Drug distribution in hospitals can be categorized as inpatient or outpatient services. For inpatients, drugs are distributed via individual prescription orders, complete floor stock systems, or unit dose dispensing. Complete floor stock stores drugs at nursing stations while unit dose prepares individual doses. Outpatient drugs are dispensed from pharmacies or satellite pharmacies based on physician prescriptions. The goal is to ensure patients receive the right medications safely and efficiently.

1. ASSIGNMEMT - I
HOSPITAL PHARMACY
DRUG DISTRIBUTION IN HOSPITAL
DEFINATION :
Drug distribution is defined as the physical transfer of drugs from the storage of the
hospital pharmacy to the patient bed.
Towards development of new and improved drug distribution system, traditional
methods of distributions are now recognised into new system. In hospital, the procedure
of drug distribution may be categorised into two groups:
• Ambulatory/ outpatient services
• Inpatient services
OBJECTIVES:
 To smoothen and continuous supply of medicines.
 Assure that right medicine gets right patients at right time at reasonable cost.
 To provide maximum patient safety by reducing medication errors.
 Reduction of medical wastage abuse.
 Cost control.
Dispensing of drugs to inpatient
IN PATIENT:
In patients are those who get hospitalized for the purpose of treatment of the diseases , surgery
and Rehabitation.
Drug distributions to inpatients falls within four categories are as follows:
• Individual prescription order system.
• Complete floor stock system (charging policy).
• Combination of above.
• Unit dose dispensing method.
1.Individual prescription order system:

2. ASSIGNMEMT - I
HOSPITAL PHARMACY
This system is generally used by the small or private hospital because of the less manpower
requirement and the appeal for individualized service.
Advantage:
• All medication order are directly reviewed by the pharmacist.
• Easily interaction of pharmacist, doctor, nurse and patient in the medication matters.
Disadvantage :
• Possible delay in obtaining the required medication and the increase in cost to the
patient.
• This system cannot be used in big hospitals.
• Difficulty in dispensing of drug in absence of pharmacist.
2. Complete floor stock system ( charging policy):
Under this system, both pharmacy and nursing are responsible for drug distribution to patients.
According to this system, the drugs are stored at the nursing station and administerd by nurse
according to the order of physician.
Drugs which are dispensed in complete floor stock system are categorised as:
1. Charge floor stock drugs
2. Non- charge floor stock drugs
A) charge floor stock drug:
• Charge floor stock drugs are those where patient is charged for every single dose
administered to him.
• Selection of the drugs in various wards is decided by pharmacy and therapeutic
committee. E.g of drugs are antibiotics ,antihypertensive drug, anticoagulant,
antiepileptic, antidepressant.
Method of dispensing charge floor stock drugs:
Envelop method:

3. ASSIGNMEMT - I
HOSPITAL PHARMACY
In this system, pharmacist fills a prelabelled envelops with needed drugs and gives it to nursing
ward. The nurse after receiving the envelops, writes the name and room number of patients on
the envelop and put it into her out basket and sent to pharmacy for costing and forward to
billing section of accounting office.
B) non-charge floor stock drugs:
Drugs are dispensed to all patients on floor on non- charged basis.
Method of dispensing non- charge floor stock drugs:
 Drug basket method: this method is adapted where nurses verify the availability of
medicines in all rooms as well as in the refrigerator and accordingly prepare a
master list of pharmacy .nurses fill demand form for delivery of drug at the floor.
When there is empty container , the nurses take it in the drug basket . Ones the
procedure is completed , the drug basket containing empty container and demand from
for floor stock supplies sent to pharmacy.
 Mobile dispensary unit: it consists of specially constructed stainless- steel trolley which
is mounted on bottom tiers . Accordingly to requirement , patients get the medicine via
this unit.
Advantage of complete floor stock system:
• Ready availability of the required drugs.
• Minimize the return of drug to pharmacy.
• Reduction in the number of pharmacy personnel required.
Disadvantage of complete floor stock system:
• Medications errors may increase.
• Increased drug inventory on the porches.
• Increased hazards associated with drug deteriotation.
• Lack of proper storage facilities on the ward may require capital outlay to provide
them.
C) combination of individual prescription order system and complete floor
stock system.

4. ASSIGNMEMT - I
HOSPITAL PHARMACY
It is used in those hospitals , where patients have to pay for their hospitalization. In this system,
their primary mean is to dispense the drugs according to individual prescription order system.
Today most of the hospital uses this system. Some hospital modifies it to include the use of
unit dose medications.
D)unit dose dispensing:
 Unit dose medications are those which are ordered ,packaged and administrated
in single or multiple units containing predetermined amount of drug and doses.
Advantages of unit dose system
• Patients receive better health ,service and have to charge for those drug and doses
which are administered to them.
• Nurses get more time for patient care because all doses of medication are prepared
by the pharmacist.
• To reduce the medication errors pharmacist allow checking a copy of the
physician original order.

5. ASSIGNMEMT - I
HOSPITAL PHARMACY
• Encourages more proficient utilizations of professional and non – professional
personnel.
• Reduces revenue losses.
• Preserves space in nurshing units by removing bulky floor stock.
Dispensing procedure in unit dose system:
This system could be followed by two ways: centralized unit dose distribution system [cudds]
and de- centeralized unit dose distribution system[dcudds]
A)centralized unit dose system:
In this system, all the drugs are stored in central area of pharmacy and the drugs are dispensed
to all inpatients in unit doses. To operate the delivery system effectively, various medicatio n
carts are used to transport unit doses to the paitents and to forward a copy of the physician
original medications order to the pharmacy for the direct explanation and filling.
B) decentralized unit dose system:
Unlike the centeralized system , decenteralized unit dose system function through small
satellite pharmacies which are located on each floor of the hospital. In this system , the core
pharmacy becomes a procurement , manufacturing ,storage and packaging center which
provides all medicine to all the satelites pharmacies. To delivery process of this system is
accompolised by the use of medications carts. Such type of system can be used for a hospital
with separate buildings.
Dispensing of drug to outpatient/ ambulatory patients
 It is also called ambulatory services and refers to those patients who are not
occupying beds in hospitals or in clinics , health centers and other places when
they come for consultation and diagnosis, treatment.

6. ASSIGNMEMT - I
HOSPITAL PHARMACY
Categories of ambulatory services:
1. Emergency outpatients: for emergency outpatient, 24 hours services are given
who requires immediate care for the survival.
2. Referred outpatient: these patients are reffered to the hospital for a specific
purpose due to lack of facilities available with the private clinic practioners or
patient needs extra care.
3. Special outpatient : after compilation of general check up the paitents are asked
to go for accurate diagnosis by the cinical , pathological or radiological
examination. After receiving the test report of examination medicine is given to
him.
4. General outpatient: these patients come for the general checkup and medicines
are prescribed to him. They may either undertake minor surgery ,superficial
surgery or dressing at hospital.
Outpatient decides the image of the hospital as per the services received by them. Thus, it is
essential to look into the following aspects while designing the hospital care service.

7. ASSIGNMEMT - I
HOSPITAL PHARMACY
• Separate waiting room with appropriate seating facilities.
• Sufficient number of service windows and separate facility for women.
• Provision for adequate light and ventilation.
Social aspect must be considered to carry out dispensing services.
Routine dispensing of out- patient:
• Patients take written prescription by the the physician, which is given to the
pharmacist where it is dispensed.
• Pharmacist guarantees that patient gets right medication.
• Pharmacist gives instructions to patient about dispensed medicine.
• Labelling of medicine.
• Manufacturing of payments by pharmacist.
• Finally, payment by medicine.

8. ASSIGNMEMT - I
HOSPITAL PHARMACY
Out- patient activity chart:
SATELLITE PHARMACY SERVICES:
• Multi-speciality hospitals are generally design for the diagnosis and treatment of
number of diseases so the concept of satellite pharmacy is adopted in such hospital
which have multi-stored building in a single premises.
• Every day in morning as well as evening it become very difficult to cope up with
distribution of drug to all the wards. So such cases hospital runs satellite pharmacy
in the form of mini pharmacies, which is situated on each floor.
• According to the hospital policies few days stock of medicine is stored in hospital.
While main pharmacy supplies all medicine to satellites pharmacies.
Advantages:
 Efficiently drugs can be distributed.
 Time of drug distribution could be reduced.
 Errors in drug distributions could be stop.

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HOSPITAL PHARMACY
Disadvantage:
 Effect on the financial statement of hospital.
 Additional manpower is required.
References :
 Https://www.researchgate.net/publication/11043023_drug_distribution_system_in_ho
spitals
 Https://www.ashp.org/-/media/assets/policy-guidelines/docs/technical-assistance-
bulletins/technical-assistance-bulletins-hospital-drug-distribution-control.ashx
 Dr.sachin v.tembhurne,dr.ashwini r . Madgulkar, a text book of pharmacy practice,first
edition,published by nirali prakashan,abhyudha pragati,1312, shivaji nagar, page no:
51-60
NAME SIGNATURE OF THE STUDENT: PRECEPTOR SIGNATURE:
(K.GURU PUJITHA LAKSHMI) (B.RAJESHEKAR )