Farmasi pesakit dalam3

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Farmasi pesakit dalam3

  1. 1. PERKHIDMATAN FARMASI PESAKIT DALAM
  2. 2. Farmasi Pesakit DalamThe Inpatient Pharmacy is responsible for the supply and dispensing of all medicines to inpatients and for the supply of medicines on discharge.
  3. 3. ObjektifTo dispense medications to inpatients and discharge patients via the prescription or imprest systemTo provide pharmaceutical care via patient counseling
  4. 4. Skop TugasDispensingMedication counselingStock management
  5. 5. IN-PATIENT PHARMACY Services both in-patients & discharge patients. Provide bedside dispensing and counseling service for discharge patients. Supply medications to in-patients in wards and units through:I) Modified Unit Dose System/Unit Of use - Each Dose is packed and labelled & kept in trolley bins. - II) Floor Stock System - Commonly used drugs are stocked in the wards for after office hours use. - Minimum & maximum stock level constantly monitored & replenished by pharmacy staff. III) Supply Of Dangerous Drug (DD) IV) Discharge MedicationIV) Counselling And Bedside Dispensing
  6. 6. GarispanduanBerdasarkan Formulari Ubat KKM  A* = Consultant for specific indication  A = Consultant or specialist  B = Medical Officer  C = paramedical staff * Item tiada dalam Formulari – perlu dapat kelulusan KPK
  7. 7. Ubat-ubatan UntukPesakit Dalam Wad (Inpatient)
  8. 8. Proses Kerja New Prescription by Doctors Further Clarifications SCREENING Contact Prescribers By Pharmacist Problems Rectified Trolley Rx Filling CounterRx For Refilling Checking According to Based on Rx Data Wards of Individual Patient Supply To Ward Staffs Patients In Wards
  9. 9. Screening (Penyaringan) 1. Preskripsi adalah lengkap  Nama pesakit dan MRN  Drug regimen adalah betul (Dose, frekuensi, cara  administrasi dan j/masa  T/tangan dan nama prescriber  Age dan berat untuk pesakit paediatrik (Prefer)  Bertarikh 2. Polifarmasi 3. Interaksi ubat *Hubungi doktor jika terdapat sebarang permasalahan pada preskripsi dan buat dan buat pembetulan yang sepatutnya.
  10. 10. Screening  2. Polifarmasi  3. Interaksi ubat  *Hubungi doktor jika terdapat sebarang permasalahan pada preskripsi dan buat dan buat pembetulan yang sepatutnya. 4. Sah 5. T/tangan pakar utk ubat khas
  11. 11. Preskripsi Bermasalah Hantar BalikSticker Kuning•Masalah Dos•Kekerapan• Jangkamasa Cop Kosign Pakar
  12. 12. Pembekalan Proses bekalan: Melabel, mengisi menyediakan persediaan ekstemporaneus, merekod, menyemak balas, Pembekalan melalui: Unit Dos Unit Of Use Imprest stock/ward stock Semaksilang
  13. 13.  In-patients by implementing the Unit-of-Use/Unit Dose System. Advantage of providing personalised and continuous supply of medication to patients, with better compliance and reduced wastage as compared to the traditional system where the wards order drugs in large quantities, which have led to overstocking and wastage.
  14. 14.  2.4 Melakukan “Bedside Dispensing” untuk pesakit Discaj dan Kaunseling 2.5 Memesan, menerima, menyemak dan mengeluarkan stok ubat 2.6 Membekalkan Dadah Berbahaya dan Item Psikotropik ke wad 2.7 Menyediakan Laporan QAP dan kompilasi statistik Membekalkan larutan intravena dan disinfektan yang baru disediakan kepada semua wad/unit. Mengawal secara berpusat pembekalan ubat-ubatan dengan mempunyai stor yang boleh menyimpan stok drug yang mencukupi untuk dibekalkan ke Farmasi Bekalan Wad dan Farmasi Satelit.
  15. 15. IN-PATIENT PHARMACY Services both in-patients & discharge patients. Provide bedside dispensing and counseling service for discharge patients. Supply medications to in-patients in wards and units through:I) Modified Unit Dose System - Each Dose is packed individually & kept in trolley bins. - Supply is on everyday basis.- II) Floor Stock System - Commonly used drugs are stocked in the wards for after office hours use. - Minimum & maximum stock level constantly monitored & replenished by pharmacy staff. III) Supply Of Dangerous Drug (DD) IV) Discharge MedicationIV) Counselling And Bedside Dispensing
  16. 16. Unit Dose The unit dose system may differ in form, depending on the specific needs of the organization. Basic unit dose systems: medications are contained in single unit packages; they are dispensed in as ready-to-administer form as possible; and for most medications, not more than a 24-hour supply of doses is delivered to or available at the patient-care area at any time. Numerous studies concerning unit dose drug distribution
  17. 17. Floor Stock/Ward Stock Ward Stock • The floor stock system is used in small hospitals where pharmacists are not available to dispense individual doses for patients. Floor Stock It consists of a predetermined list of medications that are available in the patient care area of the hospital Usually these items are inexpensive that have common use (Example: alcohol, lotion, water for injection, normal saline, etc) Certain medications for Example: emergency/Operation room medications that are required to be used almost immediately after the physician prescribes them, and it isnt practical to wait until the nurse dispenses them from
  18. 18. Inpatient drug distribution  Supplying medications to ward patients in individualised bins  Preparing medication from discharge scripts
  19. 19. Bedside Dispensing perkhidmatan terus ke katil pesakit. Khidmat ini dilakukan oleh Pegawai Farmasi yang bertugas dengan menghantar ubat terus kepada pesakit yang "discharge" (dibenarkan pulang) oleh Doktor dan seterusnya memberi kaunseling ubat- ubatan.
  20. 20. Dadah Berbahaya (DD) Menurut Dangerous Drugs (Hospital, Etc) (General Exemption) Order 1952, Schedule B, 2: All supplies of such drugs and preparations will be received by the Matron, Acting Matron, Senior Hospital Assistant or Senior Nurse of the hospital and shall be kept by her in a locked cupboard of which she alone shall have the key.
  21. 21. Dangerous Drugs (DD)/Psikotropik Ubat yang dikawal olehAkta Dadah Merbahaya (DDA) 1952 Semua Inden dan Penghantaran DD/Psikotropik hanya boleh dikendalikan oleh Matron/ Sister/ Staff Nurse
  22. 22. Senarai DD/ PsikotropikClonazepam Tab Methadone SyrupDiazepam Inj/ Tab/ Supp Midazolam Inj/ TabDihidrocodeine DF118 Morfin Injeksi/ Tab/ SirapFentanyl Inj/ Patch Oxycodone Tab Phenobarbitone Tab/Ketamin Inj SyrupLorazepam Tab Pethidine Injeksi Zolpidem Tab
  23. 23. Pemeriksaan Wad Pemeriksaan wad akan dijalankan oleh Staf Farmasi setiap 3 bulan (mengikut Jadual yang telah ditetapkan) Tujuan pemeriksaan adalah untuk memastikan: * Tiada ubat yang luput * Tidak overstocking * kaedah penyimpanan adalah betul Laporan pemeriksaan akan dikeluarkan dan pihak wad bertanggungjawab untuk membuat tindakan susulan
  24. 24. Cold chain Item- item ini perlu disimpan bawah suhu 2 - 8ºC untuk mengelakkan kerosakan ubat Perlu membawa bersama Ice Box dengan pek ais di dalam. Kebanyakan Fridge Item adalah ubat yang mahal, maka ubat tidak akan dibekalkan tanpa ice box.
  25. 25. Permonitoran Stok Memastikan stok sentiasa ada dan mencukupi Mengelakkan ubat luput Mengelakkan overstocking Mengurangkan slow moving item
  26. 26. High Alert MedicationWhat is High Alert Medication? High-Alert Medication – Medications that have a heightened risk of causing significant patient harm when used in error. The following medications which are currently listed in the have been classified as High Alert Medication.  amiodarone, IV  heparin, low molecular weight, injection  heparin, unfractionated, IV  insulin, subcutaneous and IV  magnesium sulfate injection  cyclophosphamide, oral  methotrexate, oral  nitroprusside sodium for injection  potassium chloride for injection, concentrated  potassium phosphates injection, concentrated  sodium chloride injection, hypertonic (more than 0.9% concentration)  warfarin.
  27. 27. Pembekalan Ubat HAM  Semua Ubat disemak silang sebelum dibekal  Ubat-ubat dilabel dengan “HIGH ALERT MEDICATION”  Membekalkan ubat dalam bentuk pek unit dos  Menghadkan penggunaan secara intrathecal, epidural analgesic, oleh staff terlatih sahaja
  28. 28. Storage DO NOT keep look alike or different strength drug side by side. Limit the strength and quantity available in ward floor stock. Use smaller package, concentration, dose, and number of vials for floor stock. Designated area or different label receptacle Higher strength drugs to be keep in emergency trolley and lower strength to keep as floor stock (storage container for HAM should be labeled by ward staff –eg. Insulin, heparin)
  29. 29. THANK YOU

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