Unit 1b- Hospital Pharmacy & its organization.pdf

Pharmacy practice, B. Pharmacy, PCI syllabus, Unit 1, 7th semester, Hospital pharmacy, Organization of Hospital pharmacy, Definition of hospital pharmacy, Location of hospital pharmacy, Layout of hospital pharmacy, Functions of hospital pharmacy, procurement section, manufacturing section, Quality control section, Storage section, Dispensary, Central sterile supply department, drug information services, education, training services, satellite pharmacy, mini-pharmacy, centralized pharmacy,

1. Hospital Pharmacy & It’s Organization
Pharmacy Practice (Unit I-b)
Ms. Munjewar Seema
Assistant Professor

2. 1.Definition of hospital pharmacy
2.Functions of hospital pharmacy
3.Organization structure of hospital pharmacy
4.Location and Layout of hospital pharmacy
5.Staff requirements
6.Responsibilities and functions of hospital pharmacists
CONTENTS

3. •It is the Department of Hospital in which the drugs are Procured, Manufactured, Tested,
Packaged, stored and Dispensed to both inpatients and outpatients by the professionally
skilled and legally qualified pharmacists.
•Persons who completed their diploma or degree in pharmacy and are registered in the
state pharmacy council and who have their license for practice are known as pharmacists.
What is Hospital Pharmacy?

4. •Each section of the modern hospital pharmacy performs specific functions assigned to them.
•Various sections in Hospital pharmacy are:
1.Procurement section,
2.Manufacturing section,
3.Quality control section,
4.Store section, Dispensary,
5.Central sterile supply department,
6.Drug information services and
7.Education and training services.
Functions of Hospital Pharmacy:

5. •Also Known as Purchase section
•Estimate the demand or quantity of the drug required.
•Set up the specifications for the required drug (e.g. Quality, quantity, packing, strength, etc.)
•Follow the approved purchase procedures like calling for tenders, quotations and then place
orders.
•Receive, verify and dispatch the drugs to quarantine area then to stores after approval by
quality control section.
1. Procurement section:

6. •Estimate the annual demand for each drug used in the hospital
•Plan the production schedule as per schedule M for Drug & cosmetics act 1940 and the rules
of government of India
•They are required to follow GMP and GLP
•Manufacture the required items after procuring the necessary raw materials, packing
material, etc.
•This department manufacture both IV fluids like SVP & LVP and other formulations
•Check the standards of formulations as set by QC and QA department.
2. Manufacturing section:

7. •Test the quality of all formulations either manufactured in hospital or purchased by the
hospital.
•Draw samples from the manufacturing section or quarantine area if purchased from outside.
•Analyze and submit reports to the head of department. They certify the quality of drugs used
in the hospital.
•Send samples to third-party laboratories, if required.
3. Quality control section:

8. •Receives drugs from either manufacturing section or purchase department
•Store them properly until issued to the dispensary and other places according to specified
storage conditions. (so as to preserve its efficacy and potency)
•Issue drugs to the dispensary and other departments as per their needs
•Keep an account for all input drugs, output drugs and in stock drugs. (Inventory control)
•Look for expiry dates of all items stored: periodically and physically.
•Drugs having short expiry date either used earlier or return to the supplier or discarded if
manufactured in the same pharmacy.
4. Store section:

9. •Receives the drugs required for dispensing to both outpatients and inpatients in sufficient quantities
from the stores of the hospital.
•In case of scheduled surgeries no. of things required like irrigation fluid, cottons, bandages, sutures,
etc.
•To perform different tests in pathology labs various chemicals and reagents require so dispensary
involved in laboratory supplies.
•Ward or floor stock supplies: there are different wards present in hospital and each ward have specific
type of station. All the medications required for the patients admitted in that ward are kept at that
station. Along with those medications no. of emergency medications are also stored in such type of
stations.
•Dispensary dispense all above supplies to the patients while following high standards like auxiliary
labels, proper packing, and instructions written on the envelope apart from clear and louder oral
instructions.
•Maintain accounts for the drugs issued on a daily basis.
5. Dispensary:

10. •Procure, install and maintain all the required sterilization equipment.
•Prepare, update, stock and maintain the items, equipment & instruments required by various
departments of the hospital.
•Sterilize the required items as per the SOP & supply to the departments in need.
•Always keep ready emergency ward supplies.
6. Central sterile supply department:

11. •Pharmacist in this department is required to collect, arrange and provide the necessary drug
related information by health care professionals and research students.
•Periodically, update the information available.
•Prepare and circulate literature, broachers, bulletins, and circulars on all important matters
concerning drug use to all the people involved in the process.
7. Drug information services:

12. •Provide education and training to student pharmacists, student nurses, student doctors and
even to another health care employees of the hospital.
•Undertake educational programs for the public.
8. Education & Training services:

13. Organization Structure of Hospital Pharmacy:
Board
Administration services
Head of pharmacy services (M. pharm with Ph.D)
1. Dispensing Dept.
(B. pharm)
Inpatient
Outpatient
2. Manufacturing
Dept. (B. pharm/M.
pharm)
Manufacturing of IV fluids (M. pharm)
Manufacturing of other formulations (B. pharm)
3. Quality control
Dept.
(M. pharm)
4. Clinical Dept.
(M. pharm/
Pharm-D)
5. Medical store
Dept. (B. pharm/D.
pharm)

14. •The main organizational set-up of a hospital pharmacy starts with a fully qualified and
experienced Head of department.
•They must have necessary education, specialization, training and experience in the majority of
the functions of a hospital pharmacy.
•HOD should be post graduate (M. Pharm) with Ph.D and specialization either in
pharmacology, pharmacy practice or clinical pharmacy.
•The HOD leads and directs various departments in hospital pharmacy like:
1. Dispensing department
2. Manufacturing department
3. Quality control department
4. Clinical department
5. Medical store department

15. •All the dispensing work in a hospital is controlled by the persons having Bachelor degree (B.
pharm).
1. Dispensing Department:
2. Manufacturing Department:
•A manufacturing chemist in a hospital should posses a post graduate degree (M. pharm) in
Pharmaceutics or Chemistry.
•They should have 18 months of experience in manufacturing process of drug and
formulations.
•They have responsibility to manufacture both the bulk drugs and parenteral sterile products
by the permission of drug control authority.

16. •Quality control division is controlled by quality control chemist
•He should be post graduate in analytical chemistry and approved by drug control authority.
•They check the quality of drug and formulations that are manufactured or purchased.
3. Quality Control Department:
4. Clinical Department:
•This department provides pharmaceutical care by highly skilled & professional pharmacists
should be M. pharm graduate in pharmacology or clinical pharmacology or Pharm D
graduates.
•These department provide drug therapy to achieve desired effects/outcomes which improves
the quality of the patient.
•Clinical pharmacists also determines the drug-related problems and take measures to improve
outcomes, which results in better quality of life for the patients.

17. •The medical stores of the hospital are run by pharmacy graduates with experience in
dispensing drugs.
•In this section some D. pharm holders are also appointed to help with the tasks.
5. Medical Store Department:

18. 1.Hospital pharmacy is mostly located in hospital premices only so that patients and staff can
easily approach it.
2.In multistorey building of a hospital, the pharmacy should be located on ground floor
especially dispensing unit.
3.It should be constructed in such a way that there is a continuous flow of men and materials.
4.The location and layout of a hospital pharmacy varies greatly according to the hospital type.
Location of Hospital Pharmacy:

19. In case of large
hospital inpatient
services:
some pharmacies
are
centralized
Means all the pharmacy staff and
equipment’s Located in a single area of
hospital
(centralized location)
some pharmacies
are
de-centralized
Means there is a main pharmacy
located in a central location but there
are also some mini-pharmacies called
“satellites” located throughout the
hospital at key patient care units
(at specific wards)
In case of large hospital inpatient services:

20. •Pharmacy should be well furnished to give suitable look.
•It should be provided with proper facilities for waiting patients.
•It should have educative or informative posters on health for reading during the time of
waiting.
In case of outpatient services:

21. Aseptic area Manufacturing section
Raw materials
Store
Packaging and labelling
Finished products
Passage
Administrative section
Dispensing
Billing
Open space
Layout of hospital pharmacy
•Space should be provided for routine manufacturing of stock solution, bulk powders, ointments, etc.
•Manufacturing rooms should be adjacent to pharmacy.
Layout of Hospital pharmacy:

22. 1. Administrative section
2. Dispensing area
3. Open space for waiting
4. Raw materials area
5. Manufacturing section
6. Aseptic area for preparation of sterile products
7. Store room
8. Packaging and labelling area
9. Finished product area
10. Passage between manufacturing and dispensing area

23. •Head of pharmacy department should be a post-graduate with Ph.D in pharmacy preferably
in pharmacology, pharmaceutics or hospital pharmacy.
•Director superintendent of pharmaceutical services or chief pharmacists should be M. pharm
in hospital pharmacy or pharmacology.
•Pharmacy manager should fulfill the organizational needs that are designed by pharmacy and
hospital administrators.
•Manufacturing pharmacist should be graduate in pharmacy and must have 18 months
experience in manufacturing process of drugs and formulations.
•Quality control pharmacist should have post graduation in pharmaceutical chemistry or
analytical chemistry.
Staff requirement in hospital pharmacy:

24. •Pharmacists in drug distribution should have either degree or diploma in pharmacy and
should be registered in state pharmacy council.
•A staff requirement in the hospital pharmacy mainly depends on the strength of patients
available in the hospital wards or hospital premises.
•Following table shows no. of pharmacists required based on strength of beds in hospital.
Bed strength No. of pharmacists
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

25. Responsibilities and functions of hospital pharmacists:
1. HOD pharmacists:
•They are responsible for the overall functioning of the department.
•Hence, they must have working knowledge about each and every section of their department
•That is why only experienced pharmacists are promoted and appointed as HOD.

26. •Chief pharmacists have responsibility to plan, organize and control all activities of the hospital
pharmacy.
•They should be able to guide, motivate and supervise the tasks carried out by all the sections of
the hospital pharmacy.
•Chief pharmacist have responsibility to constantly inspect the activities that are carried out in
hospital pharmacy. (for e.g., manufacturing of drug formulations require constant supervision
because a simple mistake can lead to huge losses and problems to the hospital).
•They should organize and participate in public health camps periodically whenever required.
•Additionally, they should publish newsletters, bulletins, etc. and also maintain a cordial
relationship with HODs to ensure the smooth functioning of the hospital.
2. Chief pharmacists:

27. •it is also mandatory for the senior pharmacists in charge of each section to provide training to
student pharmacists, and newly appointed junior pharmacists in their section.
3. Senior pharmacists:
4. Procurement section pharmacists:
•They are responsible for the purchase of drugs, chemicals & biologicals.
5. Manufacturing pharmacists:
•They are responsible for manufacturing of medicaments such as transfusion fluids,
parenteral products, tablets, capsules, ointments and stock mixtures.

28. •They test the quality of drugs either purchased or manufactured within hospital to certify the
drugs used in hospital.
6. Quality control pharmacists:
7. Store section pharmacists:
•They maintain proper storage of drugs to preserve their efficacy & potency.
8. Dispensary section:
•They dispense the medicaments, surgical supplies, laboratory reagents & chemicals to both
inpatients and outpatients which are prescribed by physicians.
•They also supply emergency medications to mini-pharmacies available at specific wards.

29. 9. Other Functions of Pharmacists:
1.Sterilizing parenteral preparations which are manufactured in hospital.
2.Filling and labeling of all drug containers from which medicines are to be administered.
3.Managements of stores which includes purchase of drugs, proper storage conditions and
maintenance of records.
4.Establishment and maintenance of drug information center.
5.Provide co-operation in teaching and research programmes.
6.Discarding the expired drugs and containers with worn and missing labels.
7.Maintaining liaison between the medical staff, nursing staff and patients.
8.To prepare and implement the safety programmes in the hospital.

30. Questions:
1.Define hospital Pharmacy. Write in detail the roles & responsibilities of hospital pharmacist:
10M

31. References:
1.A textbook of pharmacy practice by S. Balasubramanian, BSP books Pvt. Ltd., 2020,
ISBN: 9389974380, 9789389974386.
2.Textbook of pharmacy practice by Rakesh Saini and Sagar Singh Jough, New Delhi
New Age International (P) Limited, Publishers 2022, ISBN: 9789389802344.
3. Principles of pharmacy practice by Dr. Ramandeep Singh, Satinder Kakar and
Bhumika Mangla, PV publication, 2018, ISBN: 9781543342659.
4.Textbook of pharmacy practice by Gaurav Agarwal, CBS publishers and distributers Pvt.
Ltd., 2020, ISBN: 9789389941913.

32. Thank You !