its about the control of infections and control of ADR and formulations in the hospital pharmacy

1. DIFFERENT
COMMITTEES IN THE
HOSPITAL
BY : HEMLATA R. MORE
ASSISTANT PROFESSOR
QUALITY ASSURANCE

2. CONTENT
INTRODUCTION TO DIFFERENT COMMITTEES
PHARMACY AND THERAPEUTIC COMMITTEE
HOSPITAL FORMULARY
INFECTION CONTROL COMMITTEE

3.  INTRODUCTION TO DIFFERENT COMMITTEES
• Hospital committee plays an important role in management and decision making in hospital .
• Hospitals are organised into different departments, there are many issues of more than one department.
• These issues need people in different roles and with different expertise, to collectively take suitable
decisions and actions.
• Depending upon the types of issues in hospital various committees are formed like pharmacy and
therapeutic committee , quality improvement committee, infection control committee , pharmaco-
therapeutic committee , disaster management and emergency preparedness committee , ethics committee ,
grievance redressal and disciplinary action committee etc.

4.  PHARMACYAND THEARPEUTIC COMMITTEE
Pharmacy and therapeutic committee is a policy framing and recommending (& educational) body an
matter related to rational use of drug in the hospital , comprising members from various departments of
the hospital.
 OBJECTIVE OF THE PHARMACYAND THERAPEUTIC COMMITTEE
1. Advisory objective :
• To assist in the formulation of policies regarding evaluation , selection and therapeutic use of drugs in
the hospital.
• To advise medical staff and hospital administrator about all matters regarding drug use including
investigational drugs.

5. • To advise pharmacist about effective drug distribution and control procedures.
• To gives recommendations about the drugs to be stocked in patient care areas
2. Educational objectives :
• To assist in the formulation of policies to meet the needs of professional staff for getting complete
current knowledge about the drugs and their use.
• To review adverse drug reactions and also provide Hospital formulary system.
• To look after management of training programs for the professional staff involved in drug use

6.  COMPOSTION OF PTC
 A pharmacist
 At least three physician.
 A hospital administration or his/ her designated person and ex- officio member of the committee
 The physician may be appointed as the “ Chairman” of P.T.C.
 The pharmacist is designated as the “Secretary” of the committee.
 One representative each from
• Dept. of internal medicine.
• Dept. of surgery.
• Dept. of clinical pharmacology.
• Dept. of microbiology.
• Dept. of nursing.
• Dept. of nutrition.

7. PHARMACYAND THERAPEUTIC COMMITTEE
Medical staff
Chairman (physician)
Co-chairperson
Hospital
Administrator
(Director)
Pharmacist
Secretory staff
Joint secretory

8.  FUNCTIONS OF PHARMACY AND THERAPEUTIC COMMITTEE
1. The PTC develops, complies & rectifies the hospital formulary system sponsored by the medical staff.
The medical staff adapts the formulary to the needs of the individual hospital.
2. The committee promotes rational therapeutic & prevents duplication , waste , confusion.
3. The formulary is subjected to constant review and revision.
4. Committee minimize duplication of the same basic drugs, drug entity/ products.
5. The committee develop written policies / procedures to afford guidance in appraised selection,
procurement, storage , distribution and use of drug.
6. The PTC advises the pharmacy regarding drug distribution and control procedure.
7. It also develops policies regarding drug safety
8. The PTC studies problems related to drug administration , distribution , drug reaction, drug stocking and
drug use .
9. The committee help the development of training programs for professional staff in drug use.
10. The committee recommendation is adopted by the medical staff.

9. HOSPITAL FORMULARY
 Formulary is a list of medicines. Traditionally, a formulary contained a collection of formulas for the
compounding and testing of medication.
 The hospital formulary is a continuously revised compilation of pharmaceuticals which reflects the
current clinical judgment of the medical staff.
 The hospital formulary system is a method whereby the medical staff of a hospital, working through a
pharmacy and therapeutic committee, evaluates, appraises and selects from among numerous available
medicinal agents and dosage form those that are considered most useful in-patient care.

10.  ADVANTAGES OF HOSPITAL FORMULARY
 It provides the practitioner with approved and efficacious medicines to treat disease.
 Hospital formulary reduces the inventory cost of the drugs. It regulates the number of medicines by
improving the procurement and inventory management .
 It improves the quality assurance and easier dispensing.
 It removes the irrational combinations of drugs and also improves adverse reaction management.
 It gives stress on medicine information and focused on patients education efforts.
 DISADVANTAGES OF HOSPITAL FORMULARY
 The hospital formulary system deprives the physician of the right and prerogative to prescribing and
obtained the brand of his choice.
 The system may sometimes permit the pharmacist to act as the sole judge to which the brands of the
drugs to be purchased and dispensed.
 The system may allow buying inferior quality of drugs and it may also not reduce the cost of drug
dispensed to the patient or the third-party payer.

11.  PREPARATION / PROCEDURES FOR HOSPITAL FORMULARY
1. Introductory information
• Acknowledgement
• List of abbreviation
• Intended usage of the formulary manual.
2. Basic information of the drug
• Generic name
• Dosage form
• Strength indications
• Pharmacological action
• Precautions
• Side effects
• Frequency instructions
• Drug interactions

12. 3. Supplementary information on each drug
• Price regulatory category
• Storage guidelines
• Patient counselling information
• Brand names
4. Prescribing and dispensing guidelines
• Principle of prescription writing name and address of the patient.
• Prescribed drug should be written in formulary terminology
• Strength of prescribed medication must be given in accepted metric system
• Correct dispensing guidelines prevention and reporting of ADRs
5. General drug use advice
• Use if IV additives prescribing in special situation
• Poisoning and antidotes

13. 6. Other components
• Formulas for various diagnostic stains
• Diagnostic aids Table of common Lab values
• Index of the drugs included in the formulary metric units indexes
7. The format
• Pharmacist decides the format before commencing work on printing and publishing in the hospital
• He/she has to collect formularies of some leading hospitals as well as their format.
• Copies of finally published formulary may be sent to bodies like directorate general of health services,
Govt. of India, PCI ETC
8. Size
• It is sufficiently small in size so that it could be easily carried by clinicians , nurses etc, in the pocket of
their uniform or lab coats
• The hospital may determine their own size of the formulary
9.Types of format
• Loose leaf or bound printed or mimeographed indexing and assigning categories

14. GUIDING PRINCIPLES WHILE USING HOSPITAL FORMULARY
1. It acts as specialized guide to pharmacist , nursing staff and physicians.
2. The PTC advices & guides the pharmacist regarding the purchase & the procedures of purchases.
3. It guides on selection , procurement and storage.
4. The policies and procedures guide on distribution, safe and rational use drugs.
5. The labelling should follow an adopted format.
6. Generic prescriptions through encouraged physicians should have the freedom to prescribed by brand
names. Nomenclature is left to the physician discretion.
7. When there is no formulary, the pharmacist has to obey a physicians prescription into, he can consult
the physician when the prescribed brand is not available.
8. Substitution is not a respectable term since it has unauthorised dispensing connotation. Such a term
should better be avoided while formulating policies because when formulary is adopted & operated
properly there is no question of substitution.

15.  INFECTION CONTROL COMMITTEE
The infection control committee is an integral component of the patient safety program of the health care
facility , and is responsible for establishing and maintaining infection prevention and control, its
monitoring , surveillance , reporting, research and education.
This committee should include wide representation from all relevant disciplines or departments in the
facility
Infection is injurious contamination of body or parts of body by bacteria, viruses, fungi, protozoa and
rickettsia or by toxin that they produce.
Once the infectious agent enters the host it begins to proliferate and react with Defense mechanism of the
body producing infection symptoms and signs: pain, swelling , redness functional disorder, rise in
temperature etc.

16.  COMPOSITION OF ICC COMMITTEE
 Members of ICC
 Infection control officer- Chairman.
 Infection control nurse – secretory
 HOD’s from
Microbiology
Pathology
Pharmacy
Surgery
Medicine
 Administrative representative from
Sterilizing dept
Dietary dept

17.  ROLE OF ICC / HOW DOES THE INFECTION CONTROL
COMMITTEE PREVENT AND CONTROL INFECTIONS?
The role of the Infection Control Committee is very multi-faceted. It should be involved in
1. Planning
2. Monitoring
3. Evaluating
4. Updating
5. Educating

18. 1. Planning : Successful prevention and control of infection requires careful planning. The ICC is
actively involved with the planning and implementation of new procedures that pose a potential
infection control risk. Its role in planning process is to examine the proposal , identity potential areas
of concern, and recommend a course of action that provides the best method of infection control.
2. Monitoring : The Infection Control Committee also monitors infectious processes within the
healthcare facility. They track nosocomial infections and incidents that have the potential to cause
infection. They review infection control statistics from the facility in an efforts to minimize risk,
identity problem areas , and implement corrective actions.
3. Evaluating : Along with monitoring specific incidents, the ICC also evaluate or review infections
control procedures in all departments.

19. 4. Updating : The constant advancement of medical technology introduces changes at all levels within the
healthcare facility , new bacterial strains complicate and challenge older infection control practices, and
new research often requires re-examination of established procedures.
5. Educating : Finally, as an integral part of its leadership , the committee must take an active role in staff
education. The education process should address at least two specific areas.

20. THANK YOU !