a) Drug store management and inventory control
Organisation of drug store, types of materials stocked and storage conditions, Purchase and inventory control: principles, purchase procedure, purchase order, procurement and stocking, Economic order quantity, Reorder quantity level, and Methods used for the analysis of the drug expenditure
Drug Distribution and Control
The pharmacy shall be responsible for the procurement, distribution, and control of all drugs used within the institution. This responsibility extends to drugs and related services provided to ambulatory patients. Policies and procedures governing these functions shall be developed by the pharmacist with input from other involved hospital staff (e.g. nurses) and committees (pharmacy and therapeutics committee, patient-care committee, etc.). In doing so, it is essential that the pharmacist routinely be present in all patient-care areas, establishn rapport with the personnel, and become familiar with and contribute to medical and nursing procedures relating to drugs.
Standard IV: Drug Information The pharmacy is responsible for providing the institution’s staff and patients with accurate, comprehensive information about drugs and their use and shall serve as its center for drug information.
2. Drugs dispensed should be as ready for administration to the patient as the current status of pharmaceutical technology will permit, and must bear adequate identification including (but not limited to); name or names of drug, strength or potency, routes(s) of administration, expiration date, control number, and such other special instructions as may be indicated.
3. Facilities and equipment used to store drugs should be so designed that the drugs are accessible only to medical practitioners authorized to prescribe, to pharmacists authorized to dispense, or to nurses authorized to administer such drugs.
4. Facilities and equipment used to store drugs should be designed to facilitate routine inspection of the drug prior to the time of administration.
5. When utilizing automated (mechanical and/or electronic) devices
as pharmaceutical tools, it is mandatory that provision be made to provide suitable pharmaceutical services in the event of failure of the device.
6. Such mechanical or electronic drug storage and dispensing devices,
as require or encourage the repackaging of drug dosage forms from the manufacturer’s original container, should permit and facilitate the use of new package, which will assure the stability of each drug and meet the standards for the packaging and storing of drugs, in addition to meeting all other standards of good pharmacy practice.
7. In considering automated (mechanical and/or electronic) devices as pharmaceutical tools, the distinction between the accuracy required in accounting practices versus that required in dispensing practices should be clearly distinguished.
Complete floor stock system Under this system, the nursing station pharmacy carries both “charge” and “non-charge” patient medications. Rarely used or particularly expensive drugs are omitted from floor stock but are dispensed upon the receipt of a prescription or medication order for the individual patient.
Although this system is used most often in governmental and other hospitals in which charges are not made to the patient or when the all- inclusive rate is used for charging, it does have applicability to the general hospital. Obviously, there are both advantages and disadvantages to the complete floor stock system.
Advantages of complete floor stock system:
(i) Ready availability of the required drugs.
(ii) Elimination of drug returns.
(iii) Reduction in the number of drug order transcriptions for the pharmacy.
(iv) Reduction in the number of pharmacy personnel required.
Disadvantages of complete floor stock system:
(i) Medication errors may increase because the review of medication orders is eliminated.
(ii) Increased drug inventory on the pavilions.
(iii) Greater opportunity for pilferage.
(iv) Increased hazards associated with drug deterioration.
(v) Lack of proper storage facilities on the ward may require capital outlay to provide them.
(vi) Greater inroads are made upon the nurse’s time. To be borne in mind by the student is the fact that in some hospitals the complete floor stock system is successfully operated as a decentralized pharmacy under the direct supervision of a pharmacist.