ORGANIZATION
AND STRUCTURE
Syllabus
Organization of a hospital and
hospital pharmacy.
Responsibilities of a hospital
pharmacist.
Pharmacy and therapeutic committee.
Budget preparation and
implementation.
DEFINITION
1.
"Hospital"
means any institution, place, building or agency, public or private, whether
organized for profit or not; devoted primarily to the diagnosis, treatment or
care of patients admitted for overnight stay or longer in order to obtain
medical care, surgical care, obstetrical care, or nursing care for illness,
disease, injury, infirmity, or deformity.
2.
"General
hospital" means a hospital maintained for the purpose of providing
hospital care in a broad category of illness and injury.
3.
"Specialized
hospital" means a hospital maintained for the purpose of providing
hospital care in a certain category, or categories, of illness and injury.
4.
“Hospital
pharmacy” is defined as the practice of pharmacy in a hospital setting
including its organizationally related facilities and service.
ORGNIZATION OF HOSPITAL PHARMACY
 |
RESPONSIBILITIES OF HOSPITAL PHARMACISTS
The responsibilities of hospital pharmacists can be
summarized as follows:
I. In-patient
Pharmacist’s responsibilities
A. Dispensing
area
B. Patient
care area
(i) Supervision
of drug administration
(ii) Direct
patient care
(iii) General
responsibilities
II.
Out-patient Pharmacist’s Responsibilities
A. Dispensing
area
B. Patient
care area
C. General
responsibilities
I. In-patient
Pharmacist’s responsibilities
A. Dispensing area
1. Insures
that established policies and procedures are followed
2. Checks
for accuracy of doses prepared:
- Intravenous admixtures
- Unit dose
3. Provides
for proper drug control:
- Insures that drugs are stored and dispensed properly (e.g. investigational drugs)
- Insures that all the drug laws are followed.
4. Insures
that proper techniques are used in compounding intravenous admixtures and
extemporaneous preparations.
5. Provides
for proper record keeping and billing
- Patient-medication records
- Extemporaneous compounding records
- Intravenous admixture records and billing
- Reports (e.g monthly workload report)
6. Maintain
professional competence, particularly in knowledge of drug stability and
incompatibilities.
7. Insures
that new personnel are trained properly in the policies and procedures in the
dispensing area.
8. Coordinates
the activities of the area with the available staffs and resources.
9. Keep
the dispensing area clean and orderly.
10. Communicates
with all pharmacy staff regarding new developments in the area and assists in
employee evaluations.
11. Provides
drug information as necessary to pharmacy ,medical and nursing staffs.
B. Patient-Care area
1. Supervision
of drug administration
a.
Reviews and interprets each unit dose and IV admixture
medication order (prescription) to ensure that it is dispensed correctly.
- Reviews each patient’s drug administration form periodically to ensure that all doses are administered and noted in a chart correctly.
(i) Reviews
all the doses missed, reschedule the doses as necessary and put signatures on
all “drugs not given” notices.
(ii) Insures
that new drug-administration forms are transcribed accurately for continuity of
drug therapy.
- Confirms periodically that administered doses are noted correctly on the patient’s chart.
- Keep records of narcotic administered to the patients.
- Acts as liaison between the nursing and other medical staffs.
- Periodically inspects the medication area to insure adequate stock of drugs in the patient-care area.
2. Direct patient care (Wards, operation theatre etc.)
a. Identify
the drugs brought into the hospital by the patients.
b. Obtains
patient medication history and produce it to the physician.
c. Assists
the physician in selecting dosage regimens and schedules and then assign
drug-administration times for this schedules.
d. Monitors
patient’s total drug therapy
(i)
Effectiveness / ineffectiveness
(ii)
Side effects
(iii)
Toxicities
(iv)
Alergic drug reactions
(v)
Drug interactions
(vi)
Drug interactions
(vii)
Appropriate therapeutic outcomes.
e. Counsels
patients on
(i)
Self medication in hospital
(ii)
Discharge medication
f. Participates
in cardiopulmonary emergencies by
(i)
Procuring and preparing required drugs
(ii)
Charting all medications given.
(iii)
Performing cardiopulmonary resuscitation, if necessary.
3. General responsibilities
a. Provides
education to
(i)
Pharmacists, students and residents.
(ii)
Nurses and nursing students
(iii)
Physicians and medical students
b. Provides
drug information to physicians, nurses and other health-care personnel.
II. Out-patient pharmacist’s responsibilities
A. Dispensing
Area
- Insures that established policies ad procedures are followed.
- Checks for the accuracy in the work of supportive personnel.
- Insures that proper techniques are used in the compounding of the drug.
- Provides for record keeping and billing
a. Patient
medication records
b. Investigational
drug records
c. Outpatient
billing
d. Reports
e. Prescription
files
- Insures that new personnel are trained properly in the policies and procedures of the ambulatory patients.
- Keeps the ambulatory pharmacy area neat and orderly at all times.
B. Patient
Care Area
- Inspects periodically the medication areas on the nursing unit to insure an adequate supply of stock drugs and their proper storage.
- Identifies the drugs brought by the patients.
- Obtain patient-medication histories and conveys the information to the physicians.
- Assists the physician in selecting dosage regimens and schedules.
- Monitors the patients ‘total drug therapy’ for effectiveness, side-effects, toxicities, allergic drug reactions, drug interactions etc.
- Counsels the patients on proper use of the medication.
- Prepares medication for intravenous administration.
- Provides medication for patient’s home care.
C. General
Responsibilities
- Provides drug information as necessary to the pharmacy, medical and nursing staffs.
- Provides adequate drug control.
a. Insures
that drugs are handled properly (e.g. investigational new drug)
b. Insures
that all laws are followed.
- Participates in cardiopulmonary emergencies by
- Provides in-service education to
a. Pharmacists,
and students.
b. Nurses
and nursing students.
c. Physicians
and medical students.