Day2_Good_storage_practice.in Healthcare

Drug storage

1. Good storage practices

2. Outline Requirements for good warehousing practices Routine Warehouse or Storeroom Management Tasks Receiving and Arranging Commodities Storage Conditions Maintaining the Quality of Your Products

3. Tell us about your store room Temperature monitoring Shelves/pallets Arrangements of medicines: Pharmacology/Pharmaceutics Separate room for expired/damaged stock?

4. Requirements for good warehousing practices A facility with adequate storage and working space as well as infrastructure components that will protect commodities from harmful environmental conditions Application of proper procedures so that commodities are always available, accessible, in good condition, and pose no risk of injury to workers Availability of timely and accurate inventory data for decision-making Qualified human resources in sufficient quantity to meet operational needs

5. Routine Warehouse or Storeroom Management Tasks(1) 1. Daily Monitor storage conditions Clean receiving, storage, packing, and shipping areas, bins, shelves Remove garbage Ensure that aisles are clear Ensure adequate ventilation and cooling Ensure that products are protected from direct sunlight Update stock records and maintain files Monitor stock levels, stock quantities, and safety stocks Submit emergency order (as needed, using local guidelines)

6. Routine Warehouse or Storeroom Management Tasks(2) 2. Monthly Conduct physical inventory or cycle count, and update stock cards Check for signs of rodents, insects, or roof leaks Inspect the storage structure for damage, including the walls, floors, roof, windows, and doors

7. Routine Warehouse or Storeroom Management Tasks(3) 3. Every Three months Use established procedures to dispose of expired or damaged products Visually inspect fire extinguishers to ensure that pressures are maintained and extinguishers are ready for use Assess stock situation and place an order Receive products Store products using correct procedures; rearrange commodities to facilitate the first-to-expire, first-out (FEFO) policy Complete required reporting and documentation Reassess maximum/minimum stock levels, and adjust if needed

8. Receiving and Arranging Commodities

9. Receiving Ensure there is sufficient storage space Prepare and clean the areas used for receiving and storing the products Inspect packages for damaged or expired products Separate the damaged or expired stock from the usable stock If damage or expiry is discovered while the delivery truck is still at your site, refuse to accept the products and note the problem(s) on the delivery note Count the number of units for each product received and compare to issue voucher Record the date and quantity received on stock card

10. Arranging Basic Storage Systems Shelves Floor pallets Block-stacked pallets Pallet racking Direct storage of cartons, bottles, kits on the storage floor must be avoided!

11. Storage equipment Floor Pallet Block-stacked Pallet Pallet racking

12. Batch No: Expiry: Description Batch No: Expiry: Description Fragile Items Fragile Items Heavy Items Heavy Items Reserve Stock Reserve Stock Batch No: Expiry: Description Batch No: Expiry: Description Batch No: Expiry: Description Batch No: Expiry: Description Batch No: Expiry: Description Batch No: Expiry: Description Batch No: Expiry: Description Batch No: Expiry: Description Heavy and fragile items on the lower shelves Frequently picked items at waist height Extra stock on the upper shelves (if it is not too heavy) Boxes tidy and closed as much as possible Batch No: Expiry: Description Batch No: Expiry: Description Batch No: Expiry: Description Batch No: Expiry: Description Batch No: Expiry: Description Batch No: Expiry: Description Batch No: Expiry: Description Batch No: Expiry: Description Batch No: Expiry: Description Batch No: Expiry: Description Batch No: Expiry: Description Batch No: Expiry: Description Shelves: Basic Rules

13. Pallets If using pallets, stack cartons on pallets: At least 10 cm (4 inches) off the floor At least 30 cm (1 foot) away from the walls and other stacks No more than 2.5 m (8 feet) high (general rule)

14. Source: Photo by Negussu Mekonnen Therapeutic/Pharmacological Classes: ART, TB medicines, Anti-Diabetics, Anti- Hypertensives etc Alphabetical order: (Acyclovir, Albendazole , Amoxycillin , Azithromycin, etc ) Dosage form Frequency of use Common Systems for Arranging Medicines

15. Source: Photo by Gabriel Daniel 15 Double-locked cabinet Special Precautions for biological products, live microorganisms — Special Precautions

16. Quality Maintenance

17. Maintain Quality Source: Photo by Gabriel Daniel Inside the storage area … …what can affect the quality of the medicines? Temperature Humidity Direct light Cleanliness

18. Temperature You can be a thermometer. If you feel hot in your storeroom, your medicines are probably hot, too.

19. Follow the manufacturer’s storage instructions. Avoid extreme temperatures; they damage products (>40°C or, for some products, <0°C). Make sure room temperature is 15–25°C Monitor the temperature regularly at the hottest time of the day by placing thermometers in various zones. Temperature: Storeroom

20. Record daily the temperature in the refrigerator. Maintain the recommended refrigerator temperature: 2–8°C. Keep freezers and refrigerators in shady, ventilated area. Temperature: cold storage

21. Minimize the frequency and duration of opening the refrigerator. Keep the refrigerator well organized. Use the refrigerator exclusively for medicinal products, not for staff food. Temperature: Cold Storage (2)

22. In humid climates, dehumidifiers are useful for preventing moisture damage. If the storeroom has no dehumidifier, use ventilating fans, or open the windows if possible. Dehumidifiers Open window Quality: Humidity and Ventilation

23. Storage Options Keep liquids in amber glass Keep light-sensitive products in their original packaging. Protect from sun. Keep in a cupboard. Keep in shady corner. Keep in closed boxes. X-ray films Latex Amber Glass Quality: Direct Light

24. Post a schedule and instructions for cleaning. Make sure shelves and floor are clean regularly. Dispose of garbage often. Keep the area outside the facility clean. Schedule regular inspection. Quality: Cleanliness

25. Prohibit storage and consumption of food in areas where stock items are stored. Staff Facilities and Housekeeping

26. Dispose of flammable trash. Prohibit smoking. Provide fire extinguishers & smoke detectors, and inspect them regularly. Make sure the emergency exit is not blocked or inaccessible. Keep buckets of sand handy if no fire extinguishers are available. Check frequently for fire. Description: Description: Description: Description: Description: Description: Description: Description: Description: Security (1): Fire Precautions

27. Security (2): Facility Measures Photo by Gabriel Daniel, Management Sciences for Health, Rational Pharmaceutical Management Plus Program

28. Use double doors and double locks on entrance. Use burglar bars on windows. Restrict entry to the store. Set rules so that all staff who handle supplies are equally accountable for their actions. Order books should be used by facility departments to order from the storeroom and have designated days to order to reduce traffic to the storeroom. Security (3): General Rules

29. Protecting Against Theft: At Storage Facilities Limit access to only designated staff Limit the number of keys made for the facility; keep a list of people who have keys Secure all locks and doors Make unannounced spot checks Provide independent stock count/inventory control

30. In Health Centers Lock the storeroom/cupboards Have inventory control cards for each product Set maximum dispensing quantities Have dispensers record individual prescriptions and maintain prescription or dispensing registers Limit dispensing to authorized staff members only As additional protection against theft, monitor items that are fast moving, chronically in short supply, in high demand by customers, expensive, life saving, and easy to hide or disguise

31. During transportation of medicines— Verify documents (invoices, delivery notes and packing list) Use packing seals Use strong boxes Security (4): Outside the Facility

32. Thank you