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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5739_Библиотеки_им_академика_М_И_Перельмана.pdf
Pharmacy Practice8
Patient care: Patient care involves diagnosis, treatment of
illness or injury preventive medicine and personalized services.
Education services: By imparting teaching to physician,
nurses, pharmacist, medical staff, hospital administration and
training. Also giving education to patient like general
education, social education for rehabilitation health care and
patient counseling.
General public health care: Telling about prophylaxis
measurement and creating awareness about disease, hygiene
and their transmission.
For example: Program for TB, diabetic, hypertension and
cancer. To participation in mass public inoculation program,
etc. The other functions of hospitals are:
i. Diagnosis and treatment of disease
ii. Outpatient services
iii. Prevention of disease, and
iv. Promotion of health.
ISOLISOL
ISOLISOL
ISOL
AA
AA
A
TED KEY POINTSTED KEY POINTS
TED KEY POINTSTED KEY POINTS
TED KEY POINTS
• The word “hospital “derived from the Latin word “hospi-
talis” which in turn derived from French word “hospes”
that means “ a host or a guest”.
• Hospital is an specialized complex organization which
makes use of physicians, surgeons, and a team of technical
staff. It also provides facilities for diagnosis, therapy,
rehabilitation, prevention, education and research.
• Primary hospital provides the first contact between
individuals and families with the health system.
• Secondary hospitals are those where patients from primary
health care are referred to specialists in higher hospitals for
treatment.
• Tertiary hospitals are known as specialized hospital
usually for inpatients referred from primary and secondary
hospital for advanced medical investigation and treatment.
Examples are cardiac surgery, cancer management.
• Hospitals are classified on the basis of:
a. Clinical basis
Hospital and its Organization 9
b. Ownership and control basis
c. On the basis of different systems of medicine
d. On the basis of cost
e. On the basis of size
• The various medical staff in hospital are:
a. Doctors
b. Nurses
c. Pharmacists
d. Allied health professionals
e. Support staff.
• The various functions of a hospital are:
a. Patient care
b. Education services
c. General public healthcare
d. Diagnosis and treatment of disease
e. Outpatient services
f. Prevention of disease, and
g. Promotion of health.
PRAPRA
PRAPRA
PRA
CTICE QUESTIONSCTICE QUESTIONS
CTICE QUESTIONSCTICE QUESTIONS
CTICE QUESTIONS
VV
VV
V
erer
erer
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y Shory Shor
y Shory Shor
y Shor
t Answer Tt Answer T
t Answer Tt Answer T
t Answer T
ype Questionsype Questions
ype Questionsype Questions
ype Questions
1. Define hospital.
2. Define hospital according to WHO.
3. What is a primary care hospital?
4. What is a tertiary care hospital?
5. Enlist various medical staff in a hospital.
ShorShor
ShorShor
Shor
t Answer Tt Answer T
t Answer Tt Answer T
t Answer T
ype Questionsype Questions
ype Questionsype Questions
ype Questions
1. What are the primary and secondary care hospitals?
2. Classify various types of hospitals with suitable examples.
3. Classify hospitals according to system of medicines.
4. Classify hospitals based on economy.
5. Describe the supportive services in a hospital.
6. Describe the role and responsibilities of the supportive
services in a hospital.
7. Discuss the functions of hospital in detail.
Pharmacy Practice10
LL
LL
L
ong Answer Tong Answer T
ong Answer Tong Answer T
ong Answer T
ype Questionsype Questions
ype Questionsype Questions
ype Questions
1. What are hospitals? Classify different types of hospitals.
Describe in brief about classification of hospitals based
upon:
a. Clinical basis
b. On the basis of different systems of medicines
c. On the basis of size
2. Describe hospital organization with the help of a chart.
3. Write a short note on history of hospitals. Give the objectives
and function of it.
4. Define the functions and objectives of a modern hospital.
Objective TObjective T
Objective TObjective T
Objective T
ype Questionsype Questions
ype Questionsype Questions
ype Questions
1. Large hospital is a hospital that contains:
A. Less than 500 beds
B. More than 100 beds
C. Beds between 500 and 1000
D. More than 1000 beds
2. On the basis of ownership and control, hospitals can be
classified as:
A. Elite and budget hospital
B. Government and non-government hospital
C. Medicine and maternity hospital
D. Allopathic and homoeopathic hospital
3. Allied health professionals in a hospital include:
A. Dieticians
B. Ward boys
C. Pharmacists
D. Doctor
4. Which hospital is reffered as specialized hospital
A. Primary
B. Secondary
C. Tertiary
D. None of these
5. Match the items of column I and with appropriate items in
column II
Hospital and its Organization 11
Column I Column II
A.On the basis of size i. Allopathic, homoeopathic,
ayurvedic, unani, naturopathy
B. On the basis of cost ii. Medicine, maternity, surgical
C. On the basis of owner- iii. Large, medium, small, very
ship and control small
D. Clinical basis iv. Government, non-government
E. On the basis of different v. Elite, budget
types of medicines
AnswersAnswers
AnswersAnswers
Answers
1. D 2. A 3. C 4. C 5. A(iii), B(v), C(iv), D(ii), E(i)
The practice of hospital pharmacy started in India in 1941 but
became a regulated and respectable discipline in sixties.
“Hospital Pharmacy is defined as department of a hospital
which deals with all the steps involved in the flow of drugs in
and out of the hospital, i.e. procurement, storage, compounding,
dispensing, manufacturing, testing, packaging and distribution
of drugs”.
It is also concerned with education and research in
pharmaceutical services leading to the new advancements in
the fields of pharmacy. Hospital Pharmacy is controlled by a
professionally competent and a qualified pharmacist.
FUNCTIONS OF HOSPITFUNCTIONS OF HOSPIT
FUNCTIONS OF HOSPITFUNCTIONS OF HOSPIT
FUNCTIONS OF HOSPIT
AL PHARMAAL PHARMA
AL PHARMAAL PHARMA
AL PHARMA
CYCY
CYCY
CY
The various functions of hospital pharmacy are:
1. Dispensing of drugs and medicines as per the prescription
of the medical staff
2. Management of the stores which includes:
a. Purchase of drugs and medicines, etc.
b. Providing instructions for proper storage of such drugs
and medicines.
c. Maintenance of proper records of the drugs purchased
and the distribution thereof.
3. Manufacture and distribution of medicaments and products
such as:
a. Transfusion fluids and other parenteral products, which
are not manufactured and marketed.
b. Tablets
c. Capsules
Hospital Pharmacy
2
Hospital Pharmacy 13
d. Ointments and other externally used preparations
e. Stock mixtures
4. Providing (TDM) therapeutic drug monitoring services by
studying effects of various drugs administered to the
patients especially the indoor patients from the patients
charts maintained in the wards, etc. by the nursing staff.
5. Establishment and maintenance of drug information centre
6. Patient counseling service
7. Maintaining liaison with the medical staff, nursing staff and
patients
8. To maintain nursing department and central sterile unit
9. Participate in teaching programs of the nursing and phar-
macy students.
ORGANIZAORGANIZA
ORGANIZAORGANIZA
ORGANIZA
TION STRUCTURE OF HOSPITTION STRUCTURE OF HOSPIT
TION STRUCTURE OF HOSPITTION STRUCTURE OF HOSPIT
TION STRUCTURE OF HOSPIT
AL PHARMAAL PHARMA
AL PHARMAAL PHARMA
AL PHARMA
CYCY
CYCY
CY
The organization of a hospital pharmacy is solely responsible
for efficiently running of hospital. The hospital pharmacy
consists of dispensing section, manufacturing section, quality
control section and clinical pharmacy section (Fig. 2.1 and
Table 2.1).
LOCALOCA
LOCALOCA
LOCA
TION OF HOSPITTION OF HOSPIT
TION OF HOSPITTION OF HOSPIT
TION OF HOSPIT
AL PHARMAAL PHARMA
AL PHARMAAL PHARMA
AL PHARMA
CYCY
CYCY
CY
It should be laid in such a way that there is a continuous flow
of men and materials. In multi-storey hospital, the pharmacy
Fig. 2.1: Organization pattern of a hospital pharmacy
Pharmacy Practice14
should be preferably located on ground floor especially the
dispensing unit, so that patients and staff can easily approach
it.
In smaller hospitals, only one pharmacist is required in one
room having all facilities like dispensing, manufacturing,
administrative and all other services. In large hospitals, i.e. with
200 or more beds, departmentalization of pharmacy activities
is required and for sterile products there should be a separate
room (Fig. 2.2).
The following facilities should be provided:
• A separate area for drug information services and space
assigned on various nursing units for unit dose drug
administration
Table 2.1: Organization pattern in hospital pharmacy
Aseptic area Manufacturing area • Raw material storage
• Stores
• Finished product
Gallery for passage
Administrative block • Dispensing area
• Open space
Fig. 2.2: Various types of pharmacist and other staff in hospital pharmacy
Hospital Pharmacy 15
• Sterile products room
• A store room
• Prepacking and labelling room
• A compounding room
• An office for the chief pharmacist
• Fluorescent lamps are placed above priscription counter.
• In manufacturing sections, drains should be provided, walls
should be smooth, painted in light colour.
• Floors of pharmacy should be smooth, easily washable and
acid resistant.
• 6 sq. feet per bed in 200 beded hospital, 10 sq. feet per bed in
100 beded hospital and 250 sq. feet is the minimum required
area for any sized hospital (Fig. 2.3).
REQUIREMENTSREQUIREMENTS
REQUIREMENTSREQUIREMENTS
REQUIREMENTS
Head of hospital pharmacy department should be a post-
graduate in pharmacy preferably in pharmaceutics, pharma-
cology or hospital pharmacy.
Director Superintendent of pharmaceutical services or chief
pharmacist should be M Pharm
Pharmacist in drug distribution department should be
D Pharm or B Pharm
For quality control two pharmacists either B Pharm or
D Pharm are required.
RR
RR
R
esponsibilities and Fesponsibilities and F
esponsibilities and Fesponsibilities and F
esponsibilities and F
unctions of Hospital Pharmacistunctions of Hospital Pharmacist
unctions of Hospital Pharmacistunctions of Hospital Pharmacist
unctions of Hospital Pharmacist
• To provide pharmaceutical services and other medical
services.
• To employ adequate and competent staff.
Fig. 2.3: Pharmacist requirements based on bed strength
Pharmacy Practice16
• To develop and maintain an effective system of clinical and
administrative records and reports.
• To make plan for hospital pharmacy administration.
• To prepare the financial plan for the hospital.
• Management of stores which includes purchase of drugs,
proper storage conditions, and maintenance of records.
• Dispensing and sterilizing of parenteral preparations
manufactured in the hospital.
• To prepare and implement the safety programmes in the
hospital.
• Maintaining liaison between the medical staff, nursing staff
and patients.
• Discarding the expired drugs and containers.
• Dispensing of drugs and medicines as per the prescription
RMP.
• Proper storage of drug.
• Establishment and maintenance of “Drug Information
Centre”.
• To provide right medication, at right time, in the right dose
at the minimum possible cost.
ISOLISOL
ISOLISOL
ISOL
AA
AA
A
TED KEY POINTSTED KEY POINTS
TED KEY POINTSTED KEY POINTS
TED KEY POINTS
• “Hospital Pharmacy is defined as department of a hospital which
deals with all the steps involved in the flow of drugs in and out of
the hospital, i.e. procurement, storage, compounding, dispensing,
manufacturing.
• The various functions of hospital pharmacy are:
i. Dispensing of drugs and medicines as per the pres-
cription of the medical staff
ii. Management of the stores which includes:
a. Purchase of drugs and medicines, etc.
b. Providing instructions for proper storage of such
drugs and medicines.
c. Maintenance of proper records of the drugs purchased
and the distribution thereof.
iii. Manufacture and distribution of medicaments and
products such as:
a. Patient counseling service
Hospital Pharmacy 17
b. Maintaining liaison with the medical staff, nursing
staff and patients.
iv. To maintain nursing department and central sterile unit.
v. Participate in teaching programs of the nursing and
pharmacy students.
• The hospital pharmacy consists of dispensing section,
manufacturing section, quality control section and clinical
pharmacy section.
• Head of hospital pharmacy department should be a post-
graduate in pharmacy preferably in pharmaceutics,
pharmacology or hospital pharmacy.
• Director Superintendent of pharmaceutical services or chief
pharmacist should be M Pharm.
• Pharmacist in drug distribution department should be
D Pharm or B Pharm.
• For quality control two pharmacists either B Pharm or
D Pharm are required.
• Responsibilities and functions of hospital pharmacist are:
i. To provide pharmaceutical services and other medical
services.
ii. To employ adequate and competent staff.
iii. To develop and maintain an effective system of clinical
and administrative records and reports.
iv. To make plan for hospital pharmacy administration.
v. To prepare the financial plan for the hospital.
vi. Management of stores which includes purchase of drugs,
proper storage conditions, and maintenance of records.
vii. Dispensing and sterilizing of parenteral preparations
manufactured in the hospital.
viii. To prepare and implement the safety programmes in the
hospital.
ix. Maintaining liaison between the medical staff, nursing
staff and patients.
x. Discarding the expired drugs and containers.
xi. Dispensing of drugs and medicines as per the pres-
cription RMP.
xii. Proper storage of drug.
xiii. Establishment and maintenance of “Drug Information
Centre”.
xiv. To provide right medication, at right time, in the right
dose at the minimum possible cost.