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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5995_Библиотеки_им_академика_М_И_Перельмана.pdf
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Patient Medication History Interview
2. Which is not included in patient medication history form?
(a) Allergies (c) Prescription drugs
(b) OTC medication (d) Cost of prescription drugs
short Questions
3. What is the need for the patient medication history interview? Explain in brief.
4. What is the importance of accurate drug history in healthcare system?
long Questions
5. What is parent chart review? Discuss its importance.
6. Discuss the medication history taking TIPS.
Answer To MCQs
1. (a) 2. (d)
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Chapter
Community Pharmacy
Management
Community pharmacy is a place from where public can have medicines and can take
advice about their medication and healthcare. It is a commercial store with a combination
of prescription medicines (only available with prescription) and over-the-counter
medicines (can be purchased over-the-counter).
Community pharmacy is an organization having input–output system. The
management system manages the smooth operation of input–output system in
community pharmacy.
Some of the prime functions of management system in community pharmacy can
be illustrated as:
1. Finance
2. Humanresourcemanagement
3. Infrastructurerequirements
4. Operationmanagement
5. Marketingmanagement
1. FINANCE
i. Financial control in community pharmacy management: Stablefinancialfoundation
isbasedonplanning,developmentandoperationinacommunitypharmacyfor
achievingalong-termgoal.Efficientuseofavailablefundsisrequiredtoachieve
theoutcomeincommunitypharmacy.
Thekeyfinancialissuesthatcanbeaddressedincludetherequirementoffundto
openthecommunitypharmacywithdesireditemstofacetheincreasedcompetition.
Italso includes thestable sourceof funds as well as its efficient utilization in
pharmacy.Sometimes,theremayberequirementofadditionalfundinemergency
situation,whichenforcestheneedofstablesource.Thereshouldbewell-defined
methodtopaythemoneybacktothelendersorinvestors.
ii. Estimating the financial needs: The financialneed is predictedinthe best way
byusingtheworksheet. There should bewell-predictedestimationmethodand
planningofcapitalrequirementforthenext2–4years.Theconservativeapproach
shouldbetakeninprojectingsalesandliberalapproachesshouldbetakentoestimate
theexpenses.
10
75
Community Pharmacy Management
Afterpredictingthefinancialneed,theequitypositionoftheownershouldbe
ascertained.Itisapositionoftheproprietortosparethemoneytothepharmacy
v/sthefundcreditedbythecreditorsorthirdparty.Theproprietorofpharmacy
shouldbegin to identify the various differentsources for getting funds,if he is
incapabletocoverupneedsforcapitalrequirementofbusiness.Successfulcapital
generationandfinancialmanagementcanbeachievedbyrecognizingthevarious
sourcesoffundanditsimplications.
There are two main types of funding which include:
a. Financing through debtor:Itisaborrowingofmoneyasloan.Onthebasisoflength
ofloan,itiscategorizedasshort-termandlong-termfinancing.
b.Financing through equity:Itisprocessofraisingcapitalthroughthesaleofportion
ofequity in pharmacy to others(public, investors, or financers). In equity
financing,thefundreceiveddoesnothavetoberepaid.
iii. Financial records: Journals andledgers areused keepingfinancial recordsfor
internalaswellasexternalreasons.Injournal,informationisrecordedrelatingto
anaccountingtransactioninaspecificformatbasedontheprinciplesofdebitand
credit.Ledgersorganizethevariousfinancialactivities.‘Doubleentrybookkeeping
system’shouldbeusedforsystemictransactionofrecords.
2. HUMAN RESOURCE MANAGEMENT
Human resource management is the cardinal approach to ensure a good working
environment. There are several categories of staffs, including pharmacist, pharmacy
assistant and pharmacy technician, depending on the size of community pharmacy.
A basic procedure must be conducted for the recruitment and selection of employees
in most pharmacies. Hiring of the bad employees can have significant impact on the
working environment of the pharmacy.
Common routine sources of recruiting employees are:
a. General online job boards and websites: Theseareusedbyemployerstoadvertise
theirjobvacanciestojobseekers.
b. Recommended sources: Throughfriends,businesspartners,workers.
c. Employees of competing companies: Hiringanemployeefromacompetitor.
d. Employment recruiters: Bothfrompublicandprivaterecruiters.
e. Academic institutions: Throughtheplacementdepartmentofvariousuniversities/
colleges.
f.Labor union organizations:Iftheexistingemployeesaremembersofunion.
g. Advertising agencies:Newspapers,professionaljournals/periodicals.
h. walk-in interview through community pharmacy site.
Following are six steps associated with the selection procedures of the employee:
Step 1: Getting the applicant request on an application form.
Step 2: Reviewing of application form and invitation for personal interview or meeting.
Step 3: Checking and enquiring about the most suitable applicant from the references
provided in his application form.
Step 4: Conducting of skill or personality test, or both, to most favorable applicants.
Step 5: Referring to medical board for physical examination of most favorable applicants.
Step 6: Make a decision to hire the applicant.
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Textbook of Pharmacy Practice
Registered pharmacist, is responsible for complete professional activities and
operations in community pharmacy. A professional training program of pharmacy
should be conducted for all personnel. The pharmacist consultation management should
develop a well-documented guidelines and procedure which should be followed by all
the pharmacists to carry out their activities. A clear job description must be given to each
personnel. It is made mandatory to all of pharmacy staff members to wear a neat white
coloured apron/coat, a badge prominently displaying name and designation. Medical
examination of all of staff members should be periodically conducted in community
pharmacy to ensure the absence of infectious disease. They should be adequately
immunized periodically, if necessary. Health data of complete staffs should be recorded.
Minimum qualification required for community is:
a. Tobeatleastadiplomainpharmacy.
b. ToberegisteredasapharmacistwiththeStatePharmacyCouncil.
c. Haveundergoneadequatepracticaltraininginacommunitypharmacy.
d. Tohaveagoodcommunicationskillandhaveknowledgetogiveproperadviceto
thepatientonillnessandappropriateuseofmedicines.
Every community pharmacist must be competent enough to:
a. Playaprofessionalroletocheckprescription.
b. SuggestpatientonappropriateselectionanduseofOTCmedicines.
c. Suggestpatientonappropriateuseofprescribedmedicines.
d. Checkthedosageregimentfordrug–druganddrug–foodinteraction,ifany.
e. Bealertforadversereactionrelatedtoprescribeddrug.
f.Adviceon propermedication and selection of diet after assessing thepatient’s
conditionorillness.
g. Referthepatienttoadoctor,ifpatientconditionisnotstable.
h. Conducttheroleofahealthcareproviderandacounselor.
3. INFRASTRUCTURE REQUIREMENTS
Selection of Location
Selection of good location site is the prime criteria for the success of community
pharmacy. Various factors which are to be considered while selecting a location for
pharmacy include:
1. Demographiccharacteristics
a. Populationdensity
b.Trendsinpopulationgrowth
c. Agedistributionofpopulation
d. Incomedistributionofpopulation
e. Buyingcapacityofgeneralpopulation
f. Occupationalstructureofpopulation
2. Neighboringcompetitivecharacteristics
a. Numberandtypeofcompetitors
b.Sizeanddiversityofcompetitors
c. Placementoflocationofcompetitors
d. Competitivegrowthtrendsinmarket
77
Community Pharmacy Management
3. Physicianavailability
a. Numberofphysiciansinadjoiningarea
b.Typesofphysiciansinadjoiningtoproposedcommunitypharmacy
c. Numberofhospitals,nursinghomesanddiagnosticcentresinadjoiningareas
4. Financing
a. Requirementsforfinance
b.Availablesourcesoffunds/creditfactors
Premises
• Thepharmacylocationshouldbeeasilyidentifiablebythepublic.Theoutermostareaof
pharmacyshouldbeneatandclean.Thefacialoutsideportionshouldbeclearlymarked
withtheword“PHARMACY”,writteninEnglishaswellasinregionallanguage.
• Pharmacyshouldprovideforeasyaccessibilitytopersonwithdisabilitiesorelderly
people.
• Separateprescriptioncounterfordispensingofprescriptionisadvisabletoavoidthe
riskofdispensingerrorsandtoimprovethequalityofservices.
• Designingofpremisesofcommunitypharmacyshouldbeeasyanddirectaccessibility
ofpharmacisttopublicforinformation,counselingandadvice.
• To keep cleanand dust-freepharmacy environment,standard operating procedures
(SOPs)andcleaningscheduleshouldbefollowed.Itshouldalsobefreefromrodent,
pest/insect.Forthis,thepestcontrolmeasuresshouldbeundertakeninaroutinemanner.
• Pharmacypremisesshouldbeseparatedfromotherrooms,meantforprivateuse.
• Thepremisesofcommunitypharmacyshouldbewellbuilt,adequatelyilluminated
bylight and ventilatedand of sufficient size to allow thestorage of drugsand
pharmaceuticalsinaclearlyvisibleandappropriatemanner.
• Areafordispensingdepartmentshouldnotbelessthan6sq.metresifthereisone
additional2sq. metresforeachadditional pharmacist shouldbe developed. The
heightofthepremisesshouldbeatleast2.5metres.
• Thefloorofthepharmacyshouldbesmoothandcleanable.Wallshouldbesmoothly
plasteredortiledoroilpaintedtomaintainsmoothandwashablesurface.Itshould
bedevoidofholes,cracksandcrevices.
• SpaceinthepharmacyshouldbeasperSchedule‘N’ofDrugsandCosmeticsAct.
Itshouldbesufficientforkeepingshelves,displaycounter,counselingareas,and
sufficientspaceformovementofpersonnelandpatients.
• Thedispensingdepartmentshallbeseparatedbyabarricadetopreventtheentry
ofpublic.
• Thereshouldbeacontinuoussupplyofelectricityespeciallyfortherefrigeratorand
alsofortelephoneservice.
• Premisesshouldhavea facilityfordrinkingwaterformedicineadministrationto
thepatientandfortheuseofpersonnel.
The community pharmacy should have:
a. Plentifulplaceforpatientsatthedispensingcountertostandeasilyandforsome
tositcomfortably.
b.Patientinformationdisplaysection,includinginformationleaflets/material.
c. Separate chamber,describedas ‘counselingchamber’ for patient counseling,
storageofreferencesupportmaterials,e.g.books,internetaccess,isanessential
requirementforgoodcommunitypharmacy.
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Textbook of Pharmacy Practice
• Counseling area,where patientscan talk freely withthe pharmacist should be
well-designated.Itshouldbewelllightedandbeawayfromthecommonpublicin
pharmacytomaintaintheconfidentiality.
• Compoundingpharmacyshouldalsohaveappropriateadditionalspaceformaking
extemporaneous preparations andto keep the necessary equipment required for
compounding.
• Separatewastecollectionbasket/boxesshouldbemadeavailableforthepersonnel
andforthepatients.
• Thepharmacyshouldbeventilatedandair-conditioned.Themedicinestoragearea
shouldbeprotectedfromexposuretoexorbitantlightandheat.Propertemperature
shouldbemaintainedwithinthestipulatedrangetopreventdeteriorationofvarious
medicinesstoredinthecommunity.
• Thereshouldbeseparateareainthepharmacytoprovidetheotherrelatedservices
suchasdoctors,first-aidsanddressingservices.
Furniture and Fixtures
Well-placed shelves with provision for storage of medicines and other items in a
distinguishable manner, protected from moisture, dust, excessive heat and light should
be a part of community pharmacy. There should be proper arrangement for storing
various medicines at recommended temperature conditions.
The counseling area should be provided with a table, chairs for pharmacist and
patients, cabinet for storing patients’ medication records (PMRs).
Equipment
The refrigerated storage facilities should be installed for storing medicines, requiring
storage at cold temperature in pharmacy.
The counseling area should be equipped with
a. Referenceguide.
b. Illustrativechart,kits,andotherdisplaymaterial.
c. Patient’sinformationbrochure.
d. Some basic medicaldevices, e.g.BP apparatus,glucometer,thermometer,and
stethoscope.
e. Weighingmachine.
f.Heightmeasuringscale.
4. OPERATION MANAGEMENT
a.Managementshould implement a policy for the numberof working hours of
communitypharmacy.Indecidingthis,thelegalrequirementsshouldbeconsidered
(like48hoursinaweek).Underthesecircumstances,themanagerissuggestedto
giveincentivesforworkingmoreorhirethestaffstoworkinashift.
b. Managementsystemshouldframeapolicyforcheckingandstockingofmedicines
andotheritems forsaleat regular interval inthepharmacy.This is particularly
usefulforprescriptiondrugsandothercontrolleddrugs.Mostoftherepresentatives
ofpharmacompaniesvisittwiceinaday,soreplacementscanbeorderedquickly
whenparticularitembecomesshortorlowinquantity.
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Community Pharmacy Management
c. Pharmacyshouldbepreferablybeprovidedwithcomputersoftware(automation),
whichisbeneficialformanagementofinventory,invoicing,generatingtimelyalarm
forexpiringmedicine,maintainingpatients’medicationrecords,etc.
The computer should also be programmed to give informative presentation to the
patients and maintain database. Compounding sections of the pharmacy should be
equipped with appropriate apparatus required for compounding of preparations. The
list of items as recommended by Schedule “N’ of Drugs and Cosmetics Act should be
made available in the pharmacy.
5. MARKETING MANAGEMENT
Community pharmacy management should frame attractive sales and marketing
policies to fascinate new customers for generating more revenue. The manager should
review the policies regularly after considering the adjoining competitive environment.
Chain system of pharmacies, who has more numbers of outlets, policies should be
framed by central administrative body for promotional periods and guidelines to be
implemented in each pharmacy branch. The pharmacy manager is often responsible
for implementing sales and marketing campaigns in independent pharmacy to attract
the customer without any interference. Manager of independent pharmacy usually is
the best person to judge about the pharmacy stock and which items need pushing to
sell and maintain cycling of stock.
EXERCISE
Multiple ChoiCe Questions
Tick mark the appropriate choice
1. Qualification requirement for community pharmacist working include ___________:
(a) Diploma in pharmacy.
(b) Registration with the State Pharmacy Council.
(c) Practical training related to operation of community pharmacy.
(d) All of the above
2. Common source of potential employees in community pharmacy is __________:
(a) General online job boards and websites.
(b) Referrals: Through friends, business associates, employees.
(c) Through the placement cells of academic institutions.
(d) All of the above.
short Questions
4. Write a brief note on human resource management in community pharmacy.
5. What is the qualification required for pharmacist working in pharmacy? Explain.
long Questions
6. Discuss the important functions of community pharmacy management.
7. Discuss the infrastructure requirements for community pharmacy.
Answer to MCQs
1. (d) 2. (d)
UNIT
III
11. Pharmacy and Therapeutics Committee
12. Drug Information Services
13. Patient Counseling
14. Educational and Training Programs in Hospital
15. Prescribed Medication Order and Communication Skills
