Discharge & Counselling Policy

PURPOSE

To establish guidelines, for all pharmacy staff working in the Discharge Inpatient Pharmacy, to ensure the highest
quality of service and maximum safety to the patient to minimize or eliminate medication errors.

Dispensing Medications from discharge Pharmacy:

Discharge inpatient pharmacy provides the service to discharge patients at Aliman General Hospital.
Unapproved Drug (off label) marketed drug products for an indication for which are not approved by the Food
and Drug Administration (FDA) and European Medicines Agency (EMA) or Saudi Food and Drug Administration
(SFDA).
Discharge: When the patient discharge clinically from any wards in ALIMAN GENERAL HOSPITAL and after
considering the eligible criteria from wards.

Patient counseling is an information provided by pharmacist to patients and/or their families verbally or in written
form on direction of use, advise on side effect , precautions , storage , food or drug interactions and life style
modifications ( on the safe and effective use of the medications).

Dispensing in discharge inpatient pharmacy should follow the policy and procedure of the hospital, only elegible
and authorized prescriber prescriptions are dispensed.

All personnel will work together as one team, to ensure that the best interest of a quality service to the patient is
always met.

Prescription must be ordered by computer through authorized physician. All information’s of the prescription must
be completed. The name, code number of physician and / or signature should be on the prescription. All
medications must be enter in computer by generic name.

Prescription is verified by pharmacist, prepared by pharmacy technician and double checked by pharmacist
before dispensed to patients.
Prior to dispensing medication, the pharmacist should identify the patient by his/her three names and medical record
number.

For discharge dispensing medication, the duration of therapy should not be exceeded one month.

The physician will complete the electronic prescription. The prescription must contain the following information:
 Patient’s three name
 Patient’s medical record number
 Age and sex
 Patient weight and height.
 Diagnosis.
 Drug allergies (if any).
 Medication name and strength
 Dose and frequency
 Route of administration / Dosage form

Prepared By: Waleed Alotaibi

  Duration
 Complete instruction for use
 Indication of LASA medication.
 Indication / frequency of PRN Drugs.
 Date and time of prescription
Physicians name and code number with stamped and/or signature.
Formulary Drug for Unapproved Indications (Off Label) Refer to ALIMAN GENERAL HOSPITAL
Use of Formulary Drug For Unapproved indication which holds following Number ……………..
Patient Education and Counseling
Pharmacy staff provide verbal explanation, instruction and counseling to the patients and their families in the safe
and effective use of medication.
Pharmacy staff should check the elements of counseling checklist.
Written educational information is given in a language and forms the patient can understand.
Patient privacy is maintained during education and counseling.

REFILL ORDERS
Pharmacy staff will check the medications if available or not. If not available, please refer to the policy Of out
Stock Medication.
Pharmacy staff will identify the patient who came for refill by using two identifiers. (His/her three names and
medical record number).
Pharmacist who receives refill order will check all prescription information content.
Another pharmacist or pharmacy technician will enter refill order by click dispense ether discharge with double
checking quantity that is dispensed then print the label.
The label should contain the following information:
 Patient’s three name
 Patient Computer Number
 Drug Name
 Strength.
 Dose and frequency
 instruction for use
 Quantity
 Duration
 Route of administration/ Dosage Form
 Date issue.
Pharmacy technician will fill the order in zip lock plastic bag.

Before dispensing, the pharmacist must double check the order, medications & zip lock plastic bag for all
prescription information.

Handling, Reviewing and Dispensing of discharge pharmacy Prescriptions:

All procedures shall be within the general Policy Medication Order Clarification Verification unless
otherwise specified.

1. - Validity of prescription should be checked to be within three (3) days.

2. - A&E and antibiotics' prescriptions will be checked to be within 24 hours.

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 3. - To save patients and pharmacy time, pharmacy staff receiving a prescription must be able to
return/reject non-eligible prescriptions
4. Prescriptions for non-available items enter the medication(s) into the system and give a balance to the
patient.
The first screening process, should be responsibility of Pharmacist or Technician.

Dispensing of Refrigerated Medications:

All medications that need to be kept in a refrigerator must be given special attention

They must not be taken outside the refrigerator if the patient is not available.

Dispensing of Medications with Devices:

Medications administered by a device (e.g. insulin pen) must not be dispensed without educating patients how to use
them or ensure that the patient had educated before.

The pharmacist should check if the patient could show understanding of the right use. This can also be confirmed by
asking the patient each time.

Profiling:

All processed prescriptions shall be entered to the Oasis (HIS) following the appropriate procedure(s).

Policies on Profiling and Dispensing when computer system is down must be followed.

Labeling:

Labels could be handwritten if the computer/ printer is down (remember to issue handwritten balance form if
required).

Together with other required instructions; the label must either include a beyond use-date or a statement to prevent
use after a certain time as per Policy on Assignment of Beyond-Use Date.

Issuing of Medications to Patients:

Medications shall be handed to patients whenever possible with proper counseling.

Pharmacy may dispense the whole quantity or less depending on many factors:

 Next Appointment (if known to Pharmacy).

 Pharmacy Stock-On-Hand.
 Expiration Date of Stock-On-Hand.
 Patient's Stock-On-Hand
 Patient's Residency example: Inside or outside Riyadh.

Warfarin will not be dispensed for more than one (1) months and the warfarin booklet should be revised by the
pharmacist before dispense warfarin to the patient.

If a partial quantity is dispensed, a balance form must be issued (NOTE: T.B. and HIV patients must be given
quantities from different medications enough for specified period of time. For example, if the stock of one item
allows dispensing for three (3) weeks only, quantities of others must be enough for the same period; no longer)

Pharmacy/Patients Communication:

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Pharmacy staff shall determine the most efficient means of communication to relay messages to patients and their
families.

Some messages should be posted to inform and remind patients of special instructions or policies e.g. time period
after which a patient cannot claim his/her prescribed items and validity of prescriptions/balance forms.

Use of audio-visuals must be encouraged to educate patients about medications issues and some particular policies
and rules.

Balance or refill can be collected by patient, family relative, and driver, while for the new prescription the patient, or
relative can receive the medication from pharmacy.

Referral of Prescriptions and Balance Forms:

Prescriptions and balance forms must be screened, profiled and labels-generated by the referring Pharmacist. The
prescription, balance form and the labels must be sent to where it will be filled after phone arrangement. The official
referral form must be completed and attached to the prescription and referral form.

Handwritten referred balance forms must be accompanied by a copy of the prescription, labels and refilled form.
RESPONSIBILITIES:

Pharmacist who verify the prescription in the Hospital Information System (HIS).

Pharmacist will check the label information according to the prescription before filling.

Prepare the medications and check the expiry of medication before dispensing.

Call the prescribing physician for any intervention.

Double checking is mandatory process before dispensing any medications to the patient.

REFERENCES:

CBAHI Standard 3RD Edition, 1 Jan. 2016

Joint Commission on Accreditation of Healthcare Organization (JCAHO) 6th

Prepared By: Waleed Alotaibi