Pharmacy Services

PHARMACY SERVICES

Introduction

·       Pharmacy services in a hospital are a vital component of healthcare delivery. They ensure the safe, effective, and rational use of medicines for patients.

·       Hospital pharmacies not only dispense drugs but also provide drug information, monitor therapy, prevent adverse reactions, and promote cost-effectiveness.

·       They act as a bridge between physicians, nurses, and patients, ensuring the "right drug, at the right dose, at the right time, to the right patient."

Effective Pharmacy Services

• Availability of essential medicines at all times.
• Accurate dispensing with cross-checking to avoid medication errors.
• Timely drug supply to OPD, IPD, ICUs, and emergency units.
• Quality assurance – procurement only from approved suppliers, ensuring proper storage conditions.
• Patient counseling regarding dosage, side effects, and precautions.
• Coordination with clinicians for therapeutic drug monitoring and formulary updates.
• Ethical practices in procurement, stock handling, and distribution.

Right Billing and Issues

• Right Billing:
• Ensures correct charges for medicines dispensed.
• Transparent billing prevents overcharging and builds patient trust.
• Should reflect discounts (if any), generic substitutions, and insurance coverage.
• Issues in Billing:
• Overbilling or double billing.
• Charging for medicines not dispensed.
• Errors in entering quantities/strengths.
• Lack of integration between pharmacy billing and hospital billing systems.

Solution: Integration of computerized billing systems, audit checks, and staff training.

Return of Medicines

• Patients may return medicines due to discontinuation of treatment, excess supply, or adverse effects.
• Hospital policy should define:
• Acceptable conditions (sealed packs, proper storage, within expiry).
• Time limits for returns.
• Refund or adjustment in patient’s bill.
• Segregation of returnable vs. non-returnable drugs (e.g., narcotics usually non-returnable).
• Returned medicines should be checked for quality, labeling, batch number, and expiry before restocking.

Drug Formulary

• A drug formulary is an official list of medicines approved for use in a hospital.
• Developed by Pharmacy & Therapeutics Committee (PTC).
• Includes essential, cost-effective, and evidence-based drugs.
• Helps in:
• Rational prescribing.
• Standardizing treatment protocols.
• Controlling cost.
• Avoiding duplication of similar drugs.
• Updated regularly based on availability, resistance patterns, and newer therapies.

Role and Functions of Pharmacy

1. Procurement: Selection of reliable vendors, ensuring cost-effective bulk purchasing.
2. Storage: Maintaining proper temperature, humidity, and security (e.g., controlled drugs in lock & key).
3. Dispensing: Accurate and safe dispensing to patients and wards.
4. Inventory Management: Avoiding stock-outs or overstocking, monitoring expiry dates.
5. Patient Care: Providing drug information, counseling on dosage, adherence, and side effects.
6. Drug Information Service: Supplying physicians and nurses with updated knowledge.
7. Clinical Role: Participating in ward rounds, monitoring adverse drug reactions (ADR).
8. Regulatory Compliance: Maintaining records for narcotics, psychotropic drugs, and statutory requirements.

Types of Pharmacy

1. Hospital Pharmacy: Inside hospitals, for inpatients and staff.
2. Community Pharmacy (Retail): For general public outside hospital premises.
3. Clinical Pharmacy: Focused on patient-centered drug therapy, monitoring, and counseling.
4. Industrial Pharmacy: Deals with production, quality testing, and R&D of drugs.
5. Compounding Pharmacy: Prepares customized medicines for special cases.
6. Online / E-Pharmacy: Digital ordering and home delivery of medicines.

Planning and Layout

• Location: Easily accessible from OPD, IPD, and Emergency.
• Space Allocation:
• Dispensing area (counters, waiting space).
• Storage area (shelves, cold storage).
• Billing and records section.
• Private counseling area for patients.
• Work Flow: Separate entry/exit for staff and patients to avoid congestion.
• Security Measures: Restricted access for controlled substances.
• Environmental Controls: Air-conditioning, humidity control, fire safety.
• Layout Principle: Smooth flow from procurement → storage → dispensing → billing.

Computerization of Services

• Electronic Medical Records (EMR): Linking prescriptions directly to pharmacy.
• Automated Billing: Reduces human error and ensures transparency.
• Inventory Management Systems: Tracks stock levels, expiry dates, and reordering.
• Drug Utilization Review: Helps in analyzing prescribing patterns.
• Barcoding & RFID: Enhances accuracy in dispensing and prevents mix-ups.
• Clinical Decision Support Systems (CDSS): Alerts about drug interactions, allergies, or dosage errors.
• Online Portals & Apps: For patient refills, counseling, and tele-pharmacy.

Video Description

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