Contents: Dispensing to in-patients

Floor stock system Individual prescription system Combination of two

Dispensing to out patients:

Dispensing to in-patients:
It is important activity of the pharmacy department

Unit should be located in a place easily accessible to all

wards (free from disturbances) All sections of the in-patients pharmacy i.e., storage, dispensing, manufacturing,parenteral solutions etc,. should be continuous. In modern hospitals, satellite pharmacies are operated Physical plant of the in-patient pharmacy should be well planned No std rules regarding the requirements of personnel

Drug distribution system:

Dispensing for in-patients comprises of removing two

or more doses from a bulk drug container another for subsequent use 1.Individual prescription medication for each patient 2.Complete floor stock system 3.Combination of above two 4.Unit dose dispensing (centralized or decentralized) 5.Pharmacy coordinated unit dose dispensing & drug administration system

 Individual prescription medication for each

patient:

Compounding, dispensing usual method Name, strength of each drug-container Medication stored nursing unit cabinetnursein-charge Administration by nurse-in-charge or assistant So possible for observing adverse reactions Nurses should also aware of proper storage, labeling & accounting of drugs

Complete floor stock system:

1.Free floor stock system 2.Charge floor stock system

1. Predetermined list of medication available on every nursing unit of the hospital for use of the patient for which they do not charge. Nurse-requisition Pharmacist-dispenses-a drug basket Orders from nursing unit receives daily In modern hospitals pharmacy is made responsible for maintaining proper inventory of free floor drugs called automatic free floor stock replacement system

2.Charge floor stock:

Drugs are those for which the patient is charged

for every single dose administered to him. Only costly drugs charged for patients Under envelop system, pre-labeled envelops are filled with specific drugs & a predetermined quantity is placed at the nursing unit. When the dg is admin., the patients name, room number are entered on the envelop & placed in the out basket

A combination of 1&2:
Free floor stock drugs are charged Patient pays for the drugs as a part of nursing service

Unit dose dispensing system: In this system pharmacist prepares every dose of the medication ready for use. Solid medication is labeled for each patient Liquids r premeasured & injections r accurately measured into sterile syringes This system becomes sole responsibility of the pharmacist. Unit dose medication ordered, packaged,handled, administered &charged in multiples of single dose units eg:strip packaged tablets & capsules.

 Such system may be centralized or decentralized at the

nursing unit. Advantages: Provides improved pharma.services round the clock Medication prepared by pharmacist so errors r minimized Excessive duplication of orders & paper work at nursing station & pharmacy r avoided Patients only charged for doses administered drug wastage eliminated Automation saves time & cost

 The concept CUDD & DUDD In CUDD all in-patient dgs r dispensed in unit doses &

all dgs r stored in certain place in pharmacy In DUDD satellite pharmacies on each floor of the hospital System introduced initially for injections, tablets & capsules & liquid preparations Injections---sterile syringes Tablets, capsulesstrips liquids unit dose container bottles 15,30,45 ml etc.,

 . Pharmacy coordinated unit dose dispensing &

drug administration system: Coordination btn dg distribution & dg admin. The system operated under the supervision of pharmacist during drug administration phase In this way pharmacist shall be working with physician on the nursing unit to carry out the function of safe & appropriate use of drugs for in-patients. Along with this type of well recognized system dgs may also be distributed by mobile dispensing unit & mechanical dispensing.

Dispensing to out patients

Out- patients r those who donot occupy beds in

hospitals r also known as ambulatory patients These people mostly need primary care It is always preferable to have a separate out-patient pharmacy When this is not possible units r combined & services provided from same or separate window Separate is required cause it may cause disturbance to the in-patient & routine working of hospital & its pharmacy.

 Layout of the hospital pharmacy is very important

cause the out-patients can carry a good or bad impression about the hospital depends upon the services they get Unit must have prescription receiving window & a delivery window Waiting area should be provided This area should elegend, clean ventilated & provided with comfortable seats. Some publications relating to medicine & pharmacy, newspapers & magazines r also provided

 Receipt & issue system: If a patient visit for the first time registration is must Depending upon the symptoms he is directed to a

particular department Physician-prescription contains name, age, registration number & diagnosis of the patient Prescription is to be produced to the pharmacist at the prescription receiving counter Any doubts-direct physician After checking assembles the materials required for compounding Generally prescriptions contain pour count

 Compounded prescriptions should filled in the

container & labeled to include name,registration number, age, direction of use, storage Call check system can employed for delivering compounded drug
Recovery &service charges: In charitable hospitals the patients have to pay the

charge for the medication,services 3 important methods of pricing based on

 Fee depends on dosage form & no. of doses Fee depends on cost of drug

A professional fee is for all types of prescriptions

irrespective of cost of dgs etc., Prescrption price can be calculated by Prescription price= drug cost+professional fee Professional fee depends on practitioners environment PF=COD+Profit COD=total expences-dg cost/no.of medications ordered dispensed

 Professional fee depends on operating expenses PF=A+(BxC) +E

D A=managers salary B= prescription sales to total sales C=expenses D=total no. of prescriptions E=net profit for prescription

 Prepackaging: very convenient method improving the std of

dispensing inn hospital pharmacies. It can be employed for fast moving items or which take too much time for packaging It requires accurate procedures, controls & records in order to identify the product Based on demand for the product size of unit to be packaged & no. in each unit Type of containers & closures to be used

 Stability of the product & exp.dt

Unit cost of prepackaging Packaging facilities ADVANTAGES: Improves std of dispensing Cut down patient waiting time Usually no special equipment is necessary It can be employed for both in & out patients. PACKAGE SIZE: In most hospitals20-25 tablets or capsules

considered to be prepackage size for in-patients Out patientsdepends on no. of appointments in month