The Skin Pilot Victoria - Herpes Zoster (Shingles) form is available for all Victorian pilot pharmacies.
The purpose of the Skin Pilot - Herpes Zoster (Shingles) form is for pharmacist to supply an adult patient with certain scheduled medicines for the treatment of herpes zoster (shingles).
Please follow these steps:
- Select Record Services in the left-hand menu of PlusOne software.
- Search for the patient and select SEARCH or select from the recently dispense list.
- Check the patients CONSULTATION HISTORY. Select the SERVICE drop down and select SKIN PILOT VICTORIA - HERPES ZOSTER (SHINGLES)
- Today's date is prepopulated. Select from the Pharmacist drop down under PHARMACIST DETAILS
- Complete all compulsory fields in the PATIENT INFORMATION section.
Please note: We recommend to update patient information in your dispense software.
- Under PHARMACIST SUITABILITY you must select the check box to indicate that you have completed the required training.
You can also click the link to view the Protocol for Management of Herpes Zoster (Shingles)
Please note: The system will remember this setting for each pharmacist, so you do not need to tick it each time.
- PATIENT CONSENT - The patient must provide informed consent to the service and the collection of their personal information. The patient consent recorded in the checkbox, must be taken as informed consent using points 1 and 2 in the Patient consent to treatment and privacy information sheet to support the discussion with the patient. CLICK HERE to access the patient consent to treatment and privacy information factsheet.
Please also tick all the additional demographics for pilot evaluation that apply to the patient. There is also a requirement to select the patient payment status (e.g concessional or general) from the drop down, for reimbursement for the cost of medicines from the Victorian Government.
- SCREENING QUESTIONS will pre-populate the age based on DOB field in PATIENT INFORMATION
Please note: Patients must be 18 years of age or older. If the patient is younger than 18, please refer the patient.
- Complete the CLINICAL REVIEW including all mandatory fields
Please note: If the patient meets specific conditions, answer the question 'Are you referring the patient to their GP?' and enter the reasons for referral.
IMPORTANT: Based on the Clinical Review answers you may be directed to refer the patient to the Royal Victorian Eye and Ear Hospital, Emergency Department, Ophthalmologist or Optometrist. You will be prompted within the form (see below example).
- Complete the TREATMENT section including all compulsory fields.
If the patient has a rash present for less than 72 hours you may select Antiviral therapy.
- Select the items completed as part of the NON-PHARMACOLOGICAL & SELF CARE ADVICE section
- Complete COMMUNICABLE DISEASE NOTIFICATION
You must notify the Victorian Department of Health within 5 days of the consultation if you confirm a Herpes Zoster (Shingles) case.
Click here to access Communicable Diseases - Routine notifications online form
- Complete REFERRAL and GP LETTER (as required with patient consent). You may select to refer the patient to their Usual Prescribers, Other OR Royal Victorian Eye and Ear Hospital or Emergency Department. A PDF will be generated.
- At the top and the bottom of the form, you can save a draft, delete or complete the form.