this is hospital pharmacy attachment

2. Attachment site……Zewditu memorial hospital
Attachment period… ……from Nov14 –Nov 25
Prepared by:-
Senait Legesse
Sena Tamiru
Senehiwot Abel
Shikur Yasin

3.  Introduction
 Description of attachment area
 Observation and discussion
 Summary and recommendation
 Counseling tip monography

4. o Hospital pharmacy is a practice of pharmacy within the
hospital under the supervision of a professional
pharmacist is known as hospital pharmacy
o Responsible to satisfy all drug related issues of the
hospital and the patient.
o It’s is regulated and directed by legally competitive and
licensed pharmacist.

5. o Provides different services like; drug dispensing,
compounding and counseling
o Provision of drug related information to the patient and
other health professionals
o Preparation of hospital drug list and treatment
guidelines

6. o Clinical pharmacy practice in hospital pharmacy helps
to promote patient oriented service
o Developed to promote the rational use of medicines and
specifically to maximize therapeutic effect, minimize
risk, minimize cost and respect patient choice.
o Interacting with health care team in patient rounds.
o Well documenting and improving Optimization of
medication use

7. Zewditu memorial hospital
 Zewditu hospital is a hospital in central Addis Ababa,
Ethiopia.
 Zewditu hospital located in the in front of ministry of
Denfense on the way to Sheraton Addis.
 ????

8.  OPD pharmacy has currently 11 employees
Eight pharmacists which works by shift
Three cashiers
Emergency Pharmacy has five employees;
which are 3 pharmacists and 2 cashiers
Inpatient Pharmacy has currently 9 staffs
i.e. 6 pharmacists and 3 cashiers.
 ART Pharmacy has three staffs i.e. 3
pharmacists and no cashier
Dialysis Pharmacy has one pharmacists
and no cashier.

9.  During our practice we have tried to visit and worked
on 6 units of hospital pharmacy which are:
 Outpatient pharmacy
 ART pharmacy
 Inpatient pharmacy
 Emergency pharmacy
 Ophthalmic pharmacy
 Dialysis pharmacy

10.  Outpatient pharmacy is located in the in front of the
compound gate on the left side to emergency
department.
 It is well known for provision of services to the
patients who haven’t taken the bed inside the hospital
and takes medicine for long duration of time.

11.  It is the largest pharmacy in the hospital in which
medicine are pharmacologically ordered and have more
patient waiting area as compared to other pharmacy in
the hospital.

12. Outpatient pharmacy has currently 12 employees
 Eight pharmacists which works by shift
 Three cashiers and
 Cleaners
 It provide services to around 250-300 costumers per a
day.so 75-100 patients get service per 1 pharmacist.

13. Layout: It contains many shelves with so many
drugs ,10 windows and 18 chairs for
patient who is waiting.
 Common drugs at OPD pharmacy include:
 HCT
 Enalapril
 Nefidipine
 Frusemide
 Glibenclamide
 Asprin
 Metformin
 Omeprazole
 PTU
 Amitriptyline
 Amoxacilin tab
 Ciprofloxacin tab
 Sulbutamol oral solution
 Medicines found in
refrigerator:
 NPH
 Mixtard insulin
 Regular insulin

14.  Emergency pharmacy is located directly in the in front
the gate of a compound within an emergency
department in the ground of the building
 It gives service to patient affected to emergency
conditions.

15.  It has five employees; which are 3 pharmacists and 2
cashiers. Emergency pharmacy serves more than 100
patients per a day.
 There is no arrangement of medicine in the pharmacy.

16. Layout: It contains 1table, 2 chairs,2 beds for
pharmacists who serve at night and only one
window for handling patients.
 Common medicines found in Emergency
pharmacy include:
 Glucose injection,
 furosemide injection
 cotrimoxazole,etc…
 Medical devices:
 different cc syringes,
 IV canula ,
 surgical glove…etc

17.  Inpatient pharmacy is found on the second floor of the
old building.
 It gives service to the patient in severe condition that
have taken the bed in the hospital.

18.  It has currently 9 staffs i.e. 6 pharmacists and 3
cashiers.
 It gives services to approximately 200-250 costumers
per day.
 There is no arrangement of the medicine in the
pharmacy.

19. Layout:It contains 2 shelves,2
tables and 3 beds for
pharmacists who serve at
night.
Common medicines found at
impatient pharmacy:
 Folic acid 5 mg tablet
 potacium chloride tablet
 Acetaminophen
suppositories
 Tramadol capsule
 Methyldopa
 Norfloxacin
 TTC
 Flexin..powder,capsule
 Cotrimoxazole
suspension…etc
Injections
 Atropine injection
 Ceftazidime injection
 Cefazoline injection
 Metronidazole IV infusion
 Glucose injection
Medicines found in
refrigerator:
 Oxitocin
 Ciprofloxacin injection
 NPH
 Anti Rho-D immuno
globulin injection
 Succcinyl choline chloride
injection

20.  ART pharmacy is located on the first floor of the new
building separately from other departments.
 It gives service to HIV/AIDS infected patient only

21.  The medicines are found in both single and combination form
that is classified by their mechanism of action.
 There are some drugs in addition to ART drugs for the prevention
and treatments of opportunistic infections.
Layout:It contains 3 shelve,1 table and 2 chair
 Common drugs at ART pharmacy include:
Combination:
 1J (dolutegravir,Lamivudine,Tenofovir
50/300/300mg)
 Atazanavir,Ritonavir...300/100mg
Single form :Abacavir,Lamivudine….etc
Drugs for opportunistic infections:
Cotrimoxazole,Isoniazid,pyridoxine…etc

22.  It has three staffs i.e. 3 pharmacists and no cashier
because all medications are free.
 It gives service to around 150-200 costumers per a day.
 Generally there are 7614 ART patients

23.  The dialysis pharmacy is established since 2009 and
gives service to 14 patients per a day.
 it is found beside the dialysis center
 it gives service to patient undergoing dialysis in the
hospital without any payment.

24.  It is small pharmacy and
there is only few drugs like
enalapril, Heparin,
albendazole, Nifedipine and
instrument and supplies
such as: dializer,blood
line,dialysis kit and
different cc syringes.

25.  There are four stores in the Zewditu memorial hospital;
that are budgeted medicine store, program store, supply
store and equipment store.
 Budgeted medicine store and supply store are located
on the back side of emergency department on the
ground of the old building.

26.  The store used IFRR format for transaction of
drugs and supply between the stores and
dispensary
 The DAGU software used in the stores made
the transaction easy and clear.
 In the stores model 19 is used for receiving
and model 22 is used for issuing
 The stores receive most of the drugs and
supplies from EPFSA

27.  In medicine store the drugs are arranged in
pharmacological order and medicines like
NPH, mixtard, regular insulin and e-potien
were place in refrigerator of 2-8 degree
Celsius
 The store man record the room and
refrigerator temperature twice a day in the
morning and evening.

28. Strength and weakness

29. Pharmacy unit strength Weakness
Out patient pharmacy • have experienced and
senior pharmacist
• Appropriate prescription
evaluation and recording
of action taken
• enough patient waiting
area
• Non availability of
certain drug products
• Medications in shelves
are not ordered
according to the
designation labeled on
the shelf
• Lack of provide
counseling
• in appropriate filling of
DTP format
• No room and refgretor
temp recording
In patient pharmacy
and medical pharmacy
• Works 24 hours and
7 days a week
• Good patient
service
• Good Stock status
• Very narrow
dispensing area
• Not clean

30. Pharmacy unit Strength Weakness
Emergency pharmacy • Works 24 hours and
7 days a week
• Good patient
service
Clean room
• Low stock status
• Non availablity
staff(cashier)
ART pharmacy • Clean
• Good stock status
• Poor patient
handling
• Lack of dicipline of
some staffs
• No councling
Dialysis pharmacy • The location being
near the dialysis
center
• Not clean
• Very narrow

31. • No digital drug management system
• Drugs placement on the shelf does not match
with the classification labeled on the shelf
• Poor application of APTS including the formats
of the prescription
• Bulk medications in cartoon are placed above
the shelves.
• Narcotic and psychotropic drugs are not
placed in locked cabinets except diazepam

32.  Strength
 The department have experienced and senior
pharmacist which are ready to serve for the customers
 Provision of expensive drugs free of charge for
community healthcare insurance users.
 Emergency and Inpatient pharmacy function 24 hours

33.  In stay in different dispensing unit and store we
learned:-
 How to check the legality of the prescription
 Activities to be followed while dispensing the
medicines
 Appropriate counseling of the patient
 Interpretation of prescription

34.  corrected the placement of some drugs
which were disordered.
 shelved some drugs
 We tried to correct some errors made on the
billing process.
 Counseling of patients.
 Proper handling of the patient