Hospital pharmacy and its organization Definition, functions of hospital pharmacy, Organization structure, Location, Layout and staff requirements, and Responsibilities and functions of hospital pharmacists.

1. HOSPITAL PHARMACY
AND ITS
ORGANIZATION
MR. MANGESH BANSOD
ASST. PROF.
SDDVCPRC, PANVEL

2. Definition of Hospital Pharmacy
 Hospital pharmacy functions for receiving, storing and
dispensing drugs and medicines to patients. The hospital
pharmacy may also manufacture pharmaceuticals and
parenteral products. The department provides a range of
pharmacy services for the hospitalised and ambulatory
patients, including purchase, manufacture, compounding,
storage, dispensing, distribution, and maintaining record
for the same.
 Hospital pharmacy is the health care service, which
comprises the art, practice, and profession of choosing,
preparing, storing, compounding, and dispensing
medicines and medical devices, advising healthcare
professionals and patients on their safe, effective and

3. Functions of Hospital Pharmacy
 It attains supply of drugs, chemicals, biological and
pharmaceutical formulations only from licensed vendors
and manufacturers.
 It inspects the received items and maintains an inventory
for the same.
 It dispenses drugs, chemicals, and pharmaceutical
preparations to the patients. The pharmacists repack the
medicament in appropriate containers and label them.
 It keeps a record of all the narcotic drugs and alcohol
received and issued.
 It predicts the demand for drugs, chemicals, antibiotics,
biological, radio pharmaceuticals, etc. and takes suitable
steps to fulfill the demand.

4.  It keeps a record of each supply dispensed.
 It manufactures large volume parenterals and other drug
preparations in case of unavailability, high cost, or lack of
authentic vendors or cautious.
 It implements strict control on the quality of the supplies
received, manufactured, and dispensed.
 It discusses about the drug related information with the
medical staff, resident nurses, health care team, and the
patients.
 It participates in minimizing the incidence of illness, and
improves the general health of the population.
 It provides patient counseling.
 It implements the recommendations of pharmacy and
Functions of Hospital Pharmacy

5. Organization Structure
 The hospital pharmacy has various divisions, like
compounding and dispensing, manufacturing or
production, quality control, central sterile supply, research,
education and training, administration, and library.
 The Chief Hospital Pharmacist is the head of
pharmacy who reports to the Administrator. The number
of Assistant Chief Pharmacist , who assists the Chief in
administration, depends on the work, nature and scope of
operations, staff strength, etc.
 The Chief has a secretary and other office clerks to assist
him. Staff pharmacists, technicians, pharmacy helpers,
and other workers of hospital pharmacy are involved in
compounding, dispensing, manufacturing, drug supply,

7. Location
 The pharmacy should be situated at the ground floor
or the first floor to ease its accessibility and to provide
adequate service to various departments and nursing
stations.
 If the hospital has an out-patient department, the
pharmacy or its branch should be near it. In a multi-
storey hospital, each floor should have a pharmacy.
The layout of floor pharmacies should be such that
continuous flow of men and materials is maintained.

8.  A complete unit of the
hospital pharmacy includes
1) Office of the chief,
2) Out-patient dispensing unit,
3) Bulk compounding area,
4) Manufacturing unit for
sterile and non -sterile
preparations,
5) Packaging and labelling
area,
6) Alcohol and volatile liquid
area,
8) Radioisotope storage &
dispensing area,
9) Central sterile supply area,
10) Cold storage area,
11) Research wing,
12) Pharmacy store room,
13) Library, and
14) Waiting room.
Location

9.  An out -patient pharmacy should look pleasant, and
have enough space and seating arrangement for
patients waiting for the medicine to avoid overcrowding.
 The waiting room in out-patient pharmacy should have a
professional look, bear educative posters on health and
hygiene, and hold light literature for reading to engage
the visitors. This puts a positive impact of the pharmacy
on the visitors.
 To manufacture bulk preparations (like stock solutions,
bulk powders and ointments, etc.) routinely, a suitable
space adjacent to the pharmacy or in the basement
directly below the pharmacy should be provided.
 The medical stores of pharmacy should lie adjacent to
the pharmacy or beneath the pharmacy.
Location

10. Layout

11. Structural Design
 Wall: The walls should be of non -porous material and
plaste red on both sides. The indoor wall finishing should
be of washable antifungal paint and the outdoor finishing
should be of weather -proof paint. The walls for cold room
should be of a special building material and design to
prevent condensation.
 Floor: The floor should be of concrete and smoothly
plastered. The floor finishing should be of a non-slippery
heavy duty material to withstand heavy loads and traffic.
The floor should be non-porous, damp-proof, and resistant
to detergent. The floor -to- ceiling height should range
from 15 -30 feet according to the functional area and
handling equipments used.

12. Structural Design
 Roof: The roof should be pitched or sloped to prevent
heavy rain damage.
 Door: The doors should be of fire -retardant material.
The doors should have two leaves, and should be
sufficiently wide to allow free and easy movement of
supplies and handling equipment (such as forklifts and
stackers). The exit doors should be purposefully located
and fitted with luminous emergency exit signage.
 Window: The windows should be available at
workstation, office and staff areas, but not in storage
areas.

13. Receiving Area
 Loading and Unloading Area: This area should be
adequately spaced and properly sheltered by taking care of
the vehicle height.
 Receiving Counter: It should have adequate waiting space
and should be equipped with suitable office furniture and
equipment.
 Sorting and Unpacking Area: This area should be
adequately spaced to enable sorting and checking of goods.
The space should be sufficient for the utilization of forklift.
 Transit/Holding Area: The transit/holding area should be
adequately spaced for storing:
 Items requiring further clarification/investigation before
receiving,
 Transit items not requiring special storage conditions, and
Pallets.

14. Storage Area
 General Storage Requirement: The storage area
should be provided with air - conditioning facilities for 24
hours. Its temperature should be effectively controlled
between 16 -25°C. The electrical supply to refrigerators,
freezers, cold room and air conditioning facilities should be
linked to the hospital emergency power supply.
 A computerised alarm system should be connected to the
main electrical control system of the hospital for detecting
electrical failure of cold chain equipment. Adequate space
should be provided for forklifts, stackers, and trolleys, and
for accommodating IT facilities. The area should have
sufficient numbers of pallets, shelves, and racks.

15.  Drug Store: It should have adjustable, modular, heavy duty
open racks for storing packages of different sizes. It should
have a sufficient storage area for bulk items. It should be
equipped with heavy duty plastic pallets for storing bulk
items and larger cartons off the floor. These pallets should
be designed to be used with forklifts to move around
groups of larger items. The drug store should have
designated area with cautionary signage and chemo-spill
kit for cytotoxic drugs.
 Dangerous Drugs/Psychotropic Substances Store: This
area is meant for storing dangerous drugs/psychotropic
substances, thus should be kept under lock and key in a
special room/cabinet with alarm system.
Storage Area

16. Storage Area
 Cold Room/Pharmaceutical Refrigerator/Freezer Area: This area
should be provided based on the functionality of hospital. It should be
present within the drug store for storing drugs that require low storage
temperature (like vaccines, antisera, and other biological products). Every
cold room/pharmaceutical refrigerator/freezer should be equipped with a
computerised temperature recorder system.
 Intravenous (IV) Fluid Store: This area should be adequately spaced to
accommodate haemodialysis and peritoneal dialysis solution, and
intravenous solutions. The space should also be sufficient for using
forklift.
 Surgical Store: This area is designed for storing bulk
surgical/consumable/disposable items/X -ray films. It should have
adjustable, modular, and heavy duty open racks. It should be provided
with adequate space to accommodate bulk items.
 Non-Drug Bulk Store: This area is designed for storing dispensing
bottles, containers, labels, and envelopes. It should have adjustable,
modular, and heavy duty open racks. It should be provided with adequate

17. Store with Special Requirement
 Inflammable Store : This area should be located at minimum 10 feet
distance away from other adjacent buildings. It should be designed for
storing inflammable items (ethanol, methanol, acetone, etc.) and should be
equipped with fire fighting equipments, smoke detectors, and exhaust fans
for proper ventilation. The location and design of inflammable store should
provide maximum air circulation so that accumulation of fumes or gases
can be avoided.
 Corrosive Items Store: This area should be designed for the storage of
corrosive items ( such as phenols and hypochlorites). It should be
equipped with special plumbing and drainage system, and eye wash
station.
 Medical Gas Store: This area should be designed for the storage of
portable medical gas cylinders. The floor should be reinforced to bear the
weight of heavy gas cylinders. All electrical facilities should fulfill the
requirements of the Fire Fighting and Rescue Departments and
Department of Environment. Proper ventilation should be maintained.
 Quarantined Item Store: A designated area or cabinet should be provided
and clearly labelled.

18. Issuing Area
 Temporary Holding Area: Supply to various
departments is carried out in this area. Indents from
various departments should be processed and prepared
for supply and kept here till collected.
 Issuing Counter: It should have an adequate waiting
space, and should be equipped with appropriate office
furniture and equipment. It should provide a sufficient
space for material handling equipment.

19. Administrative Area
 Pharmacist In-Charge Office: This area is provided for the pharmacist
in -charge to perform the administrative work. It should be located to
allow supervision.
 Pharmacist Work Station: This area is provided for the pharmacist. It
should be half-glass panelled to allow supervision. Workstations and
computer terminals should also be present here.
 General Office: This area is provided for the assistant administrative
officers and administrative assistants. Work-stations with computer
terminasl should be present here.
 Meeting/Discussion Room: This area should have sufficient space for
discussion and routine administrative meetings.
 Document Room: This area should have sufficient space for storing files
and records.
 Reception Counter and Customer Waiting Area: This area should be
equipped with appropriate office furniture and equipments. The customer

20. Ancillary Area
 Personnel/Staff Rest Room: This room should be provided for
staff rest, and should be equipped with staff lockers and
domestic appliances such as refrigerator, electric kettle, water
dispenser, microwave oven, table, chairs, and sofa.
 Wash Room: Separate wash rooms for male and female with
separate changing rooms, toilets and shower facilities should
be provided. A dedicated toilet for visitor should be made
available.
 Housekeeping/Utility Room: This room should have sufficient
space for storing cleaning materials and equipment. It should
have good ventilation for washing and drying of equipment.
 Security Guard Post: This area should be located at the main
entrance of the store. The room should be equipped with

21. Floor Space Requirements
 Hospital pharmacy floor area depends on the range of its
operations, number of divisions, medicaments manufactured,
number of patients served (out -patient pharmacy), number
of indoor patients, strength of the pharmacy staff, etc.
 The floor space should be in accordance to the norms laid
down by the Drugs and Cosmetics Act (under Schedule M).
The floor area should be minimum 250m 2.
 The area requirements increase at 10m 2 per bed for 100
beds, 6m 2 per bed for 200 beds, and at least 5m 2 per bed
for larger hospitals.
 Teaching institutes demand a greater area.

22. Staff Requirements
 The number of pharmacy staff members relies on the following factors:
 Number of beds, Service-out-patients and in-patients,
 Whether the pharmacy is involved in manufacturing drugs or formulations,
and
 Whether the pharmacy is involved in stocking and dispensing of surgical
and laboratory supplies.
 A hospital pharmacy should appoint the following staff personnel:
 One member as the Chief pharmacist or Director.
 Atleast 4 registered pharmacists in smaller hospitals so that one
pharmacist handles 60 patients. Total patients involve (both in-patients and
out-patients).
 Sufficient number of assistants, attendants, and sweepers.
 Pharmacist-cum-clerk or clerks depending on the hospital size.
 A hospital pharmacy manufacturing drugs and formulations should have

23. Qualification
 The Chief Pharmacist or Director should be a post
graduate degree holder in pharmacy (preferably in
pharmacology or hospital pharmacy).
 The manufacturing chemist is required to have
graduated in pharmacy and hold experience in
manufacturing drugs and formulations for at least
18 months.
 The analytical chemist should be a post graduate
in pharmaceutical chemistry or analytical
chemistry.
 Registered pharmacist and pharmacist - cum-
clerk require diploma in pharmacy and registration
in state pharmacy council.

24. Responsibilities and Functions of Hospital
Pharmacists
 Hospital pharmacists are engaged in hospital
pharmacy services in public sector.
 They are skilled in practice of medicines and
dispense prescriptions, purchase, manufactures, and
performs quality test of all medicines used in a
hospital. Being the members of healthcare team, they
coordinate with medical and nursing staff for better
treatment of patient. They help and refer knowledge
to patients on their medicines. The
responsibilities of a pharmacist vary with the
departments and this has been discussed below.

25. In-Patient Pharmacist Responsibilities
 Dispensing Area: The responsibilities of the pharmacist
in dispensing area are:
 Policies: He/she ensures that the framed hospital policies and
procedures are being obeyed.
 Accuracy: He/she maintains proper control on the accuracy of
dosages prepared (particularly for intravenous administration).
 Maintenance of Records: He/she maintains records of drugs
supplied, returned bills of investigational drugs and intravenous
admixtures, etc.
 Storage: He/she have adequate control over the stocked drugs.
 Working: He/she ensures the compliance of all the laws and
rules, and that compounding is done by adequate techniques.
 Coordination: He/she manages all the conducts of dispensing
area.
 Drug Information: He/she remains updated about the drugs in
the hospital in terms of their side effects, therapeutic efficacy,
stability, etc.

26. In-Patient Pharmacist
Responsibilities
 Patient Care Area: This area indicates any site of a hospital where
patients are examined. Parts of the patient care area where
pharmacists are involved are:
 Coordination: He/she coordinates all the pharmacy service is in the
nursing unit.
 Communication: He/she consults nurses and medical staff for
medicine administration problems.
 Technical: He/she shares technical sections giving instructions to the
technicians for new procedures and dealing with difficult patients.
Pharmacist connects the technician, nursing, and medical staff, thereby
ensuring that proper techniques are followed by the technician for drug
administration.
 Supervisory: He/she supervises and re -checks all the prescriptions for
their correct entry in the unit dose system. The pharmacist periodically
inspects individual patient’s drug administration form for all doses being
administered and charted correctly. He/she periodically ensures
whether the administered doses are mentioned on patient’s chart and
the drug charges are correctly calculated. He/she re-examines the
missed doses, re-schedules them, and signs all “Drugs not given”
notices. He/she timely checks the medication areas for maintenance of

27. In-Patient Pharmacist
Responsibilities
 Direct Patient Care: This relates to any facet of health ca re of a patient ,
like treatments, counseling, self -care, patient education, and drug
administration. Parts of the direct patient care area involving pharmacists
are:
 Patient’s Medication History: He/she takes down the patient’s
medication history and forwards it to the physician.
 Identification of Drugs: He/she identifies the drugs brought in the hospital by
patient.
 Patient Monitoring: He/she monitors the overall patient’s drug therapy for its
effectiveness, side effects, toxicities, and allergic reactions.
 Patient Counseling: He/she counsels the patient for self -administered drugs
and discharge drugs.
 Selection of Drug: He/she supports the physician while selecting the drugs,
dose regimens, and schedule the time for drug administration.
 Cardiopulmonary Emergencies: He/she gets involved in emergencies , like
cardiopulmonary cases.
 General Responsibilities: He/she provides education and drug information
to other health professionals.

28. Out-Patient Pharmacist Responsibilities
 Central Dispensing Area: The pharmacists perform the following tasks:
 He/she ensures the use of correct compounding techniques.
 He/she maintains adequate record and billing for patient’s medication particulars, records of tentative
drugs, records of out-patient’s bills (charging of services and material), and maintaining and preparing all
reports.
 He/she keep up with the prescription files.
 He/she maintains the tidiness of outdoor pharmacy.
 Patient Care Area: The pharmacists perform the following tasks:
 He/she regularly visits an d checks the medication areas in the nursing unit. He/she ensures adequate
supply of required drugs and other articles.
 He/she identifies the drugs brought in the clinic by the patients.
 He/she pharmacist records the patient’s medication history and delivers it to the physician’s knowledge.
 He/she assists the physician n selecting the drug regimen.
 He/she also helps in selecting right drug products and their entities.
 He/she involves in patient counselling for use of medication and preparation for intravenous
administration.
 General Responsibilities
 He/she understands and coordinates complete pharmaceutical needs of the outdoor service area.
 He/she makes sure that all drugs are properly managed.
 He/she takes part in cardiopulmonary emergencies.
 He/she offers in -service education and training to pharmacists, pharmacy students taking practical
training for their diploma or degree courses, and nurses.