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HOSPITAL PHARMACY
By: Hemlata R. More
(Assistant professor )
Quality Assurance
CONTENT
Definition and Scope
Organizational Structure
Professional Responsibility and Qualification and experience of Hospital Pharmacist
Job Specification and Work load Requirement on Hospital Pharmacist
Good Pharmacy Practice(GPP)
Hospital Pharmacy Standard ( FIP AND ASHP)
Introduction to NAQS guidelines and NABH accreditation and Role of Pharmacist
 Definition
Hospital Pharmacy is the organization or department of the hospital to manage the procurement ,
storage, preservation , sterilization , compounding , preparation, dispensing or distribution of
medicine in the hospital.
Scope of Hospital Pharmacy
The scope of hospital pharmacy includes more traditional roles such as compounding and
dispensing of medication, and it also includes more modern services related to health care ,
including clinical services, reviewing medication for safety and efficacy , and providing drug
information
 Organization Structure of Hospital Pharmacy
 PROFESSIONAL RESPONSIBILITY OF HOSPITAL
PHARMACIST
Two types of responsibility are there
In-patient
Responsibility
Out-patient
Responsibility
Central
dispensing area
Patient care area
Direct
responsibility
Central
dispensing
area
Patient care
area
General
responsibility
 QUALIFICATION AND EXPERIENCE REQUIREMNT OF
HOSPITAL PHARMACIST
◦ Minimum academic requirement for hospital pharmacist include a two year D. Pharm diploma course and pre-
registration training programme.
◦ Hospital pharmacist are responsible for the dispensing and procurement of medical products and supplies used in
the hospital.
◦ Hospital pharmacist can also work in health centres, care , facilities, clinics, nursing homes and GP surgeries.
◦ Tasks and responsibility , apart from the core functions of dispensing prescription medicines and supplies, include
working with other medical personnel to provide treatment and advice to patients, recording patients histories
relating to medicinal use, and ensuring the safe and secure storage of all medicines and hospital supplies.
◦ Pharmacist also have to prepare medicines and conduct quality checks in instances when individual drug
components need to be mixed together before treating patients.
◦ They plan and monitor clinical trials and stay updated on pharmacy regulations , treatments and developments in
research and design.
 JOB SPECIFICATION OF HOSPITAL
PHARMACIST
1. Compound and dispense medication as prescribed by doctors and dentist by calculating ,
weighing , measuring and mixing ingredient.
2. Review prescription from doctors to ensure accuracy, to ascertain the needed ingredient and to
evaluate their suitability for the patient.
3. Provide information and advice about drugs their side effect, correct dosage and proper storage.
4. Keep record such as pharmacy files, patients profiles, change system files, inventories , register
of poisons , narcotics or controlled drugs.
5. Plan implement or maintain procedures for mixing, packaging, or labelling pharmaceuticals
according to policy and legal requirement, to ensure quality security and proper disposal.
6. Assess the identity , strength or purity of medications.
7.Work with other health care professional to plan , monitor , review or evaluate the quality or
effectiveness of drugs.
8. Order and purchase pharmaceutical supplies, medical supplies or drugs , maintain stock and
storing and handling it properly.
9. Analyse prescribing trends to monitor patients compliance and to prevent excessive usage or
harmful interactions.
10. Advice customers on the selection of medication brands, medical equipment or health care
supplies.
 GOOD PHARMACY PRACTICE (GPP)
Good pharmacy practice (GPP) defines pharmacist provide quality pharmacy services to every patients. It’s the
practice of pharmacy that responds to the needs of the people , who use the pharmacists services to provide optimal ,
evidence based care.
GOOD PHARMACY PRACTICE (GPP) ORGANIZES FOLLOWING MAJOR ROLES FOR PHARMACIST
1. Prepare , obtain, store, secure, distribute, administer, dispense and dispose of medical products.
2. Provide effective medication therapy and management.
3. Maintain and improve professional performance.
4. Contribute to improve effectiveness of health care system and public health.
MISSION OF GOOF PHARMACY PRACTICE
The mission of good pharmacy practice is to provide medication and health care products and services to people and
society to achieved good outcomes from treatment.
REQUIREMENT OF GOOD PHARMACY PRACTICES
Following are some of the important requirements of good pharmacy practice
1. A pharmacist first priority must be the welfare of the patient.
2. A pharmacy service must supply medication and health care products of assure quality and must monitor the
effects of their use.
3. A pharmacy service must contribute in the promotion of rational and economical prescription and appropriate use
of medicines.
4. Each element of pharmacy services must be relevant to the patient, is clearly defined and is effectively
communicated to all those involved.
ROLE OF PHARMACIST IN SATISFYING GOOD PHARMACY PRACTICE REQUIREMENT
1. He must be established and maintain relationship particularly with physician as a therapeutic collaborative
partnership which involves mutual trust and confidence in all matters relating to pharmacotherapeutics.
2. All the colleagues pharmacist must work together to improve pharmacy services.
3. In hospitals, pharmacy manager should accept a share of responsibility for the selection, evaluation and
improvement of quality of drugs use.
4. Pharmacist must update the information about therapeutic and medicines in use.
5. Pharmacist must ensure the integrity of supply chain and quality of medicines.
6. Pharmacist should accept personnel responsibility for maintain and accessing their own competence throughout
their professional working lives.
7. Pharmacist must prepare , store, secure, distributed and dispose of medical products.
8. Pharmacist must prepare extemporaneous medicines and medical products.
9. Pharmacist must provide effective medication therapy management to access patient health status and needs.
10. Pharmacist must provide information about medicines and health related issues.
11. Pharmacist must monitor patient progress and outcomes.
12. Pharmacist must contribute to improve effectiveness of health acre system and public health.
13. Pharmacist must engaged in preventive care activities and services.
14. Pharmacist must support national policy that promotes improve health outcomes.
15. Pharmacist must comply with national professional obligation guidelines and legislation.
 HOSPITAL PHARMACY STANDARDS
 FIP BASEL STATEMENTS
 FIP is the global federation of national associations of pharmacist and pharmaceutical scientists. It is active across
all areas of pharmacy practice , pharmaceutical science and education , primarily through the work of member
associations and dedicated volunteers.
It initiates and implements numerous projects and program to improve the responsible use of medicines.
Hospital pharmacist from around the world met in Basel , Switzerland in 2008 to discuss the future of hospital
pharmacy hosted by FIP ( International Pharmaceutical Federation ).
In 2014 they again gathered in Bangkok and launched an updated version of Basel statement with 65 statements.
This statements cover following six main areas of hospital pharmacy ( FIP Basel Statement ).
Continue
This statements cover following six main areas of hospital pharmacy ( FIP Basel Statement ).
1. Procurement
2. Influences on prescribing
3. Preparation and delivery of medicines
4. Medication administration
5. Monitoring medication
6. Human resource and training
 ASHP ( AMERICAN SOCIETY OF HEALTH – SYSTEM PHARMACISTS )
American society of health – system pharmacists have been formerly called as American Society Hospital
Pharmacist.
It is a professional organization that represents pharmacist who serves as patient care providers in hospital and other
health care settings.
It is a professional organization that demonstrates the description of minimum standards competencies of
pharmacist in health care settings.
Following are the minimum standards required to the pharmacist demonstrated by ASHP,
1. Proper knowledge and understanding of the health care institution and pharmacy department.
2. A complete knowledge and understanding of the duties and responsibilities of his position.
3. A work knowledge of the pharmaceutical medical terms, abbreviations and symbols regularly used in prescribing
and dispensing.
4. A working knowledge of the general chemical and physical properties of all drugs handled in manufacturing and
packaging operation in the pharmacy department.
5. A working knowledge of commonly used weight and volume equivalent and an ability to carry out the arithmetic
calculations essential for the usual dosage determination and solution preparation.
6. The ability to perform the important functions relating to drug purchasing and inventory control.
7. A working knowledge of drugs dosage, routes of administration and dosage form.
8. A working of the procedures and operations associated with the manufacturing, packaging , and labelling of drug
products.
9. A working knowledge of the procedures and techniques associated with the sterile manufacturing and parenteral
admixtures preparations.
10. The ability to perform the functions relating to a unit dose drug dispensing system.
11. The ability to perform the manipulative and record keeping functions relating to the dispensing of prescription.
 NAQS (NATIONAL QUALITY ASSURANCE STANDARDS)
• National Quality Assurance Standards have been developed keeping in the specific requirements for public health
facilities as well as global beast practices.
• NAQS are currently available for district Hospitals, CHCs, PHCs and Urban PHCs.
• National Quality Assurance programme under National Health Mission (NHM) has been launched with objective
assuring Quality Services at public health facilities, and also improve it further for enhance users experience at the
facilities.
• Under National Quality Assurance Program, two types of certifications are envisaged state and national level
certification.
STATE CERTIFICATION NATIONAL CERTIFICATION
• Responsibility of state / SQAU
 Validity one year
 Facility shall apply for National Certification within one year of attaining State Certification
• Responsibility of CQSC/ NHSRC
 validity three years
 After national certification , facility will undergo surveillance audit by SQAC for next 2 years. Financial incentives
as per level and scope of certification.
During the course of implementation states, health facilities and services providers have felt a need of having
guidelines for the certification of the facilities under NQAP; hence this supporting document has been created
OBJECTIVES
1. To build and institutional framework mechanism for conducting Quality Assessments in health facilities.
2. To maintain a repository of NQAS Certification.
3. To provide holistic view to QAAssessor on methodology , scope of work , technical and managerial aspects for
conducting QA assessments.
4. Surveillance assessment of health facilities in second and third year after their National Level Certification.
 SCOPE: The scope of these Guidelines is limited to:
• Assessment of primary and secondary care public health facilities i.e., District Hospitals, subdivisional Hospital ,
Community Health Centres , Primary Health Centres and Urban Primary Health Centres for NQAS
Certification.
• Surveillance assessment of public health facilities certified at national level.
 NABH ACCREDITATION
o NABH : National Accreditation Board for Hospital and Healthcare Providers (NABH) is a constituents board of
Quality Council of India (QCI), set up to establish and operate accreditation programme of health care organizations.
o ACCREDITATION : A public recognition of the achievement of accreditation standards by a healthcare
organizations , demonstrated through an independent external peer assessment of that organisation’s level of
performance in relation to the standard.
 BENEFITS OF ACCREDITATION
I. Accreditation benefits all stake Holders. Patients are the biggest beneficiaries . Accreditation results in high quality
of care and patient safety.
II. The patients gets services by credentials medical staff
III. Accreditation to the hospital continues improvement.
IV. Its also provide opportunity to healthcare unit to benchmark with the best.
V. Accreditation provides an objective system of empanelment by insurance and other third parties.
 TEN STEPS IN ACCREDITATION
1. Obtain copy of NABH standard.
2. Carry out self assessment on status of compliance with NABH standard.
3. Identify gap areas and prepared action plan to bridge the gaps.
4. Ensure that NABH standards are implemented and integrated with hospital functioning.
5. Obtain copy and submit application form for assessment.
6. Pay the accreditation fee.
7. Received from NABH the assessment programme including dates and names of assessors.
8. Facilitate the assessment.
9. Received recommendation on accreditation.
10. Maintain quality improvement programme based on continuous monitoring of patients care services.
 ROLE OF NABH IN PREPARING ORGANIZATIONS FOR ACCREDITATION
NABH provides information on documents and procedure.
NABH also organizes awareness programmes in general as well as on request individual organization.
It also guide the applicant organization on different requirement at various stages of accreditation .
The convenience of applicant organisations , NABET , which is another constituent board of QCI has a program for
a registering qualified consultants/consulting organizations.
These registered individuals / organizations are involved in providing consultancy to various healthcare
organizations for NABH standards implementations within their organizations
• NABH standards for hospitals : Access , Assessment and Continuity of Healthcare.
THANK YOU !

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HOSPITAL PHARMACY .pptx

  • 1. HOSPITAL PHARMACY By: Hemlata R. More (Assistant professor ) Quality Assurance
  • 2. CONTENT Definition and Scope Organizational Structure Professional Responsibility and Qualification and experience of Hospital Pharmacist Job Specification and Work load Requirement on Hospital Pharmacist Good Pharmacy Practice(GPP) Hospital Pharmacy Standard ( FIP AND ASHP) Introduction to NAQS guidelines and NABH accreditation and Role of Pharmacist
  • 3.  Definition Hospital Pharmacy is the organization or department of the hospital to manage the procurement , storage, preservation , sterilization , compounding , preparation, dispensing or distribution of medicine in the hospital. Scope of Hospital Pharmacy The scope of hospital pharmacy includes more traditional roles such as compounding and dispensing of medication, and it also includes more modern services related to health care , including clinical services, reviewing medication for safety and efficacy , and providing drug information
  • 4.  Organization Structure of Hospital Pharmacy
  • 5.  PROFESSIONAL RESPONSIBILITY OF HOSPITAL PHARMACIST Two types of responsibility are there In-patient Responsibility Out-patient Responsibility Central dispensing area Patient care area Direct responsibility Central dispensing area Patient care area General responsibility
  • 6.  QUALIFICATION AND EXPERIENCE REQUIREMNT OF HOSPITAL PHARMACIST
  • 7. ◦ Minimum academic requirement for hospital pharmacist include a two year D. Pharm diploma course and pre- registration training programme. ◦ Hospital pharmacist are responsible for the dispensing and procurement of medical products and supplies used in the hospital. ◦ Hospital pharmacist can also work in health centres, care , facilities, clinics, nursing homes and GP surgeries. ◦ Tasks and responsibility , apart from the core functions of dispensing prescription medicines and supplies, include working with other medical personnel to provide treatment and advice to patients, recording patients histories relating to medicinal use, and ensuring the safe and secure storage of all medicines and hospital supplies. ◦ Pharmacist also have to prepare medicines and conduct quality checks in instances when individual drug components need to be mixed together before treating patients. ◦ They plan and monitor clinical trials and stay updated on pharmacy regulations , treatments and developments in research and design.
  • 8.  JOB SPECIFICATION OF HOSPITAL PHARMACIST 1. Compound and dispense medication as prescribed by doctors and dentist by calculating , weighing , measuring and mixing ingredient. 2. Review prescription from doctors to ensure accuracy, to ascertain the needed ingredient and to evaluate their suitability for the patient. 3. Provide information and advice about drugs their side effect, correct dosage and proper storage. 4. Keep record such as pharmacy files, patients profiles, change system files, inventories , register of poisons , narcotics or controlled drugs. 5. Plan implement or maintain procedures for mixing, packaging, or labelling pharmaceuticals according to policy and legal requirement, to ensure quality security and proper disposal. 6. Assess the identity , strength or purity of medications.
  • 9. 7.Work with other health care professional to plan , monitor , review or evaluate the quality or effectiveness of drugs. 8. Order and purchase pharmaceutical supplies, medical supplies or drugs , maintain stock and storing and handling it properly. 9. Analyse prescribing trends to monitor patients compliance and to prevent excessive usage or harmful interactions. 10. Advice customers on the selection of medication brands, medical equipment or health care supplies.
  • 10.  GOOD PHARMACY PRACTICE (GPP) Good pharmacy practice (GPP) defines pharmacist provide quality pharmacy services to every patients. It’s the practice of pharmacy that responds to the needs of the people , who use the pharmacists services to provide optimal , evidence based care. GOOD PHARMACY PRACTICE (GPP) ORGANIZES FOLLOWING MAJOR ROLES FOR PHARMACIST 1. Prepare , obtain, store, secure, distribute, administer, dispense and dispose of medical products. 2. Provide effective medication therapy and management. 3. Maintain and improve professional performance. 4. Contribute to improve effectiveness of health care system and public health.
  • 11. MISSION OF GOOF PHARMACY PRACTICE The mission of good pharmacy practice is to provide medication and health care products and services to people and society to achieved good outcomes from treatment. REQUIREMENT OF GOOD PHARMACY PRACTICES Following are some of the important requirements of good pharmacy practice 1. A pharmacist first priority must be the welfare of the patient. 2. A pharmacy service must supply medication and health care products of assure quality and must monitor the effects of their use. 3. A pharmacy service must contribute in the promotion of rational and economical prescription and appropriate use of medicines. 4. Each element of pharmacy services must be relevant to the patient, is clearly defined and is effectively communicated to all those involved.
  • 12. ROLE OF PHARMACIST IN SATISFYING GOOD PHARMACY PRACTICE REQUIREMENT 1. He must be established and maintain relationship particularly with physician as a therapeutic collaborative partnership which involves mutual trust and confidence in all matters relating to pharmacotherapeutics. 2. All the colleagues pharmacist must work together to improve pharmacy services. 3. In hospitals, pharmacy manager should accept a share of responsibility for the selection, evaluation and improvement of quality of drugs use. 4. Pharmacist must update the information about therapeutic and medicines in use. 5. Pharmacist must ensure the integrity of supply chain and quality of medicines. 6. Pharmacist should accept personnel responsibility for maintain and accessing their own competence throughout their professional working lives. 7. Pharmacist must prepare , store, secure, distributed and dispose of medical products. 8. Pharmacist must prepare extemporaneous medicines and medical products.
  • 13. 9. Pharmacist must provide effective medication therapy management to access patient health status and needs. 10. Pharmacist must provide information about medicines and health related issues. 11. Pharmacist must monitor patient progress and outcomes. 12. Pharmacist must contribute to improve effectiveness of health acre system and public health. 13. Pharmacist must engaged in preventive care activities and services. 14. Pharmacist must support national policy that promotes improve health outcomes. 15. Pharmacist must comply with national professional obligation guidelines and legislation.
  • 14.  HOSPITAL PHARMACY STANDARDS  FIP BASEL STATEMENTS  FIP is the global federation of national associations of pharmacist and pharmaceutical scientists. It is active across all areas of pharmacy practice , pharmaceutical science and education , primarily through the work of member associations and dedicated volunteers. It initiates and implements numerous projects and program to improve the responsible use of medicines. Hospital pharmacist from around the world met in Basel , Switzerland in 2008 to discuss the future of hospital pharmacy hosted by FIP ( International Pharmaceutical Federation ). In 2014 they again gathered in Bangkok and launched an updated version of Basel statement with 65 statements. This statements cover following six main areas of hospital pharmacy ( FIP Basel Statement ). Continue
  • 15. This statements cover following six main areas of hospital pharmacy ( FIP Basel Statement ). 1. Procurement 2. Influences on prescribing 3. Preparation and delivery of medicines 4. Medication administration 5. Monitoring medication 6. Human resource and training
  • 16.  ASHP ( AMERICAN SOCIETY OF HEALTH – SYSTEM PHARMACISTS ) American society of health – system pharmacists have been formerly called as American Society Hospital Pharmacist. It is a professional organization that represents pharmacist who serves as patient care providers in hospital and other health care settings. It is a professional organization that demonstrates the description of minimum standards competencies of pharmacist in health care settings. Following are the minimum standards required to the pharmacist demonstrated by ASHP, 1. Proper knowledge and understanding of the health care institution and pharmacy department. 2. A complete knowledge and understanding of the duties and responsibilities of his position. 3. A work knowledge of the pharmaceutical medical terms, abbreviations and symbols regularly used in prescribing and dispensing.
  • 17. 4. A working knowledge of the general chemical and physical properties of all drugs handled in manufacturing and packaging operation in the pharmacy department. 5. A working knowledge of commonly used weight and volume equivalent and an ability to carry out the arithmetic calculations essential for the usual dosage determination and solution preparation. 6. The ability to perform the important functions relating to drug purchasing and inventory control. 7. A working knowledge of drugs dosage, routes of administration and dosage form. 8. A working of the procedures and operations associated with the manufacturing, packaging , and labelling of drug products. 9. A working knowledge of the procedures and techniques associated with the sterile manufacturing and parenteral admixtures preparations. 10. The ability to perform the functions relating to a unit dose drug dispensing system. 11. The ability to perform the manipulative and record keeping functions relating to the dispensing of prescription.
  • 18.  NAQS (NATIONAL QUALITY ASSURANCE STANDARDS) • National Quality Assurance Standards have been developed keeping in the specific requirements for public health facilities as well as global beast practices. • NAQS are currently available for district Hospitals, CHCs, PHCs and Urban PHCs. • National Quality Assurance programme under National Health Mission (NHM) has been launched with objective assuring Quality Services at public health facilities, and also improve it further for enhance users experience at the facilities. • Under National Quality Assurance Program, two types of certifications are envisaged state and national level certification.
  • 19. STATE CERTIFICATION NATIONAL CERTIFICATION • Responsibility of state / SQAU  Validity one year  Facility shall apply for National Certification within one year of attaining State Certification • Responsibility of CQSC/ NHSRC  validity three years  After national certification , facility will undergo surveillance audit by SQAC for next 2 years. Financial incentives as per level and scope of certification. During the course of implementation states, health facilities and services providers have felt a need of having guidelines for the certification of the facilities under NQAP; hence this supporting document has been created
  • 20. OBJECTIVES 1. To build and institutional framework mechanism for conducting Quality Assessments in health facilities. 2. To maintain a repository of NQAS Certification. 3. To provide holistic view to QAAssessor on methodology , scope of work , technical and managerial aspects for conducting QA assessments. 4. Surveillance assessment of health facilities in second and third year after their National Level Certification.  SCOPE: The scope of these Guidelines is limited to: • Assessment of primary and secondary care public health facilities i.e., District Hospitals, subdivisional Hospital , Community Health Centres , Primary Health Centres and Urban Primary Health Centres for NQAS Certification. • Surveillance assessment of public health facilities certified at national level.
  • 21.  NABH ACCREDITATION o NABH : National Accreditation Board for Hospital and Healthcare Providers (NABH) is a constituents board of Quality Council of India (QCI), set up to establish and operate accreditation programme of health care organizations. o ACCREDITATION : A public recognition of the achievement of accreditation standards by a healthcare organizations , demonstrated through an independent external peer assessment of that organisation’s level of performance in relation to the standard.  BENEFITS OF ACCREDITATION I. Accreditation benefits all stake Holders. Patients are the biggest beneficiaries . Accreditation results in high quality of care and patient safety. II. The patients gets services by credentials medical staff III. Accreditation to the hospital continues improvement. IV. Its also provide opportunity to healthcare unit to benchmark with the best. V. Accreditation provides an objective system of empanelment by insurance and other third parties.
  • 22.  TEN STEPS IN ACCREDITATION 1. Obtain copy of NABH standard. 2. Carry out self assessment on status of compliance with NABH standard. 3. Identify gap areas and prepared action plan to bridge the gaps. 4. Ensure that NABH standards are implemented and integrated with hospital functioning. 5. Obtain copy and submit application form for assessment. 6. Pay the accreditation fee. 7. Received from NABH the assessment programme including dates and names of assessors. 8. Facilitate the assessment. 9. Received recommendation on accreditation. 10. Maintain quality improvement programme based on continuous monitoring of patients care services.
  • 23.  ROLE OF NABH IN PREPARING ORGANIZATIONS FOR ACCREDITATION NABH provides information on documents and procedure. NABH also organizes awareness programmes in general as well as on request individual organization. It also guide the applicant organization on different requirement at various stages of accreditation . The convenience of applicant organisations , NABET , which is another constituent board of QCI has a program for a registering qualified consultants/consulting organizations. These registered individuals / organizations are involved in providing consultancy to various healthcare organizations for NABH standards implementations within their organizations • NABH standards for hospitals : Access , Assessment and Continuity of Healthcare.