DOCTOR OF PHARMACY IV YEAR HOSPITAL PHARMACY 14T00408 CHAPTER-2 Hospital pharmacy-Organization and management Dr.V.Chanukya pharm bStudent Learning Outcomes Upon completion of the chapter, the student will be able to: «Know various drug distribution methods *Know the professional practice management skills in hospital pharmacies provide unbiased drug information to the doctors *Know the manufacturing practices of various formulations in hospital set up appreciate the practice based research methods «Appreciate the stores management and inventory control.Contents ¢ Hospital pharmacy-Organisation and management I. Organizational structure-Staff, Infrastructure & work load statistics Il. Management of materials and finance III. Roles & responsibilities of hospital pharmacistDefinition: Hospital pharmacy The practice of pharmacy within the hospital under the supervision of a professional pharmacist is known as hospital pharmacy. The department or service in a hospital which is under the direction of a professionally competent, legally qualified pharmacist, and carry out functions like — Supply of all medications to the nursing units and other services, where special prescriptions are filled for patients in the hospital, — Dispensing of prescriptions for ambulatory patients and out-patients — Manufacture of pharmaceuticals in bulk — Dispensing of narcotic and other controlled prescribed drugs, — Extemporaneous injectable preparations should be prepared and sterilized — Stocking and dispensing of professional suppliesOrganizational structure of pharmacy department With the selection and categorizing of the employees, it now becomes essential to develop a chart showing the flow of administrative authority. Obviously, in the very small departments, this is usually generally understood and no problems arise. However, in the large units with assistant chief pharmacists, supervisors, and lay personnel, authority must be delegated by the chief pharmacist. Clearly this can and should be tailored to meet the specific requirements of the department and hospital. Once prepared and approved, it should be conspicuously posted for each of the departmental employees to read and adhere to.Medium Hospital pharmacy Departmental organization sampleIn large hospitals, departments of pharmacy have a more complex organization. Note for example, tertiary care Hospital's Department of Pharmacy organizational chart. It should seem obvious to the student that each of the subdivisions of the department are assigned specific responsibilities. The following are some of the responsibilities of each division.Tertiary care Hospital pharmacy Departmental organization sample PHARMMCEUTICAL qeoaentoemvices S241 RESEARCH DIVISIONS ISION Dea MRORMATION sit emvices + PARCMSE NO PrARMacisT Pava mec PATIENT PROAEE ND | CENTRAL SUPPLY mowers ermavenous peucne RADIOPHARMACEUTICAL DIVISION ADMIXTURE DIVISION DIVISIONS ‘DRUG INFORMATION SERVICE:1. Administrative Services Division * Plan and coordinate departmental activities. * Develop policies. * Schedule personnel and provide supervision. * Coordinate administrative needs of the Pharmacy and Therapeutics Committee. + Supervise departmental office staff. 2. Education and Training Division * Coordinate programs of undergraduate and graduate pharmacy students. ¢ Participate in hospital-wide educational programs involving nurses, doctors etc. ¢ Train newly employed pharmacy department personnel.3. Pharmaceutical Research Division Develop new formulations of drugs, especially dosage forms not commercially available, and of research drugs. Improve formulations of existing products. Cooperate with the medical research staff of projects involving drugs. . In-Patient Services Division Provide medications for all in-patients of the hospital on a 24-hour per day basis. Inspection and control of drugs on all treatment areas. Cooperate with medical drug research.Out-Patient Services Division Compound and dispense out-patient prescriptions. Inspect and control all clinic and emergency service medication stations. Maintain prescription records. Provide drug consultation services to staff and medical students. Drug Information Services Division Provide drug information on drugs and drug therapy to doctors, nurses, medical and nursing students and the house staff. Maintain the drug information center. Prepare the hospital's pharmacy newsletter. Maintain literature files.7. Departmental Services Division * 1. Control and dispense intravenous fluids. + 2. Control and dispense controlled substances. * 3. Coordinate and control all drug delivery and distribution systems. 8. Purchasing and Inventory Control Division + Maintain drug inventory control. ¢ Purchase all drugs. ¢ Receive, store and distribute drugs. + Interview medical service representatives.9. Central Supply Services Division ¢ Develop and coordinate distribution of medical supplies and irrigating fluids. 10. Assay and Quality Control Division * Perform analyses on products manufacturered and purchased. * Develop and revise assay procedures. * Assist research division in special formulations. 11. Radiopharmaceutical Services division * Centralize the procurement, storage and dispensing of radioisotopes used in clinical practice12. Manufacturing and Packaging Division * Manufacture wide variety of items in common use at the hospital. * Operate an overall drug packaging and prepackaging program. * Undertake program in product development. * Maintain a unit dose program. 13. Sterile Products Division * Produce small volume parenterals. * Manufacture sterile ophthalmologic, irrigating solutions etc. * Prepare aseptic dilution of lyophylizal and other "unstable" sterile injections for administration to patients.Objectives of hospital pharmacy To professionalize the functioning of the pharmaceutical services in hospitals. To ensure availability of the required medication at an affordable cost at the required time. To plan, organize and implement the policies of the pharmacy. To perform functions of management of material, purchase, storage of essential items. To maintain strict inventory of all items received and issued. To counsel the patient, medical staff, nurses and others involved in patient care on the use of drugs, possible side effects, toxicity, adverse effects, drug interactions etc. To serve as a source of information on drug utilization.8. To manufacture drugs, large/ small volume parenterals which are critical for use in patients. 9. To participate in and implement the decisions of the pharmacy and therapeutics committee. 10. To organize and participate in research programmes, educational programmes, 11. To provide training to various members of the patient team on various aspects of drug action, administration and usage. 12. To engage in public health activities to improve the well-being of the population. 13. To interact, cooperate and coordinate with various other departments of the hospital.Functions of hospital pharmacy: Forecast of demand Selection of reliable suppliers Prescribing specifications of the required medicament Manufacturing of sterile or non-sterile preparations Maintenance of manufacturing records Quality control of purchased or manufactured products Distribution of medicaments in the wards Dispensing of medicaments to out-patients Drug information source in hospitals Centre for drug utilization studies Implement recommendations of the pharmacy and_ therapeutic committee Patient counseling and maintaining liaison between medical, nursing and the patient.ASHP Guidelines: Minimum Standard for Pharmacies in Hospitals * The following minimum standard guidelines are intended to serve as a basic guide for the provision of pharmacy services in hospitals by American Society of Health-System Pharmacy (ASHP). ¢ These guidelines outline a minimum level of services that most hospital pharmacy departments should consistently provide. * Certain elements of these guidelines may be applicable to other health care settings or may be useful in evaluating the scope and quality of pharmacy services.Staff and work load statistics Areas of responsibility within the scope of pharmacy services shall be clearly defined to each staff. The responsibilities and related competencies of professional and supportive personnel shall be clearly defined in written position descriptions. These position descriptions shall be reviewed and revised as required by the hospital’s policies. Position descriptions should reflect more general aspects of performance (e.g., communication, motivation, teamwork) in addition to specific responsibilities and competenciesDirector of Pharmacy. The pharmacy shall be managed by a professionally competent, legally qualified pharmacist. The director of pharmacy should be thoroughly knowledgeable about and have experience in hospital pharmacy practice and management. An advanced management degree (e.g., M.B.A., M.H.A., or M.S.) or an administrative specialty residency is desirable..The director of pharmacy shall be responsible for « Establishing the mission, vision, goals, and scope of services of the pharmacy based on the needs of the patients served, the needs of the hospital (and any health system of which the hospital may be a component), and developments and trends in health care and hospital pharmacy practice. ¢ Developing, implementing, evaluating, and updating plans and activities to fulfill the mission, vision, goals, and scope of services of the pharmacy* Actively working with or as a part of hospital or health-system leadership to develop and implement policies and procedures that provide safe and effective medication use for the patients served by the institution. * Mobilizing and managing the resources, both human and financial, necessary for the optimal provision of pharmacy services. + Ensuring that patient care services provided by pharmacists and other pharmacy personnel are delivered in adherence to applicable state and federal laws and regulations, hospital privileging requirements, and national practice standards.Pharmacists. ¢ The pharmacy shall employ an adequate number of competent, legally qualified pharmacists to meet the specific medication-use needs of the hospital’s patients. * Pharmacists hired on a temporary or contract basis shall meet the same requirements as those employed by the hospital. Support Personnel. ¢ Sufficient support personnel (e.g., pharmacy technicians and clerical or secretarial personnel) shall be employed to facilitate pharmacy services. * Support positions shall have a written job description that includes a statement of the competencies required for that position. * Support staff shall be properly trained and supervised, and professional development programs for them are desirable.* Pharmacy technicians should have completed an ASHP accredited pharmacy technician training program, should be certified by the Pharmacy Technician Certification Board, and shall meet the requirements of applicable laws and regulations. * Pharmacy technicians working in advanced roles should have additional training and demonstrate competencies specific to the tasks to be performed. Education and Training. + All personnel shall possess the education and training required to fulfill their responsibilities and shall participate in relevant continuing-education programs and activities as necessary to maintain or enhance their competence.Recruitment, Selection, and Retention of Personnel. + Personnel should be recruited and selected by the pharmacy director on the basis of job-related qualifications and prior performance. + Anemployee retention plan is desirable. Work Schedules and Assignments. * The director of pharmacy shall ensure that work schedules, procedures, and assignments optimize the use of personnel and resources. * There shall be a written departmental staffing plan that addresses how patients’ needs will be met during periods of staff shortages and fluctuation in workload and/or patient acuity. + Remote medication order processing may be employed to help address staff shortages or workload fluctuationsCHIEF PHARMACIST Provide the overall supervision of the activities of the Pharmacy Service of comparatively large general or special hospitals and perform other related functions. Specifically, the Chief Pharmacist shall: = Establish and implement policies and procedures of the pharmacy in accordance with the policies of the hospital and of the DOH; Instruct, train and supervise all employees of the Pharmacy Service; Review and approve schedule of duties of the pharmacy staff Provide information concerning drugs and drug therapy to physicians, nurses and other health personnel of the hospital; Participate actively as member and secretary of the hospital’s Pharmacy and Therapeutics Committee (PTC); Assist in the evaluation of reports on ADR, and Infection Control Programs;ll. 12: 13. 14. Plan and prepare research activities on behavioral and socio- economic,pharmaceutical operational and clinical researches; Supervise checking of deliveries to bulk storeroom of the pharmacy for safekeeping and proper storage. . Prepare reports and memoranda to the COH, Administrator and other departments of the hospital on pharmacy matters; Plan suitable educational and training programs for professional staff and pharmacy interns in accordance with the requirements of the DOH Attend meetings/seminars related to drugs and hospital pharmacy practices; Recommend pharmacy development or improvements to the COH; Check and evaluate overall performance of the pharmacy.SUPERVISING PHARMACIST * Supervise activities of the Pharmacy Service of smaller general or special hospitals and/or supervise the activities of employees in the Pharmacy Service of a comparatively large general or special hospital, and perform other related functions. Specifically, the Supervising Pharmacist shall: 1. Assume the duties and functions of the chief pharmacist in his/her absence; 2. Supervise record-keeping activities3. Supervise the receiving, checking and proper storage of all drugs biological and medical supplies; 4. Check the prepared schedule of duties of pharmacists and other personnel; 5. Assist in the planning and preparation of research activities; Assist in the preparation of suitable educational pharmacy programs for professional staff Supervise dispensing of drugs to in and out-patients; Attend meetings related to drugs and hospital pharmacy practices; Assist in the evaluation of the overall performance of the pharmacy staff and review performance appraisal forms of pharmacy personnel; and 10. Listing of all regulate and narcotic drugs on their appropriate booksSENIOR PHARMACIST Under general supervision, the Senior Pharmacist shall supervise the activities of a small group of employees of the Pharmacy Service of a general hospital or special hospital and perform other related functions. * Specifically, the Senior Pharmacist shall: 1. Assume the functions and responsibilities of the supervising pharmacist in his/her absence; 2. Assist the supervising pharmacist in the supervision of Pharmaceutical Service activities or perform other duties relating to the preparation, care, distribution, disposition and inspection of drugs and supplies3. Assist the supervising pharmacist in planning, organizing and implementing pharmacy policies and procedures in accordance with established policies of the hospital and the DOH; 4. Guide subordinates in work prioritization and specific tasks to be performed and reviewed; 5. Supervise the maintenance of the Drug Information Center with updates, journals and literature files, etc.; 6. Supervise the bottling and labelling of stocks from bulk compounded stocks; 7. Inspect and monitor drugs in all treatment areas; 8. Participate in all research activities: 9. Discuss performance report with subordinate employees 10. Participate in the QAP of the Pharmacy Service+ PHARMACIST + Under general supervision, the pharmacist fills and dispenses drugs and medical supplies to in-patients and Out-out-patients ordered or prescribed by a licensed physician, dentist or veterinarian. The Pharmacist shall: 1. Fill prescriptions and dispense drugs; i) Compound preparations not available commercially; 3. Label all drug containers issued to various services; 4. Check the manufacture and expiration dates and labels of drugs5. Participate in medical rounds when deemed necessary for medication history of patients in promoting rational drug therapy; 6. Notify physicians of any therapeutic incompatibilities, potential drug interactions and duplicate prescriptions; 7. Make certain that the right patient takes the right drug and right dosage at the right time; 8. Participate in research activities; 9. Attend scientific seminar-workshops/consultative meetings and continuing education on drug-related matters and_ hospital pharmacy practices; 10. Participate in the QAP of the Pharmaceutical Service; 11. Prepare performance appraisal reports.CLERK Under general supervision, the clerk shall: 1. Do all the typing/filing/safekeeping of documents, receiving and releasing papers pertinent to the operation of the Pharmacy Service; 2. Prepare adjustment sheets as the basis for the statistical report on the monthly consumption and balances of stocks in the pharmacy; 3. Participate in the QAP of the Pharmacy Service 4. Attend staff development programs and seminar/workshops relevant to his/her work;STOREKEEPER Under general supervision, the storekeeper shall: 1. Receive/check/post drugs on ledger cards for safekeeping and proper storage in the bulk storage area and record releases for pharmacy stocks in the active storage area; Transfer/withdraw drug items from bulk storeroom to active storeroom of pharmacy for distribution assisted by the utility worker; Conduct regular and weekly follow-up of physical inventory of drugs; Attend seminar/workshops, and other staff development programs relevant to the work; Participate in the QAP of the Pharmacy ServiceUTILITY WORKER Under general supervision, the utility worker shall: 1. Maintain housekeeping and sanitation of the pharmacy as well as its bulk and active storage areas; . Maintain facilities of the pharmacy; . Attend to the administrative needs in the operation of the Pharmacy Service; . Assist the storekeeper in the transfer or withdrawal of drug items from the bulk storage area to the active storage area of the pharmacy for eventual distribution; . Participate in the QAP of the Pharmacy Service;Personnel requirement in hospital pharmacy No standard rules regarding the requirement of personnel for inpatient pharmacy. Number of pharmacists required for a hospital are calculated on the basis of workload, and the number of bed available. For a small hospital minimum 3 pharmacist are required. As the number of bed increases, the number of pharmacist also increases. Pharmacist should possess adequate pharmacy qualification and experience. If manufacturing drugs is involved in pharmacy, adequate number of technicians, assistants, peons etc. required.Pharmacist requirement on the basis of bed strength Bed strength No of pharmacist required Upto 50 beds 3 Upto 100 beds 5 Upto 200 beds 8 Upto 300 beds 10 Upto 500 beds 15Infrastructure / Facilities Pharmacy + Adequate space, equipment, and supplies shall be available for all professional and administrative functions relating to pharmacy services. * These resources shall meet all applicable laws and regulations; shall be located in areas that facilitate the provision of services to patients, nurses, prescribers, and other health care providers; and shall be integrated with the hospital’s communication and delivery or transportation systems.Medication Storage and Preparation Areas. * There shall be suitable facilities to enable the receipt, storage, and preparation of medications under proper conditions of sanitation, temperature, light, moisture, ventilation, segregation, and security to ensure medication integrity and personnel safety throughout the hospital. Compounding Areas. * There shall be suitable facilities to enable the compounding, preparation, and labeling of sterile and nonsterile products, including hazardous drug products, in accordance with established quality-assurance procedures. * The work environment should promote orderliness and efficiency and minimize the potential for medication errors and contamination of productsPatient Assessment and Consultation Area. + In outpatient settings, a private area for pharmacist—patient consultations shall be available to confidentially enhance patients’ knowledge of and adherence to prescribed medication regimens. Office and Meeting Space. * Adequate office and meeting areas shall be available for administrative, educational, and training activities. Automated Systems. * There shall be policies and procedures for the evaluation, selection, use, calibration, monitoring, and maintenance of all automated pharmacy systems. + Automated mechanical systems and software can promote safe, accurate, and efficient medication ordering and preparation, drug distribution, and clinical monitoringInformation Technology. A comprehensive pharmacy computer system shall be employed and should be integrated to the fullest extent possible with other hospital information systems and software, including computerized providerorder- entry, medication administration, electronic health record, and patient billing systems. Pharmacists should be involved in the development and maintenance of order sets, templates, and dose ranges used in computerized provider-order-entry and clinical decision-support systems. Pharmacy computer systems should be integrated with the hospital’s clinical, financial, and administrative information systems. All computer systems shall include adequate safeguards to maintain the confidentiality and security of patient records, and a backup system should be available to continue essential computerized functions.Drug Information. + Adequate space, current resources, and information-handling and communication technology shall be available to facilitate the provision of drug information. + The department of pharmacy shall select its drug information resources, and pharmacists shall play a leadership role in the selection of drug information resources used by other health care providers in the hospital. * Up-to-date, objective drug information shall be available, including current print or electronic periodicals, newsletters, best-practices guidelines, and recent editions of reference books in appropriate pharmaceutical and biomedical subject areas5 6. 7. 8 9. Infrastructure- Managment Located in the ground floor or in the first floor. Sufficient space for seating of patients. Waiting room for out-patients. It should contain educative posters on health , hygiene and offer literature for reading. Suitable space —routine manufacturing of bulk preparations (stock solutions, bulk powders and ointments etc. Office of the chief pharmacist. Packaging and labeling area Cold storage area Research wing Pharmacy store room 10. Library 11. Radio isotope storage and dispensing areaEquipment's required in hospital pharmacy Prescription case Drug stock cabinets with proper shelves and drawers. Sectional drawer cabinets with cupboards bases. Work tables and counters for routine dispensing. Sink with drain board. Cabinet to store mortar and pestles. Cabinet for glass utensils, flasks, funnels and beakers. Refrigerator of suitable capacity. Narcotics safe with individually locked drawers. Office desk with telephone connection and file cabinet. Dispensing window for nurses and outpatients.Location of hospital pharmacy Located in hospital premises so that patients and staff can easily approach it. In multistoried building of a hospital, the pharmacy should be preferably located on ground floor especially the dispensing unit. It should be laid in such a way that there is a continuous flow of men and materials.Layout of hospital pharmacy LN MATERIAL ASEPTIC AREA MANUFACTURING SECTION STORES FINISHED PRODUCTS PASSAGE ADMINISTRATIVE DISPENSING SECTION OPEN SPACEFloor space requirements 250 sq. feet is the minimum required area for any sized hospital. 10 sq. feet per bed in 100 beded hospital. 6 sq. feet per bed in 200 beded hospital. Floors of pharmacy should be smooth, easily washable and acid resistant. In manufacturing sections, drains should be provided, walls should be smooth, painted in light colour. Wooden cabinets are laminated. Fluorescent lamps are placed above priscription counter. Counter for Bunsen burner are also required.Requirements On The Basis Of Bed Strength (Area in sq. feet) a cE 3 Store room dispensary office 100 B - 450 100 B - 350 100 B- 10 300 B - 1000 300 B - 500 300 B -150 700 B - 2400 700 B - 800 joo B - 200 5 6 Manufacturing under aseptic Parenterals condition for eye drops, eye 300 B - 600 lotions & other preparations for 700 B - 600 external use 300 B- 250 700 B - 250000 4 v Manufacturing of compressed tablets And capsules *For tablets 700 B - goo *For capsules joo B - 200Flow charts for materials and men . General flow chart for outpatients Rx written by doctor iearccccrnetM mo EU CCRT > selection “— pricing FST ORM nce OT TCO labelling Dispensed to patient EI Free Regular Narcotic prescription t prescription file fileGeneral flow chart for in-patients Inpatient d selectionFLOW OF MATERIALS Requisition or an indent § For supply of medicines and other items J Maintain inventory for received items Distributes the medicine to out-patients and in-patientsQasim College of Pharmacy, Nandyal COPY RIGHTS RESERVED — [iisineeae | BN (rel Corte eo issues Inpatient department Detect manufacturing ok Quality control Outpatient Glpeatiineie Manufacturing issues MARCH -2019. EDUCATION FOR PEACE & PROGRESS: 14700406 /Chapter-2 /S53Finances -Management Primary source- charges received from the patient. Charges received by the patients are either fully paid by himself or from third party. Research work grants from government and private sectors. Invested endowment funds Other types of investment Gifts, contributions towards general functional expensesFinancial management focuses on making wise decisions about obtaining and using financial resources. These resources include both funds that the owners of an organization have invested in it and funds that the organization has borrowed. Pharmacist managers face many such decisions: how much inventory to carry, which sources of supply to use, how to set prices, which third-party prescription plans to participate in, which drugs to include on a formulary, whether a new disease management service will be profitable, whether the hospital should open a pharmacist-managed hypertension clinic. Being familiar with the tools and techniques of financial management will help pharmacists make better decisions when faced with such questions.Goals of financial management The principal goal of financial management is to increase the value of the organization. A major part of achieving this goal is making efficient use of financial resources. Pharmacies, for example, carry inventories of prescription and nonprescription drugs. They must invest cash, a scarce financial resource, to buy inventories. Pharmacies make the most efficient use of cash that is invested in inventories when they carry the smallest amount of inventory necessary to meet consumer demand. Carrying larger inventories is inefficient because it takes cash away from other, more productive uses. Making the most efficient use of financial resources is more important than ever before in pharmacy practice.Pharmacies of all types face substantial competition and economic challenges. The community pharmacy market has become increasingly competitive. Ambulatory consumers can obtain their prescription medicines from a number of outlets including pharmacies in supermarkets and mass merchandising stores (such as K-Mart and Wal-Mart), mail-order pharmacies, ambulatory care clinics, and physicians’ offices, as well as traditional chain and independent community pharmacies. All of these face financial pressures from the reimbursement policies of government, managed-care, and other third-party prescription programs intent on controlling prescription drug costs. These policies have dramatically decreased the prices and gross margins that pharmacies receive for prescriptions. In the new competitive environment, pharmacies must use financial resources efficiently if they are to survive and grow.Hospital pharmacies face similar financial pressures. Insurance companies, managed-care organizations, and federal and state governments have instituted a number of programs to control the increases in hospital costs. The federal Prospective Pricing System, for example, mandates that hospitals be paid no more than a fixed and predetermined amount for each inpatient with a given diagnosis. If the hospital spends more than this amount to treat the patient, it must pay for the excess. The federal government has also implemented prospective pricing programs for ambulatory care services provided in hospitals and for long-term care facilities (nursing homes).Accounting and financial management A proper understanding of the tools and techniques of financial management requires a basic working knowledge of accounting. Accounting is a specialized language used to communicate financial information. This information is communicated via financial statements. Accounting data, and the financial statements developed from them, are maintained because they aid decision making. Financial statements facilitate decision making in three areas. First, financial statements provide information to decision makers. With this information, decision makers can better assess the financial implications of various decisions they must make. For example, bankers are decision makers. Before making loans, they will carefully evaluate the financial statements submitted by applicants to decide whether they can repay the loansSecond, financial statements aid decision makers by reporting the results of past decisions. The prudence of a banker’s past lending decisions will be reflected in his or her current financial statements. Likewise, a manager who makes poor service and pricing decisions will notice, on financial statements, a decrease in profits. Finally, financial statements keep track of a range of financial items such as cash, debts, and assets. Decision makers need this information to efficiently and effectively manage their organizations.Financial statements provide decision makers with the following types of information: Present financial status of the business. The balance sheet, or statement of financial position, indicates what a business owns and what it owes at one point in time. Past profit performance of the business. The income statement, also called the profit and loss statement, indicates whether the business made a profit or suffered a loss over some period of time. Where the business is getting its cash and how it is spending it. This is found on the statement of changes in financial position or the cash flow statement. How the owners’ investment in the business has changed over some period of time. This information is found in the statement of capital or the statement of retained earnings.Limitations of financial management Financial management is a tool that managers can use to better assess the financial implications of decisions they face. Its use should be limited to deciding among potential courses of action that will help the pharmacy to reach its goals. In most cases, it should not be used to decide what those goals are, nor should most decisions be based solely on financial criteria. On the other hand, given that a pharmacy has limited financial resources, the decision as to which particular clinical and educational services to offer would benefit from a financial analysis. Financial statements do not contain all the information, or in many cases even the most important information, about the factors that affect the finances of a pharmacy.Santhiram College of Pharmacy, Nandyal COPY RIGHTS RESERVED OLES AND RESPONSIBILITIES OF HOSPITALPHARMACIST INDOOR PHARMACISTS Ka Zn a) Central dispensing area: 1.To ensure that all drugs are stored and dispensed correctly. 2.To check the accuracy of the dosages prepared. 3.Maintain proper records 4. Preparation of bills 5.Co-ordinate over all pharmaceutical needs of the patient 6.Framed policies and procedures are followed 7.Maintain professional competence 8.communicate with all pharmacy staffs b) Patient care areas 1.Maintain liaison with nurses 2.Reviewing of drug administration 3. Provide instruction and assistance to the junior pharmacist MARCH 2019 EDUCATION FOR PEACE & PROGRESS 14700408 /Chapter-2 /S63% Santhiram College of Pharmacy, Nandyal COPY RIGHTS RESERVED c) Direct patient areas: 1. Identification of drugs brought into the hospital 2.Obtaining patients medication history 3.Assist in the selection of drug products 4.Monitor patients total drug therapy 5.Counseling patients 6. Participating in cardio-pulmonary emergencies d)General responsibilities: 1, Ensure that all drugs are handled properly 2. Participate in cardio-pulmonary emergencies 3.Provide education and training for pharmacists MARCH -2019 EDUCATION FOR PEACE & PROGRESS 14700406 /Chapter-2 /S64Fs anthiram nthiram College of Pharmacy, Nandyal COPY RIGHTS RESERVED = Outdoor pharmacist responsibilites: a) Central dispensing area: 1. To ensure that all drugs are stored and dispensed correctly. 2. To check the accuracy of the dosages prepared. 3.Maintain proper records 4.Preparation of bills 5.Keeps the pharmacy neat and tidy manner b)Patient care areas MARCH 2019 1. Inspect periodically the medication areas 2.Identify the drugs brought into the hospital 3.Monitoring of drugs 4.Counsel the patients EDUCATION FOR PEACE & PROGRESS. 14700406 /Chapter-2 /S65aX Santhiram College of Pharmacy, Nandyal COPY RIGHTS RESERVED c)General responsibilites: 1.Ensure that all drugs are handled properly 2.Participate in cardio-pulmonary emergencies 3.Provide education and training for pharmacists 4.Co-ordinate overall pharmaceutical need of the outdoor services MARCH -2019 EDUCATION FOR PEACE & PROGRESS 14700408 /Chapter-2 /S66Referances 1. Hospital pharmacy by William .E. Hassan 2. b. A text book of Hospital Pharmacyby S.H.Merchant & Dr. J.S. Qadry. Revised by R.K.Goyal & R.K. Parikh 3. ASHP Guidelines: Minimum Standard for Pharmacies in Hospitals