Dispensing During Off-HoursShams kursan
• The major criticism of small hospital was  the lack of pharmaceutical service on 24  hours.• Two major reasons for that ...
Means of the hospitals to provide 24-hour a day pharmacy coverageA. Use of the Nursing SupervisorB. Emergency Boxes and Ni...
Use of the Nursing Supervisor
Use of the Nursing Supervisor• It permit the evening and night nursing  supervisor to enter the pharmacy and  provide limi...
Use of the Nursing SupervisorDisadvantage:1. Dangerous2. An illegal practice (in some areas)
Use of the Nursing Supervisor• However; the advocator said:There exists a correlation between the nurse  selecting a medic...
Use of the Nursing Supervisor• The fallacy of this view:  The medication in nursing station have   Already had the benefit...
Use of the Nursing Supervisor•   Nursing personnel serving in this category    should be:a. Specifically prohibited form c...
Emergency Boxes and Night Drug           Cabinets
Emergency Boxes•   Is necessary to expedite treatment in situations    where time is of the essence.•   So, the emergency ...
Emergency Boxes• In order to accomplish this goal;  The pharmacy should’ve reserve boxes  prepared so that the units may b...
Emergency Boxes• If the hospital policy charge for the supplies  used from emergency box   the nurse should prepare a char...
Emergency Boxes•   “Emergency cart” or “resuscitation    cart”; Mobile units have on them the same    basic supplies conta...
Emergency Boxes• Emergency box must be checked on  regular basis(monthly) by hospital  pharmacist.• In order to:   Remove...
Emergency Boxes• This system requires placing an inventory and  product control card in the box
Emergency Boxes•    The objectives of the card;1.   Serves as an inventory of the emergency box2.   Shows when the unit wa...
The night drug supply cabinetII.     The night drug supply cabinet       An adjunct to the charge floor stock        medi...
The night drug supply cabinet• The large cabinets are usually  constructed in the wall of the pharmacy  →→ serviced from w...
The night drug supply cabinet• It should be stocked with:     Pre-packaged     Labeled containers of the drugs• Many hos...
The night drug supply cabinet• The nursing supervisor leave identified charge  ticket Listing:  – the item removed  – To w...
Use of Physicians
Use of Physicians• Require the physician enter the  pharmacy and obtain any special  medication not provided through: •   ...
Use of Physicians• drawbacks :  o   A physician might waste a great deal of      time searching for a product  o   An unfa...
Use of Physicians• Advantage: o   The physician may be influenced to     use available drug which will     accomplish the ...
Pharmacist on call
Pharmacist on call• In order to encourage this type of coverage,  many administrators have developed:   Bonus   Extra pa...
Purchased Service
Purchased Service• Contracting with local community  pharmacy for: • Night • Holiday • vacation relief for the staff pharm...
Purchased ServiceAdvantages• Safe and legal• protect the drug needs of the  hospital and patient• safeguard the health nee...
Purchased Service• Where there is more than one  pharmacy in the community, care  should be taken to avoid any  claims of ...
Purchased Service• This may be accomplished by:  • Develop a set of specifications and    requirement concerning the desir...
THANK YOU
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Dispensing during off hours

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Dispensing during off hours

  1. 1. Dispensing During Off-HoursShams kursan
  2. 2. • The major criticism of small hospital was the lack of pharmaceutical service on 24 hours.• Two major reasons for that are:1. Shortage of trained personnel2. Prohibitive costs
  3. 3. Means of the hospitals to provide 24-hour a day pharmacy coverageA. Use of the Nursing SupervisorB. Emergency Boxes and Night Drug CabinetsC. Use of PhysiciansD. Pharmacist-On-CallE. Purchased Service
  4. 4. Use of the Nursing Supervisor
  5. 5. Use of the Nursing Supervisor• It permit the evening and night nursing supervisor to enter the pharmacy and provide limited type of services• The first and the most widely used
  6. 6. Use of the Nursing SupervisorDisadvantage:1. Dangerous2. An illegal practice (in some areas)
  7. 7. Use of the Nursing Supervisor• However; the advocator said:There exists a correlation between the nurse selecting a medicine from the drug cabinet on the pavilion and selecting the same item from the pharmacy.
  8. 8. Use of the Nursing Supervisor• The fallacy of this view: The medication in nursing station have Already had the benefit of special packaging Handling and labeling by professionally competent.• So, it should be practiced with caution(if it is the only mean available to small hospital)
  9. 9. Use of the Nursing Supervisor• Nursing personnel serving in this category should be:a. Specifically prohibited form compounding a mixtureb. Restricted to dispensing from the selection of pre-labeled and pre-packaged items
  10. 10. Emergency Boxes and Night Drug Cabinets
  11. 11. Emergency Boxes• Is necessary to expedite treatment in situations where time is of the essence.• So, the emergency box must be: i. Large enough ii. Sufficiently compact(to facilitate handling items) iii. Kept in a ready accessible place(known to all ward personnel) iv. Ready for use at all times
  12. 12. Emergency Boxes• In order to accomplish this goal; The pharmacy should’ve reserve boxes prepared so that the units may be handled on an exchange basis reduce the period of time without a ready to use emergency box
  13. 13. Emergency Boxes• If the hospital policy charge for the supplies used from emergency box the nurse should prepare a charge ticket and submit it to the pharmacy with the used box
  14. 14. Emergency Boxes• “Emergency cart” or “resuscitation cart”; Mobile units have on them the same basic supplies contained in emergency box plus : i. Facilities for the administration of oxygen ii. The application of suction iii. A cardiac pacemaker
  15. 15. Emergency Boxes• Emergency box must be checked on regular basis(monthly) by hospital pharmacist.• In order to:  Remove outdated  Deteriorated medications
  16. 16. Emergency Boxes• This system requires placing an inventory and product control card in the box
  17. 17. Emergency Boxes• The objectives of the card;1. Serves as an inventory of the emergency box2. Shows when the unit was last checked3. Provides the nursing personnel with adequate directions for replenishing any item which may have been used.
  18. 18. The night drug supply cabinetII. The night drug supply cabinet  An adjunct to the charge floor stock medications already on the pavilion.  Range from simple cabinets with drawers to large elaborate installations which include narcotic vaults and refrigerate compartments.
  19. 19. The night drug supply cabinet• The large cabinets are usually constructed in the wall of the pharmacy →→ serviced from within the pharmacy →→ yet is accessible from the corridor side to authorized nursing personnel
  20. 20. The night drug supply cabinet• It should be stocked with:  Pre-packaged  Labeled containers of the drugs• Many hospitals also store certain medical and surgical supplies.(oxidized cellulose)
  21. 21. The night drug supply cabinet• The nursing supervisor leave identified charge ticket Listing: – the item removed – To whom it was administeredThe next morning the pharmacy personnel restock the unit and forward the charged ticket to accounting office.
  22. 22. Use of Physicians
  23. 23. Use of Physicians• Require the physician enter the pharmacy and obtain any special medication not provided through: • The floor stocks • Night cabinets • Emergency box
  24. 24. Use of Physicians• drawbacks : o A physician might waste a great deal of time searching for a product o An unfair burden to place upon their already heavily taxed work hours.
  25. 25. Use of Physicians• Advantage: o The physician may be influenced to use available drug which will accomplish the same purpose
  26. 26. Pharmacist on call
  27. 27. Pharmacist on call• In order to encourage this type of coverage, many administrators have developed:  Bonus  Extra pay plans• A rotational plan of on-calls will not burden single individual
  28. 28. Purchased Service
  29. 29. Purchased Service• Contracting with local community pharmacy for: • Night • Holiday • vacation relief for the staff pharmacist
  30. 30. Purchased ServiceAdvantages• Safe and legal• protect the drug needs of the hospital and patient• safeguard the health needs of the area on a round-the-clock basis.
  31. 31. Purchased Service• Where there is more than one pharmacy in the community, care should be taken to avoid any claims of favoritism or politics
  32. 32. Purchased Service• This may be accomplished by: • Develop a set of specifications and requirement concerning the desired service • Request the local establishments to submit their bids.• Only the retail pharmacies with adequate staff, inventory, and delivery service can qualify to bid.
  33. 33. THANK YOU

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