infection control and biomedical waste regulations, we ask of the following when preparing for

a pickup. Please ensure the Sharps Containers are CLOSED to avoid needle stick injuries and kindly remind Patients

NOT to give their Patient charts to Bayshore drivers.

DO put in the sharps container DO NOT put in the sharps container

Needles and syringes Other items that could cause

a puncture, cut or abrasion Empty glass vials Empty medication cassettes Unused narcotics bags or cassettes Empty chemotherapy bags,

tubing and gloves (in RED hazardous sharps container

Pump Food Household garbage Medical supplies (i.e. gauze, dressings, bandages, etc)


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Lost/Damaged Equipment

Lost equipment is always a challenge that Bayshore Specialty Rx faces. It is imperative that Patient’s, LHIN and Nurses

are all aware that the equipment is the property of Bayshore and must be returned in good condition upon

completion of therapy. At no given time does the Patient EVER own the equipment.

The most common item lost is the CADD Solis VIP Charger, then the CADD Solis VIP Pump and then the battery.

Top 3 Reasons Why Equipment is Lost:

1) Unable to contact/locate Patient or family member (including alternative phone numbers/contacts provided)

2) Patient unable to locate the charger

3) Patient indicating that equipment was picked up however never returned to Bayshore

In an effort to try and reduce the amount of lost and damaged equipment, Bayshore developed a Home Infusion

Information Guide that is sent with every new initial order that requires the CADD pump. The brochure was created

in an easy to read and understand format to assist and educate Patients on the importance aspects of their service

not just pertaining to the equipment

We encourage Nurses to review this brochure with their Patient’s as well as any other material/documentation that is

provided by the Pharmacy.

Also in an effort to reduce the amount of equipment pieces

lost each month, Bayshore developed a new bag that the

equipment is sent with. On the bag, it displays images of

what each piece of equipment looks like as well as a

reminder of proper equipment care.


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Product Complaints

Bayshore processes every order that is received by the LHIN the same day. If the Nurse placed an order with the LHIN

and the required delivery date/time has passed it is best to follow up with the LHIN to ensure it was sent to Bayshore.

If a product is missing or incorrect, the Nurse or Patient/Caregiver is encouraged to contact the Pharmacy so they can

investigate whether the order was received incorrectly by the LHIN or whether it was an internal error. If the error

was caused by Bayshore, they will rectify the situation free of charge to the LHIN, however if the error was initiated

from the LHIN, the Nurse is to contact the LHIN as they will have to initiate a new order to rectify the problem.

On occasion, by the time Bayshore is made aware of the issue and arranges for a pickup, a Nurse or the

Patient/Caregiver has already given the item to a Bayshore driver or has disposed of it along with the packaging.

Please DO NOT give a product to a driver unless they are there to specifically pick up the item(s). Bayshore has a

process in place for these situations to ensure ALL pickups of incorrect or defective products are quarantined so they

are returned to the facility and an investigation can be conducted. Specific paperwork and documentation is given to

the driver to ensure the product is not discarded once brought back to the facility.

For any product complaints, please ensure these are brought to the attention of Bayshore immediately. Please keep

the item and packaging as without these it is difficult to complete an investigation. If the complaint cannot be

resolved by coaching over the phone, Bayshore will initiate a pick up.

The Pharmacy will ask for the following

information:

Caller’s name Contact number Date incident occurred Number of units involved in the

complaint Lot Number (if available) Item description Item code Manufacturer code Details of issue/complaint

When the product is received back to the Pharmacy, it is examined and tested in order to find a root cause. When

necessary, products are sent to the manufacturer for further review and root cause analysis. The manufacturer will

communicate with Bayshore their findings and whether any concerns have been brought forward by other users. If it

is established that there was a defect with a product, the manufacturer would be responsible for alerting businesses

selling this product and establish alternative products for use. Substitution or replacement products would be

initiated where appropriate and communicated to the LHINs and Service Providers. Bayshore will also follow up

with the person who reported the complaint to provide feedback and alternative options if needed.

1 • Patient experiences an issue with the product received

• Patient/Caregiver or Nurse to contact Bayshore immediately

2

• Bayshore's Clinical Resource Coordinator will try to resolve the issue over the phone

• If issue cannot be resolved, a pickup of the original item and a delivery of a replacement item with be scheduled

3

• Item is returned back to Pharmacy and an investigation performed

• BSRx will follow up with Patient and communicate with the LHINs and SPOs if the manufacturer established a defect with their product and there is reason for concern


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Private Patients

Bayshore Specialty Rx not only supports the LHIN however also supports different private business streams such as

WSIB, ODSB, IFHP, etc.

Bayshore offers the following services to any Patient regardless if they are on LHIN service or not.

Infusion Medication, Equipment and Supplies

Feeding Equipment and Supplies

Medical Supplies such as Ostomy, Wound Care, Urinary, Incontinence Care, etc.…

If Bayshore does not currently carry the item required, they will source the product and get back to you

within 1-3 business days

Open Monday – Sunday 8:30am-9:00pm

Dedicated Private Patient Ordering Coordinator scheduled weekly Mon-Fri 9:00am-5:30pm to process

orders and address any issues/concerns

For Infusion and Feeding Equipment, Bayshore will rent the pumps to Patients privately for a daily rental fee.

Patients are to contact the Pharmacy directly to discuss their options and pricing.

Documents

ONBOARDING MANUAL - Bayshore HealthCare · 2020. 1. 29. · Onboarding Manual Nov 12 2019 4 Online Catalogue Bayshore Specialty Rx created an Online Picture Catalogue with all Infusion