HOSPITAL PHARMACY (D. Pharm)

Title: Hospital Pharmacy: Improving Patient Care and Medication Management

Introduction
- Welcome to the presentation on Hospital Pharmacy.
- Hospital pharmacies play a crucial role in patient care and medication management.
- This presentation will explore the functions, responsibilities, and challenges faced by hospital pharmacists.

What is a Hospital Pharmacy?
- Definition: Hospital pharmacy is a specialized pharmacy department within a healthcare facility, responsible for the procurement, storage, dispensing, and safe administration of medications to inpatients and outpatients.
- Hospital pharmacists work closely with healthcare teams to optimize drug therapy and patient outcomes.

Functions of Hospital Pharmacy
1. Medication Dispensing: Hospital pharmacists dispense prescribed medications accurately, ensuring the right drug, dose, and dosage form for each patient.
2. Medication Management: Pharmacists monitor and review medication regimens, checking for drug interactions, allergies, and appropriateness of therapy.
3. Inpatient and Outpatient Services: Hospital pharmacies serve both inpatients and outpatients, providing essential medications during hospitalization and discharge.
4. Clinical Pharmacy Services: Pharmacists participate in ward rounds, offering medication consultations and recommendations to healthcare providers.
5. Drug Information: Hospital pharmacists provide drug-related information to healthcare professionals and patients, ensuring safe and effective use.
6. Compounding: When required, hospital pharmacists compound specialized medications tailored to individual patient needs.

Roles of Hospital Pharmacists
- Medication Safety: Ensuring the safe use of medications by conducting safety checks and implementing error prevention strategies.
- Drug Procurement: Collaborating with suppliers and maintaining appropriate drug inventories to meet patient needs.
- Quality Assurance: Ensuring that medications meet high-quality standards and are stored and handled properly.
- Patient Education: Providing medication counseling to patients, ensuring they understand how to take their medications correctly.

1. HOSPITAL PHARMACY d-pharm 2 nd year e.r.20 Presented by Pragati K. Mahajan Preparation date July 2023

2. Introduction Define Hospital :- Hospital is a complex organization which utilizes specific scientific equipment and functions through trained staff team educated to the problems of modern medical science. All welded together in the common purpose of restoration and maintenance of good health. Or An institution of community health its function embrace the entire spectrum of medical care-prevention, diagnosis, therapy, rehabilitation, education and research. Its primary commitment is towards the patient. Pragati K. Mahajan

3. Classification of hospital Pragati K. Mahajan

4. Classification of hospital A) On the basis of Clinical orientation I) Major diseases Psychiatric hospitals or mental hospitals. T.B. Hospitals. Leprosy hospitals. Cancer hospitals. Ii ) Anatomical & Physiological Specialization Ear, nose and throat hospitals. Orthopedic hospitals. Eye hospitals. III) Client group they serve Pediatrics hospital for children’s Gynecological hospitals for women. Maternity hospitals for mothers . IV) System of medicine Allopathic (modern medicine) hospitals. Ayurvedic (traditional system) hospitals. Homeopathic hospitals. Unani hospitals. Nature cure centers. Physio-therapy centers . Pragati K. Mahajan

5. Classification of hospital B) ON THE BASIS OF NON-CLINICAL ON THE BASIS OF OWNERSHIP Public or government ownership Central Govt. Hospitals E.g. Railway Hospital, Defense Hospital. 2) State Govt. Hospitals. E.g. Civil Hospitals At District Headquarter Sassoon Hospital. Pune. 3) Local Self Govt. Hospitals. E.g. B.M.C. Hospital, Like Bhagvati Hospital, Mumbai. These Are Run By Municipalities. Private ownership Trusties-the Board Of Trusties Manage Affairs E. g. Jaslok Hospital, Mumbai 2) Religious Bodies/Orders. E. g Ram Krishna Mission Hospital, Vellore. Limited Companies-they Can Be Incorporated As Public Subscribes To The Share Capital. E. g. Apollo Hospital. Ltd., Chennai 4) Other Private Hops. / Nursing Homes. Pragati K. Mahajan

6. Classification of hospital C) On the basis of size Pragati K. Mahajan

7. Classification of hospital D) On the basis of cost A) Elite hospital Consist of high technology & medical science advancement Comprise deluxe room with T.V. Telephone and refrigerator They known as “five star hospitals” Example apollo hospital B) Budget hospital Meant for moderated low budget people ( example charitable & civil hospital ) Pragati K. Mahajan

8. Classification of hospital Pragati K. Mahajan

9. The administer of hospital and his responsibility The Physician is an administrator of hospital. Responsibilities Administrator is selected by governing body to run hospital. Governing body makes the policies & set the goals & administrator implements that policy. Administrator is the link between governing body , clinical services and all other employees He oversees the training of intern students, nurses and volunteers. He co-ordinates with departmental heads of the hospital He constitutes various committees for various functions. He has to provide facilities equipment and assistance to clinical department for better patient's health care. Pragati K. Mahajan

10. Hospital pharmacy Define hospital pharmacy :- Hospital pharmacy receives drugs and medicines and other medical supplies, store them , dispenses them to inpatients and outpatients and ,may have a manufacturing extension to manufacture pharmaceuticals and parentals in bulk under supervision of qualified registered pharmacist . Pragati K. Mahajan

11. Function of hospital pharmacy Main function of hospital pharmacy is to take care of inpatient and outpatient . The filing and labelling of drug containers. The dispensing of drugs, chemicals and pharmaceutical preparations. It decrease the incidence of diseases through early detection and treatment ,so it acts as a lifesaving It conducts research and specialized training program . The inspection of all pharmaceutical supplies. D ispensing of all narcotic drugs and alcohol and maintenance of record Specifications of the quality of drugs, chemical , antibiotics, biologicals and pharmaceutical supplies used in the treatment of patients. To make larger volume injection fluid and other parentals and to maintain aseptic condition while doing so. Pragati K. Mahajan

12. Scope To educate patients , nurses, interns & pharmacy trainers on various aspect of drugs. To work as a educating and counselling patients, promoting health and preventing disease. Proper storing of drugs and record keeping Discarding the expired drugs medicine and container To used as a data bank of drug information . It check the medical item are received and maintained record Pharmacist roles are no longer limited only compounding and dispensing job it expanded to participate inpatient care system more actively . To organize and participate in research projects, educational programs, conference and co-operate with all departments. To ensure availability of right medication at the right time, dose at minimum cost. Pragati K. Mahajan n

13. National And International Scenario Of Hospital Pharmacy Pharmacy is an integral part of the healthcare system .The pharmacist is third largest group of healthcare professional in world The main job of pharmacist is to manufacture and dispense the drug but now they are expanded to patient care. Many of countries are not accepting the pharmacist as healthcare team although they are capable to work in these field. In INDIA hospital pharmacist has a limited role in comparison to western countries. Many of countries such as AUSTRALIA, UNITED KINGDOM AND UNITED STATES granted the pharmacist to prescribed drug for patient to reduce burden on physicians and improve quality of care. Hopital pharmacy is a important part of hospital to provide pharmaceutical preparation's. Developed countries has clearly define role of hospital pharmacist ,but many of countries have not define their roles. Pragati K. Mahajan

14. Location and layout of hospital pharmacy Hospital pharmacy department should be situated in some central area on the first floor or on ground floor of hospital so that it is easily accessible to patient and various department of hospital and nursing stations. Outpatient pharmacy should have pleasant look & enough space for seating of patients who are waiting for medicine . It should display educative posters on health and hygiene Space must be assigned for routine manufacturing of preparations which can be processed profitably e.g. Stock solutions, bulk powders, ointments, The manufacturing room can be adjacent to the pharmacy .A dumb –waiter should connect the two. The medical stores of a pharmacy should also be adjacent to the pharmacy itself . A dumb –waiter should connect the two. Pragati K. Mahajan

15. Layout of Hospital pharmacy Pragati K. Mahajan

16. Pharmacist requirement According To Qualification Chief pharmacist must be post-graduate in pharmacy and having an adequate practical experience. The hospital pharmacy set up consist of dispensing section, manufacturing section quality control section, clinical pharmacy section Pragati K. Mahajan

17. Pragati K. Mahajan

18. According to work load The number of pharmacist is varies with the size of hospital and services it offers. The number of pharmacist can calculate on basis of workload like number of prescriptions received and dispensed. As the number of bed increases the number of pharmacist also increase , but not proportionately. There must be 3 pharmacist in very small hospital Pragati K. Mahajan Bed strength Number of pharmacist required Up to 50 beds 3 Up to 100 beds 5 Up to 200 beds 8 Up to 300 beds 10 Up to 500 beds 15

19. Good pharmacy practice in hospital pharmacy It is a pharmacy practice that response to the need of people who use the pharmacists service to people optimal , evidencebased care. To support this practice it is essential that there be an established national framework of quality standard International pharmaceutical federation (FIP) developed standard for pharmacy services under the heading of "Good Pharmacy Practices" in community and hospital pharmacy settings. Pragati K. Mahajan

20. REQUIREMENTS OF GOOD PHARMACY PRACTICE pharmacy service must supply medication and health care products of assure quality and must monitor the effects of their use. Provision of appropriate information and advice to the patients. Pharmacist first priority must be the welfare of the patient A pharmacy services must contribute in the promotion of rational and economical prescription and appropriate use of medicines. . Pragati K. Mahajan

21. Role of pharmacist in good pharmacy practice Role of pharmacist in GPP are to prepare , obtained , secure, distribute, administer dispense and dispose of medical products at the standard level. He must establish and maintain relationship particularly with physician which involves mutual trust and confidence in all matters relating to pharmacotherapeutics. All the colleagues pharmacist must work together to improve pharmacy services. In hospital pharmacy manager has responsibility for the selection evaluation and improvement of quality of drugs used. Pharmacist must update the information about therapeutics and medicines in use. Pragati K. Mahajan To be continue….

22. Pharmacist must prepare extemporaneous medicines and medical products. Pharmacist must provide effective medication therapy management to access patient health status and needs. Pharmacist must provide information about medicines and health related issues. Pharmacist must monitor patient progress and outcomes. Pharmacist must contribute to improve effectiveness of health care system and public health. Pharmacist must engage in preventive care activates and services. Pharmacist must support national policy that promotes improved health outcomes. Pharmacist must comply with national professional obligation guidelines and legislations. Pragati K. Mahajan Role of pharmacist in good pharmacy practice

23. HOSPITAL PHARMACY STANDARDS FIP is the global federation of national associations of pharmacists and pharmaceutical scientists. FIP BASEL statements is active across all areas of pharmacy practice, pharmaceutical science and education, primarily through the work of member associations and dedicated volunteers. It initiates and implements numerous projects and programs to improve the responsible use of medicines. Hospital pharmacists from around the world met in Basel, Switzerland in 2008 to discuss the future of hospital pharmacy hosted by FIP (international pharmaceutical federation). In 2014 they again gathered in Bangkok and launched an updated version of Basel statement with 65 statements. Pragati K. Mahajan

24. HOSPITAL PHARMACY STANDARDS These statements cover following six main areas of hospital pharmacy (FIP Basel statement) Procurement Influences on prescribing Preparation and delivery of medications Medication administration Monitoring medication Human resources and training Pragati K. Mahajan

25. ASHP American society of health-system pharmacists have been formerly called as American Society Of Hospital Pharmacist (ASHP). This organization is made up of more than 60,000 member including pharmacy technicians, pharmacist in training and professional pharmacist Minimum standards required to the pharmacist demonstrated by ASHP Proper knowledge and understanding of the health care institution and pharmacy department A complete knowledge and understanding of the duties and responsibilities of his position A working knowledge of the pharmaceutical medical terms, abbreviations and symbols regularly used in prescribing and dispensing. A working knowledge of the general chemical and physical properties of all drugs handled in manufacturing and packaging operation in the pharmacy department Pragati K. Mahajan

26. ASHP A working knowledge of weight and volume equivalents and an ability to calculations essential for the usual dosage determinations and solution preparation. The ability to perform drug purchasing and inventory control. Knowledge of drug dosage, routes of administration and dosage forms. Knowledge of the procedures, and operations associated with the manufacturing, packaging, and labeling of drug products, parenteral admixture preparation. The ability to perform the functions relating to a unit dose drug dispensing system. The ability to perform the manipulative and record keeping functions relating to the dispensing of prescriptions. Pragati K. Mahajan

27. NABH ACCREDITATION AND ROLE OF PHARMACIST The National Accreditation Board For Hospital And Healthcare (NABH) was started in the year 2005. It is developed by the QUALITY COUNCIL OF INDIA (QIC). The accreditation program was started with the intent to improve the standards of health care organizations. It is made up to operate hospital accreditation (approval) program for health care organization QUALITY INDICATORS NABH provides guidelines to setup patient and hospital management centered standards NABH provides guidelines for the benefits of patients, employees and hospitals. NABH also provides guidelines in training of hand hygiene, fire safety, biomedical waste management and BLS (basic life support) Pragati K. Mahajan

28. Standards For Hospital Pharmacy Legal requirements Qualified pharmacist should have their certificate displayed in the pharmacy The pharmacy should not sold the physician samples. All the legal documents should be update during valid time. Schedule H And X drug should only be sold by retailer , when they prescribed by a licensed medical professional Access to medications The pharmacy in-charge should be aware of the procedure for obtaining medications The pharmacy should stock only those medicines which are listed on the hospital’s formulary The room and area where the medication the medication are kept should be clean and free from vermin and bugs. The proper security like CCTV and entry restriction should . Pragati K. Mahajan

29. Medication safety Refrigerator should be available for the drugs which are not stable at room temperature. A list of high risk drugs should be identified and made easy available Personal items like food drinks should not be kept in the refrigerator which is used for drugs Other safety For fire safety fire extinguisher should be available. Pragati K. Mahajan

30. Thank you Pragati K. Mahajan