Hospital pharmacy is the department or service in a hospital which is under the direction of a professionally competent, legally qualified pharmacists, and from which:
- All medications are supplied to the nursing units and other services.
- Special prescriptions are filled for patients in the hospital, for ambulatory patients and out-patients.
- Pharmaceuticals are manufactured in bulk.
- Narcotic and other prescribed Medications are dispensed.
- Injectable preparations prepared and sterilized.
- Professional supplies are often stocked and dispensed.
- Dispensing and compounding pharmacist
- Clinical pharmacist
- DIC (Drug Information Center)
The mission of Hospital pharmacists is to help people make the best use of medications.
Hospital pharmacist job description includes many tasks and duties, that make pharmacist very important individual in:
1- Pharmacy &Therapeutic Committee
What is Pharmacy & therapeutic committee?
A group of physicians, pharmacists, and other healthcare providers from different specialities, who advise a managed care plan regarding safe and effective use of medications.
The P&T Committee manages the drug formula and acts as the organizational line of communication between the medical and pharmacy components of the health plan.
Role of hospital pharmacist in P&T committee
Hospital pharmacist actively contributes to the pharmacy administration process through active participation in the pharmacy and therapeutic committees.
A. Overseeing policies and procedures related to all aspects of medication use within an institution through:
- Addition to or deletion from the drug formula.
- Developing medication use guidelines.
- Methods for ensuring the safe prescribing, distribution, administration, and monitoring of medications.
- The process for using non-formulary agents, investigational Medications, restricted use Medications, or controlled substances.
- The process of managing Medication product shortages.
- Written regulations governing the activities of medical sales representatives and the use of Medication samples.
- A written procedure to handle Medication product recalls.
B. Medication use evaluation (MUE).
C. Adverse-Medication-event monitoring and reporting, medication-error prevention.
D. Pharmacist job description and work plan approval.
E. Continuous education & staff development.
F. Clinical trials & research activities.
2- Clinical service & patient care
- Pharmaceutical care.
- Clinical pharmacokinetics consultation services.
- Education &training services.
- Patient counselling.
3- Medication distribution & control
Hospital pharmacists are responsible for the core process of Medication distribution all over the hospital, Medication distribution process includes:
- Procurement: Medication Selection, Purchasing Authority, making decisions regarding products, quantities, product specifications.
- Medication Storage and Inventory Control, Proper environmental control (i.e., proper temperature, light, humidity, and conditions of sanitation, ventilation, and segregation)
- Preparation of medications which includes both sterile and non-sterile products.
1- Preparation of non-sterile products
- Bulk Compounding, Packaging, and Labeling
- Prepackaging of oral solids, liquids, topical preparations and powders, for a unit dose distribution system according to the consumption rate and the inventory.
- Preparation of commercially unavailable formulations required for a group of patients such as paediatrics, geriatrics, intensive care unit patients and using nasogastric fed patients.
- Labelling of the prepared products (generic name, dosage form, strength, batch number, expiry date etc.) and using Accessory labels (shake well, may not be refilled, and the like).
2- Preparation of sterile products
The pharmacy is responsible for assuring that all such products prepared to be used in the institution are:
- Rational and free of incompatibilities, microbial and pyrogenic contaminants.
- Correctly calculated and prepared (i.e., contain the correct amounts of the correct Medications).
- Properly labelled, stored, and distributed.
3- Dispensing of medications
The Patient’s medical records profile must be reviewed by the pharmacist before dispensing the patient’s medication(s).
These include the revision of (Patient’s full name, date of hospital admission, age, sex, weight, height, hospital I.D. number, and provisional diagnosis or reason for admission, Lab. test results, Sensitivities, allergies, and other significant contraindications, medication history.
The pharmacist is requested to review the medications to be dispensed against the physician’s original medication order to eliminate transcription errors (check dates of original orders, strengths, dosage forms, quantities, dosage frequency or directions, and automatic stop dates.
The reviewing process will be including Detection of potentially serious interactions, unintended dosage changes, medication duplications and overlapping therapies, and medications contraindicated because of patient allergies or other reasons.
The reviewing pharmacist is requested to document any identified problems or errors actions as a method of reporting to other healthcare professional for subsequent corrective actions.
The dispensing process includes providing special care to special orders (i.e., “stat” and emergency orders and those for nonformulary medications, investigational medications, restricted use medications, or controlled substances) these orders should be processed according to specific written procedures.
There are different techniques can be used to dispense medications within the hospital premises. These techniques or system include:
1- Unit dose dispensing system
Medications are contained in, unit dose packages; in ready-to-administer form for not more than a 24-hour supply of doses.
Monitoring of administration and Information to be recorded (the medication name, dose and route of administration, date and time of administration, and initials of the person administering the dose.)
Counselling of the patient must be conducted to ensure understanding and compliance with his medication regimen
2- Floor stock
In this system, all but the most unusual drug items are stocked on the nursing stations in all patient care areas.
Floor stocks of drugs are minimized and limited to drugs for emergency use and routinely used “safe” items such as mouthwash and antiseptic solutions.
3- Individual Prescription Order System
In this system, virtually all medications are dispensed by the pharmacist on individual prescription orders.
4- Medication Safety
- Medication error reporting
- Medication-related problems (including adverse Medication reaction ADR) detection and reporting
- Disposal of Hazardous Substances (e.g. toxic or flammable solvents and carcinogenic agents).
5- Role of hospital pharmacist in the quality use of medicines
- Participate in setting Guidelines, policies and procedures.
- Medication safety practices or goals.
- Patient and employee satisfaction surveys.
- Medication use evaluation MUE activities.
- Medication errors and Adverse Medication reactions ADR evaluations.
- Pharmacy performance measures/indicators.
- Quality management education and training.
- Job specific or general competence assessments.