ACKNOWLEDGEMENT

It is a pleasure to thank the people whom made this orientation report possible. It is difficult to overstate my gratitude to my supervisor Mr. Haji Rusni B.Sharif and all staff pharmacy. With their enthusiasm, inspiration, and great efforts to explain things clearly and simply, they helped to make this orientation report to be done on time. I would like to thank also the pharmacy technicians and pharmacists of Hospital Selayang because throughout my report writing period, they provided encouragement, sound advice, good teaching, good company, and lots of good ideas. I would have been lost without them. I would like to thank my lectures Ms.Nah Bee Boey, Ms.Lee Hooi Leng,Ms. Norashikin, for teach and guide us to complete this orientation report. Thank you so much also to my dear friends who also posted together with me in Hospital Selayang , for their constant reminders and much needed motivation. And lastly to God, who made all things possible.

WEEK 1 (18/7/11 - 22/7/11)

This is the first week of my practical in Hospital Selayang. I will be attached to this hospital for 14 weeks. This journal will be covering only semester 7 which is from 18/7/11 to 4/11/11. The first day of us went to the main pharmacy department which is located on the second floor of the Hospital Selayang. We all wait infront of the waiting area to meet Mr. Haji Rusni B.Sharif ( Pharmacy Assistant U38). Then we were

assembled to meeting room and he gives us a brief explaination about pharmacy deparment. Then we were given work shedule for 14 weeks. We were divided into group of two . Two group were attached to six different department CDR(Cytotoxic Drug Reconstitution), TPN(Total Parenteral Nutrition), inpatient, outpatient, manufacturing and store). We were guided by Mr.Haji Rusni to look around the hospital from that we get to know the location of each department place and have a chance to intoduce with the each department pharmacist incharge. My patner was shamala . First I was attached to TPN (Total Parental Nutrition ) and my friend was attached to CDR( Cytotoxic Drug Reconstitution). The followed day ,it was my first day in TPN deparment. I meet with Mr.Hong Yuming ( pharmacist of TPN deparments) and intoduce myself . Firstly he explain about the Aseptic Technique,Sterile Compounding Area(Clean Room),Laminar AirFlow Hoods, handwashing , equipment and supplies and the preparation of IV admixtures. Then she bring me to look around the TPN rooms. There are 3 rooms inside the TPN. First is the outside room which is used for drees changing room. In this room we wearing protective appareal to enter the aseptic area. The second room is compounding preparation room. We cannot enter the room without protective appareal. The third room is compounding room. Only the pharmacists can enter the room. He teach me how to record the temperature of fridge. It must record on morning and evening before we all go back. The first day got no preparation so my pharmacist teach me the proper hand washing before entering the aseptic room. She also explain about the horizontal laminar air flow hood,the flow of filtered air is from the back of the hood to the front. The followed day got prepation of solution B so my pharmacist ask me to wear all the protective appareal. Firstly I wear the disposable coveralls or gowns. Then I wear the head cover and shoe. Thirdly I wear the mask. After that I wash my hands with alcohol 70% for 10 to 15 minutes. Lastly I wear the gloves and enter the aseptic room. Here I swab the pass box ,the apparatus used for the preparation sucg as needles,syringes,ampoules and vials. After swaping I put all the apparatus inside the pass box. The pharmacist who doing the preparation take the apparatus from the pass box. Once the pharmacist finish doing the IV admixture means they put inside the pass box. Then I take it from the pass box and label

it. After labeled I put the IV admixture inside a big plastic bag. The bag is stored inside the TPN fridge.

WEEK 2 ( 25/7/11 - 29/7/11)

This is my second week practical in new departments which is in CDR (Cytotoxic Drug Reconstitution). My supervisor here was Miss.Siti Syarihan who are the leader Pharmacist in the CDR department. She explain to me about the Policy of component Preparation Room, Standard of Procedure(SOP) of Biological Safety Cabinets(BSC), Protective Apparel,preparation and handling of cytotoxic and hazardous drugs. Hazardous agents require special handling procedure to minimize the potential for accidental exposure. Since it my first day,my pharmacist ask me to enter the CDR compounding preparation room to help his preparation. That day preparation is Cyclophosphamide anticancer drug. She teach me how to wear the protective garments,such as disposable coveralls or gowns,gloves,mask,shoe and hair covers which is used to shield personnel from exposure. After that I wearing all the personnel protective appareal and then enter the compounding preparation room. In that room she ask me to swab the pass box,the desk and the appropriate equipments used for the preparation such as beaker,kidney shape bean and the measuring cyclinder with alcohol 70%. In the same week, I get to know all the apparatus which are using in the CDR preparation. I also learnt the procedures and safety precautions. Other than that I also get to know a few anticancer drugs such as Cyclopsosphamide,5-Fluroracil and etc. For moreover I also learn about labeling,storage and transport of CDR drugs. Hazardous drugs should be identified by distinctive label indicating that the product requires special handling. Labels should be attached to drug packages and their storage shelves.

WEEK 3 (1/8/11 - 5/8/11)

This week im at manufacturing department according to my duty roster. My first day start with introduce myself to En. Mohd Firdaus. He briefly explain to me every section that get in manufacturing department. There were internal, external , prepacking and unit of dose. The first work that I get start at manufacturing department was weighing the measurement of the sodium bicarbonate and sealed the packet. Put 100 packet of sodium bicarbonate in each plastic. When doing this method i must wear gown, hair cap, face mask and gloves.

WEEK 4 (8/8/11 -12/8/11)

This is forth week at Hospital Selayang. This week I at store management .Firstly I go introduce myself to Mr.Hafiz ( pharmacist U44). I start my day with explanation about store by Mr.Hafiz.The store in hospital selayang can be classified into two which is the major store and sub-store. The major store divided into five parts which is store plastic equipments, store surgical 1and store surgical 2, store for fridge items and store for drugs. A day before any of the pharmacy technician will indent all the drugs. They will enter the quantity of the needed drugs in the track care system where it will be notify automatically by store department. The next day, store in charge person will prepare the drugs and call the outpatient saying the drugs were prepared. Then the pharmacy technician comes to the main store to collect the medication. The medication is checked over the list printed. I help the store management people to take and arrange the drugs according to the list. The bulk drugs are first put into the box after that the box is placed on the pallet. Each and every drugs before taking from the Rak must be recorded in the red bin card. The manufacturing date and expiry date should be checked for every drugs. This is a daily base process where everyday there will be stock indent in the morning when there are fewer patients. Besides that I learnt how arrange the drugs according to the usage. The external drusg are arranged besides the store such as creams, suppositories,etc. the internal drugs such as tablets, capsules,etc are arranged infront of

the store. The eye drop and hear drops are placed in the middle side of the store. Some drugs are placed into the lock and key cabinet. Those drugs are very expensive and very difficult to get. In store I also learnt how to pack the drugs into the bigger plastics.

WEEK 5 (8/8/11 -12/8/11)

The week 5 I was attached to the inpatient department. Like usual I and my patner shamala introduce ourself to Pn.Balqis ( pharmacist U44). She explain us about managing the troli and the pharmacist will give us 1 or 2 troli from different ward. Firstly we must print out the list of current patient in the wad and the discharge patient of 1 day of the ward given. Then we must take fail and prescription that putted on the file according the ward given to us. We must arrange the prescription by seeing the name , mrn , bed number and ward of the the each patient on the prescription and in the list that print out was same or not. If not we must take the prescription to computer and type the number of mrn and search for the patient was discharge ready or not and now the patient is placed at which ward. Then pasted the prescription in the file according the bed number that mention in the prescription. Label the bin name and mrn of the patient according the list. Filled and arranged in the bin with the medicine by seeing the prescription that mention bd, tds , qid , on or od.

WEEK 6 (15/8/11 -19/8/11)