Drug distribution system in hospital

2. Drug distribution is defined as, “Physical transfer of
drugs from storage area in the hospital to the patient’s
bedside”.
This involves two types of drug distribution. They
are:
 In-patient distribution
 Out-patient distribution

3. OUT-PATIENT
SERVICES
IN- PATIENT
SERVICES

4.  The drug distribution to the in patient
department can be carried out from the out patient
dispensing area.
 The pharmacists involved in dispensing the drugs
for out patient can dispense drugs for in patients too.
 The pharmacist employed for drug distribution to
the in patient wards should be well skilled and
qualified staff.

5.  Out patient refers to the patients not occupying beds
in hospital or in clinics, health centers and other
places where out patients usually go for health care.
 No medicaments should be issued without the
prescription.
 After the issue has been made the quantities supplied
must be recorded.
 In short form the out patient department was called as
OPD.

6. There are five different systems for drug distribution in
hospitals:
 Individual prescription order system
 Complete floor stock system
 Combination of individual prescription and floor
stock System
 Unit dose system
 Non-floor stock system

7.  It is a type of prescription system where the
physician writes the prescription for individual
patient who obtains the drug prescribed from any
medical store or hospital dispensary by paying own
charges.
 This system is generally used by the small and/or
private hospitals because of the reduced man power
requirements and desirability for individualized
service.

8. ADVANTAGES:
All medication orders are directly reviewed by
pharmacist.
It provides closer liaison among pharmacist, physician
nurse and the patient
It provides closer control of inventory
DISADVANTAGES:
 Wrong errors, illegible writings of the physicians.
 Physician may write high economic drugs in the
prescription or cost effective drugs.

9. Under this system ,the drugs are given to the
Patient through the nursing station and the
pharmacy supplies from the drug store of a
hospital.

10. ADVANTAGES:
 The drugs are readily available for administration
 Minimum return of drugs
 Reduced in-patient prescription orders
 Reduction in number of pharmacy personnel required
DISADVANTAGES:
 Increase in chance of medication errors
 Increase in drug inventory
 Increase chances of drug deterioration due to lack
of proper storage facilities and due to unnoticed drug
degradation
 Increased workload on nurses

11. NON-CHARGE
FLOOR STOCK
DRUGS
FLOOR STOCK
DRUGS
CHARGE FLOOR
STOCK DRUGS

12.  In this method medicines which are stocked in the
nursing stations all the times & charged to the patients
account after administered to them.
 The patient is charged for every single dose
administered to him.
 Once the floor-stock list is prepared it is the
responsibility of the hospital pharmacist to make the
drugs available.

13.  These system includes the medicaments placed in the
nursing station that are used by all the patients on the
floor.
 There shall be no direct charge from the patients
account.
This is divided into two methods. They are:
1. Drug basket method
2. Mobile dispensary unit

14. DRUG BASKET METHOD:
 Nurses fills a requisition form for the delivery of drugs
at their floor.
 When there is an empty container, the nurses place it
in the drug basket.
 Once the basket is completed, deliver of drugs is
done via messenger services.

15. MOBILE DISPENSARY UNIT:
 It is specially made up of stainless steel
 60 inches height
 48 inches wide & 25 inches deep
 It is mounted on bottom tyres.

16. Charged floor-stock
I. The charges are made
patients account after
they been administered.
II. Every dose of the drug administered
to the patient are charged.
III. Only the dose of the drug
charged
which are expensive & rarely used.
IV. Floor-stock list is prepared which is
sent to make the drugs available at
all the nursing stations.
Non charged floor-stock
I. The drugs are not made in the
account directly even after the drug
have been administered.
II. Charges are made indirectly to the
patient.
III. The cost of the drugs are not as
high as the drugs ued are tablets &
capsules.
IV. A pre-determined listis
prescribed by the nursing
station.

17. This system is followed in the government and
also in private hospital who run on the basis of
no profit and no loss.
Individual prescription or medication system is
followed as a major means.
Requirement of drugs or surgical items are given
to the patient who purchase and deposit these
items in hospital wards or rooms under
supervision of registered nurse .

18.  Those medications ordered, stored, packed, handed,
administrated and charged in multiples of single does
units containing a predetermined amount of a drug or
supply sufficient for one regular dose.
 A single unit package is one which
contain one complete pharmaceutical
dosage form.
 EX- 1 tablet or 1 capsule.

19. ADVANTAGES
Better financial control
It prevents loss of partially used medications.
Does not require storage facilities at nursing stations.
DISADVANTAGES
Irregular dosage
skill physician is required for administration of drug.
Regular monitoring is required.

20. DUDDCUDD

21. All in-patient drugs are dispensed in unit doses and all
the drugs are stored in central area of the pharmacy
and dispensed at the time the dose is to be given to
the patient
To operate the system, delivery devices such as
medication carts or pneumatic tubes are required

22. This operates through small satellite pharmacies located on each
floor of the hospital.
PROCEDURE:
 Patient profile card containing full date ,disease ,diagnosis
is prepared.
 Prescription are sent directly to the pharmacist witch are then
entered in the patient profile card.
 Pharmacist checks medication order.
 Patient profile card and prescription order is filled by
pharmacy technicians.
 The nurses administer the drugs and make the entry in their records.

23. These drugs should kept under lock and key
A separate register should be maintained to register
them
PROCEDURE:
Medical superintendent is overall responsible for
handling of controlled drugs.
Chief pharmacist procures, stores and dispense the
drugs

24. Prescription of narcotic drugs under Narcotics and
psychotropic substances act 1985 must include
following information
a) Patients full name
b)Address
c) Date
d)Name and strength of drug
e) Quantity of drug
f) Signature of prescriber
g)Dose and route of administration

25. If the required drug is not in the stock the complete
controlled drug prescription must be written on hospital
prescription blank form by registered medical practitioner
and signed
Delivery of narcotic drugs from pharmacy to wards
should be carried out by reliable person
After dispensing, nurses resume responsibility for
administration, control and auditing of the inventory
If patient refuse or doctor cancels any dose , nurse should
destroy the drug in to sink and record “Refused by
patient” or “Cancelled by doctor”

26. THANKS