ST.

JOHN’S MEDICAL COLLEGE, BENGALURU

A REPORT ON THE HOSPITAL POSTING IN

PHARMACY

SUBMITTED TO
THE DEPARTMENT OF HOSPITAL ADMINISTRATION
SUBMITTED BY
FR. ANUPRATHAP B
REESHA J

FIRST SEMESTER
POSTING REPORT [MARCH 13th to 18th 2023]
MASTER OF HOSPITAL ADMINISTRATION
1.DEFINITION
Pharmacy is a branch of pharmacology which deals with the collection, preparation,
standardisation, compounding, dispensing of drugs in such a way so as to make the
medication suitable for the easy, effective and palatable administration in the treatment of the
disease.

2. Scope
The Pharmacy services shall prove drugs and pharmaceutical products for both out-patient
and in-patient round the clack
The Drugs and Therapeutic Committee (DTC) develop the drug formulary for the hospital.
All drugs supplied from the Pharmacy shall be strictly according to the Hospital Drug
Formulary
To provide services m accordance with organisational goals and applicable laws.

3. Purpose

To provide guidelines for effective management of Pharmacy services for patients s as well as
hospital.
To provide guidelines to plan, acquire, store, move and control the medication and material.

4. Procurement

The DTC approved drug and disposables are procured to the sub-store Pharmacies, as per the
following procedure.

The indents are of 2 types: Auto indent Manuel indent.

4.1 Auto indent

a) from floor Pharmacies to Pharmacy Main Store

the auto indent will be generated from floor pharmacy to the pharmacy main store daily with
a requisition number
The quantity of the intends are assigned as per the consumption rate and as per the Reorder
Level (ROL).
The auto indent will be issued to the respective floor Pharmacies on daily basis.
b) From Pharmacy main Store to purchase department:
The auto intend will be generated to purchase department from Pharmacy Main Store
considering the consumption rate, Reorder level (ROL) and Economic Order Quantity
(EOQ).
As per the authorized purchase order, the items will be received in the GRN section of the
Pharmacy Main Store.
After the double check of the items, the items are accepted to the Pharmacy Main Store
4.2 Manual Indent
Manual indents are made for daily local purchase of drugs that are not available or less
quantity is available in the Pharmacy, also new drug requests by doctor or any amendments of
the purchase order quantities.
a) From floor Pharmacies to Pharmacy Main Store:
Intends are made manually by the respective floor in-charges or any Designated
Pharmacist in the absence of in-charges considering the out-of-stock items, the less
quantity items and for the drugs which were out of stock while auto intend was generated.
From the Pharmacy Main Store, the items will be issued as per the requisition number.
b) From Pharmacy Main Store to the Purchase Department:
Manual intends are generated to the Purchase Department for the drugs which are out of
stock and new drug requests by doctors.
The intended items will be received in the GRN section of the Pharmacy Main Store.
After receiving, the items should be separately kept as on request items, new drugs,
fridge items, costly items.
5. Statutory Requirements
5.1 Licenses:
Retail Drug License - Form 20 & Form 21
Wholesale drug license - Form 20B & Form 21B
Narcotic license - Form V (NDPS)
Pharmacists Registration
Schedule - X drugs
5.2 Registration certificates:
Karnataka Pharmacy Council Registration certificate
5.3 Acts:
Pharmacy Act, 1948
Drugs and Cosmetics Act, 1940
Narcotics and Psychotropic Substances Act, 1985
Drugs and Magic remedies Act, 1954
The Medicinal and Toilet Preparations (Excise Duties) Act,1956
The Drug price (control) order, 1995
Food safety and standard act, 2006
The poison Act, 1919
National Pharmaceutical Pricing Authority (NPPA)
6. List of Pharmacies in St. John’s
7. Procedure to obtain medications when the Pharmacy is closed.
7.1 Pharmacies
24/7 Pharmacies are functioning at St. John’s hospital so, there is no situation where
Pharmacy is closed. Hence patients can obtain the drugs from the Pharmacy anytime.
Pharmacies that are open round the clock:
1) Ground floor Pharmacy 2) Second floor extension Pharmacy 3) 2 nd 4) 3 floor OT
Pharmacy 5) New block emergency Pharmacy
7.2 Ward Stock

 Each ward, ITU, ICU is having 8 set of medications considering the need of each
department.
 The list of medications is approved by the HOD pharmacy
 The LASA, high risk medications are stored separately with proper label and colour
code according to the High-risk and LASA medicine policy.

7.3 Out of Stock

If the items are found out of stock in the Pharmacy, the in charge of the Designated
Pharmacy or in the absence of an authorised person is responsible for making an intend to the
Pharmacy Main Store and get the items as soon as possible.

If the items are found out of stock in the Pharmacy Main Store, the in-charge should put an
intend to the purchase department and decide to procure the medications as soon as possible.
7.4 Emergency Medicines
Emergency medicines as per the DTC approved list are identified and kept separately in the
outpatient pharmacy in ground floor.
Emergency drugs are also available in crash cart in different departments as per the approved
list.
Mass causality drugs are kept separately in the ground floor pharmacy and in EMD in Mass
Casualty Trolley.
8. COMMUNICATION KEY TO ENSURE UNINTERRUPTED MEDICATION SUPPLY
AND SAFE CARE
The Hospital has a system of informing the stakeholders the issues related to key changes in
pharmacy services and medication usage to ensure uninterrupted and safe care. When there is
a change in the formulation, the information is given to CMS and concerned
clinical HODs. When there is no supply of medications in the market due manufacturer issues
and unforeseen market conditions, information shall be communicated to the Purchase and D
and TC for further action. Amendment shall be made in the Hospital formulary with approval
from D and TC. Recall of the medications are communicated to alt stakeholders within 24
hours through official Email/Circular by the Head of the pharmacy.
All communications to the key personnel are made through office B mail to D&TC, CMS,
CNS, concerned clinical HOD and ADH.
A copy of the communications is kept in the Pharmacy department
9. Drug and Therapeutic Committee (DTC)
9.1 Purpose:
To develop and implement policies and guidelines on the use of medicines at SJMCH.
To evaluate new medicines and recommend approval, or otherwise, for their use at SIMCH.
To monitor trends in drug expenditure and liaise with the trust executive.
9.2 Composition of the drug and therapeutic committee (D.T.C)
CHAIRPERSON Associate Director of Hospital (ADH)
CONVENER Chief of Medical Services (CMS)
SECRETARIAL ASSISTANCE Senior Pharmacist

9.3 Members
HOD Pharmacy
Chief of Nursing Services
Associate of Medical Services (AMS)
AMS, HOD Microbiology, HOD Quality & Accreditation
Vice Dean, Professor of Pharmacology
Representative Dept. of General Surgery
Representative Dept. of Neurology
Representative Dept. of OBG
Representative Dept. of Endocrinology
Representative Dept. of Nephrology
Representative Dept. of Dermatology
Representative Dept. of Psychiatry
Representative Dept. of Pharmacology and in-charge of drug information services.
Representative Dept. of General Medicine
Representative Dept. of Purchase
Senior pharmacist

10. Policies and Procedures for Storage of Medications

10.1 Policy
Pharmacy shall ensure the storage requirement of the drugs as specified by the manufacturer

10.2 Purpose
to establish a safe and efficient procedure for stocking medications in the main pharmacy
store, sub-store, and wards.
To ensure that the medications are stored in a clean, safe, and secure environment ss specified
by manufacturer and ere protected from theft by lock.

10.3 Scope
This shall be applicable to all areas where medications are stored including wards.

10.4 Stock level: Thus is the level of stock which should be reached after every indenting.
This is
the level which should be used while indenting the stock. The stock to be indented can be
calculated as

QUANTITY TO BE INDENTED = STOCK LEVEL - EXISTING STOCK

A. Minimum stock level: This is the minimum level of stock that shall be available in the
store for any given item if any given point of time. This is given to avoid stock out situations.
This shall specially be ensured for Vital and Essential category items.

B. Maximum stock level: This is the maximum level of stock that can be stocked for any
given item. This is to avoid overstocking. This shall especially be ensured for ‘A’ category
items.
10.5 Reorder Level (ROL): Inventory level at which an entity should issue a purchase order
to replenish the amount on hand,
ROL= (MAXIMUM DAILY USAGE RATE X LEAD TIME) + SAFETY STOCK
10. 6 Responsibility
Chief of Medical Services
Head of the Pharmacy
Pharmacy Main Store In-charge
Chief of Nursing Services,

10.7 Process

Following general conditions shall be ensured for storage of medicines:

 All the drugs will be stored in racks with levels of shelves arranged m anatomical
therapeutic chemical classification (ATC) manner.
 The drugs will be kept in different boxes, different strength of same drug will be
stored m separate boxes.
 Name, dosage for and strength of the drug shall be written on the front of the box.
 A separate rack shall be used for storage of liquid medication, injections, and
consumables.
 Look alike and sound alike medications are stored physically spart from each other
with approved colour code.
 Near expiry drug are stored separately.
 High risk medications are identified and stored separately with an approved colour
code.
 Chemotherapy medicines are stored in different locations for better identification.
 Narcotic drugs are stored as per narcotic policy (Refer Policy for narcotic)
 Adequate quantity of identified list of emergency medication shall be always stocked.

10.8 Inventory Control

Following inventory control tools shall be used for medication storage and control of
inventory:
 A computerized store module shall be used for proper record keeping and following
inventory control processes.
 First in first out method (FIFO)of storage and issue.
 ABC end VED matrix analysis of all medicines
 Priority control of A and V categories of inventory
 Specific re-order level for A and V categories and B, B category of medicines to be
determined using usage of last 3} months and lead time.
  Enough buffer stock shall be maintained for important categories of medicines,
especially emergency medicines.
10.8.1 Re-order Level
Store management and inventory control
 Hospital Formulary as developed by Drugs & Therapeutic committee to be followed
for inventory stores.
 All items in hospital's formulary shall be procured and stocked as per the stock
levels.
Categorization: The items in hospital's formulary have been categorized for better and
scientific inventory control. This Categorization is as follows
1. A/B/C - All items have been classified based on their annual cost consumption in the
hospital. brief description is as follows:
A-These items consume 70% of the total inventory cost and make up only 10% of the
total inventory by quantity.
B- These items consume 20% of the total inventory cost and are 20% of the total
inventory by quantity.
C-These items consume only 10% of the total inventory cost and constitute 70% of the
total inventory by quantity.
2. V/E/D - All items have been classified based on their importance (of use) in the hospital.
Brief description of this is as follows:
V-= Vital items, these are very important items without which hospital cannot function
even for a day
E-—Essential items.
These are important items without which it is difficult for a hospital to function.
D- Desirable items. These items are of low importance and do not affect the
functionality of the hospital even in a stock-out situation.

3. Economic Order Quantity (EOQ): Economic order quantity (BOQ) is the ideal order
quantity which should be purchased to minimize inventory costs such as holding costs,
shortage costs, and order costs.

10.8.2 Stocking:
Stocking levels of each item has been determined based on ABC (Cost basis) and VED
(Vitality basis) of the items.
These stocking levels have been calculated based on a fixed ordering cycle of 15 days and
approximate lead time of 1-month Brief descriptions of these are as follows:
 The hospital follows three-time principles for appropriate stocking, i.e to ensure
that the stock-out situation does not anise for vital and essential items and
overstocking is not done for A category items.
  The medicine inventory shall be kept under security. Physical verification of
inventory shall be done at least once in 3 months for stored quantity and cross
matched with quantity in records.
10.8.3 Stock check of high-cost items
The high-cost medications should be stored separately with proper accountability for
each item. C-items (high-cost items) will be carried out weekly as per the checklist.
A Comprehensive physical stock check of all pharmacy items will be done once a year.
10.9 Factors affecting Storage of Medications
10.9.1 Appropriate temperature
Different temperature range
Cold: Between 2 - 8 degree Celsius
Cool: Between 8 - 25 degree Celsius
Room Temperature: Between 20 - 30 degree Celsius
10.9.2 Appropriate light (or darkness)
All drugs, which require light protection while in storage, remain in the original pack, closed
shelves until the time of dispensing.
10.9.3 Appropriate ventilation
Medications that need ventilation are kept on the open shelves.
10.9.4 Appropriate humidity
Relative humidity levels of 60 percent or lower.
10.9.5 Prevention from rodents, insects
 Pest control activities are carried out on regular basis.
 Pharmacy staffs will be responsible for periodic surveillance of the effectiveness of
pest control program.
 The medications are kept in the cupboards, shelves and in the tracks, that are closed
and in tight bottles/containers to prevent the entry of pests and to prevent spilling
10.9.6 Clean, safe, and secured area
 The medications are kept in clean and dust free areas, the overall cleanliness of the
storage areas also maintained.
 Entrance to the pharmacy is limited only to the pharmacy staff.
 Other department staff can enter the pharmacy for work related matters with the
permission of HOD pharmacy or in charge of the respected pharmacies.
 Narcotics should be kept separately in a secured area with double lock system and the
entry to the narcotic storage area should be limited to one or two authorized
pharmacists
 Medications are checked regularly to verify the stock and detect instances of loss or
theft. High-cost medications are kept safe and secured in cupboards under lock and
key.
  CCTV are available with visual monitoring and recording facility at all unit
Pharmacies round the clock to prevent theft and pilferage.
10.10 Storage of Refrigerator products
 A refrigerator is a cold place in which the temperature is maintained thermostatically
between 2 & & degree Celsius, A freezer is a cold place in which the temperature is
maintained thermostatically between -20 & -10 degree Celsius.
 Item requiring refrigeration stored appropriately, ice line shall be maintained as per
manufacture guidelines
 Vaccines should be stored in Ice Lined Refrigerators (ILR jas per the immunization
Program Guidelines.
 Temperature monitoring of the cold storage area and refrigerator shall be done at least
twice a day.
 Temperature record document shall be maintained in the department.
 In case of any variation in the temperature of the cold storage area, if shall be
reported immediately to the maintenance department for rectification.
 Food items shall not be stored in refrigerator containing drugs and other such items
10.10.1 Ice Lined Refrigerator
10.10.1 .1 Definition
Ice-Lined refrgierators are lined with ice packs which is designed for storage of vaccines at a
temperature range of 2°C to 8°C.
11. Types of audits:
A. Medication Chart Audit
B. Antimicrobial Agents Audit (OP)
C. Narcotic Drugs Prescription Audit.
D. OP Prescription Audit
A. Medication Chart Audit
a) In-patient medication chart audit is done on daily basis.
b) Report of the Audit will be sent to the Quality department every month.
c) The parameters of the Audit are as follows:
Medication Errors
 Documentation of Drug Allergies
 Illegibility
 Error prone abbreviations
 Prescribing in CAPITAL letters
 Prescribing in generic name
 Date and time of writing the order.
 Prescriber’s name, signature, and seal
 Documentation of administration
  Improper documentation by the staff nurse
 Documentation of high-risk medication administration
 Antibiotic therapy- rationality, strength, and duration.
B. Antimicrobial agents Audit (OP)
a) OP patient antimicrobial prescription audit is done monthly, and the report Will he sent to
the department of quality
b) The parameters of the Audit are as follows
Type of therapy
Name of the Antimicrobial agents
Rationality of use.
c)Narcotic Drugs Prescription Error Audit
Audit of 3E form is done on daily basis.
Errors related to the Narcotic Prescription will be reported
D) OP Prescription Audit
o OP Prescription Audit la done on daily basin,
o The parameters of the Audit are as follows:
Medication Errors Y Drug-drug Interactions
Out of Formulary Drugs
Legibility of the Prescription
Prescribing in generic name
Prescribing in CAPITAL letters
Prescriber’s signature and seal.
11.1 Process
 Clinical Pharmacists will be doing the daily audit in the wards and Pharmacy.
 Report of the audit will be sent to the Quality department monthly.
 Report will be uploaded in NABH website portal every 3 months.
 Corrective and Preventive actions will be taken based on the audit report.
11.2 Medication Reconciliation
11.2.1 Definition
Medication Reconciliation is the process of comparing a patient's medication orders to all the
medications that the patient has been taking.
12. Policies and Procedures for Safe Dispensing of Medications
12.1 Policy
 Dispensing of medications shall be done in a manner that ensures quick and efficient
delivery which minimizes the errors.
 Pharmacy items will be dispensed/issued only by a qualified pharmacist.
12.2 Purpose
 To provide guideline for safe dispensing of medications
 To minimize the dispensing errors and thereby improve the quality of patient care.
12.3 Scope
This is applicable to all nursing & pharmacy staff dealing with the dispensing of medications
12.4 Responsibility
 Each staff in the pharmacy or its sub stores is responsible for the correct dispensing of
medicines according to the request (prescription).
 Nurse in charge in each Nursing station is responsible for the storage of medicines in
the Nursing Station.
 Nursing staff is responsible for the correct administration of medications to the
patients.
12.5 Process
Outpatient medication dispensing
Medicines shall be dispensed only by qualified Pharmacists
Identify the patient correctly by Both name and op number
The order shall be screened for appropriateness of drug. dose. route. frequency and
duration.
Therapeutic duplication, drug-drug interaction, allergies, and formulary status be
checked. Pharmacist shall verify the name, signature, and seal of the prescriber along
with the date and time. Expiry date and condition of each drug shall be checked prior
to dispensing.
High risk medicine orders must be verified by 2 qualified Pharmacists before
dispensing.
Each medicine shall be labelled property.
Labelling Requirements
Drug name
Strength dose/concentration
Frequency
Duration
 Time of administration

 Inpatient Medication Dispensing Pharmacy items are dispensed / issued only by a

qualified Pharmacist. Inpatient Indent form must be read carefully before
dispensing the medication
 Expiry date and condition of each drug shall be checked prior to dispensing
 High risk medicine orders must be verified by 2 qualified Pharmacists before
dispensing
Cut-strips Policy
 Cut-strips Policy shall be dispensed to the patient with the Name of the drug, expiry
date and bate number labelled in the dispensing packet.
 Remaining part will be kept in the storage container in the handwritten drug name,
batch, and expiry date.
13. Procedure for Medication Recall
13.1 Policy
To establish policies for medication, recall
13.2 Purpose
To provide guidelines for medication recall.
Responsibility e Pharmacy HOD
Registered Pharmacists
13.3 process:
External Recalling Process
 Medication must be of the Highest Quality:
 Only medication of the highest quality is dispensed from the Pharmacy.
 Any drug of compromised or questionable quality shall be immediately removed from
inventory with proper documentation, and the pharmacy software will be updated to
reflect such removal.
 If the product was never received, or if inventory has been depleted, the recall
procedure Is complete.
D. External Notifications with Existing Inventory:
If the recalled product was received, and if any inventory remains at pharmacy, It will be
documented on the pharmacy logbook end inventory shall be segregated from the rest of the
stock until the entity making the recall notification advises pharmacy to return of destroy the
product.
14. Process flow chart- internal recalling process

15. Policies and Procedures for Narcotic Drugs and Psychotropic Substances
15.1 Introduction
Safe medication management and use of High-Alert narcotics is the most concerned aspect
of patient care. Hence, the hospital must follow the narcotic policy (Narcotic Drugs and
Psychotropic Substances Act, 1985) which gives strict requirement on procurement, storage,
prescribing, dispensing, administration, and monitoring of narcotic drugs.
15.2 Purpose
 To comply with the Narcotic Drugs and Psychotropic substances Act and
Regulations.
  To monitor Narcotic Prescription and administration.
 To monitor accountabilities all narcotics.
 To monitor and restrict inappropriate use of narcotics and psychotropic medicines
within the hospital for outpatients and in-patient wards.
15.3Responsibility
 Licensed Medical Practitioner
 Registered Nurse
 Registered Pharmacist.
15.4 Policy and Procedure
Storage
 All Narcotics shall be stored in designated cupboards inpatient care areas as approved
by the pharmacy.
 Pharmacy services shall be responsible for supplying the patient care areas with the
required Narcotics,
 If a patient care area remains closed for longer than 10days, the Pharmacy Main Store
shall be contacted to arrange transfer back to the same.
Prescription
All Narcotics shall be ordered as per the Rules and Regulations.
Form: For Outpatients department Oral narcotics/Transdermal narcotic patches:
The hospital dues not purchase any implant related to Orthopaedics and the same is
purchased by the patient party upon instruction by the consultant orthopaedic surgeon,
however, prior to the use of the implant purchased by the patient party, the same is thoroughly
examined by the Orthopaedic surgeon to determine its adequacy for the patient.
16. Special Instructions
 Any Pharmacy item to be kept in the Pharmacy must be approved by the DTC (CMS
representing DTC) and the Associate Director Hospital
 A-written document of the approval with required evidence must be kept in the
Pharmacy as per the hospital policy,
 Pharmacy Main store must keep a register for the consignment items received,
stored, and used with required details,
 Buying or keeping any Pharmacy item in the hospital as consignment means, supply
of item as per the request for the purpose mentioned in the written document,
 The procurement process of consignment item will be completed after the usage of
the item only. (In the case of consignment items only).
 Consignment planning and inventory control should be done in such a way that the
maximum possible benefits can be availed out of the purchase. E.g.: Forecasting of
the consumption, Discount on payment, Quantity discount etc,
 The advantage to the Institution must be evaluated periodically. (Dead Stock, non-
moving, Expiry) ¢ If a consignment item has not moved for a period of 90 days or for
90 days from the date of delivery challan, or if the consignment is not used for the
 patient, pharmacy must communicate to the department concerned and process its
return to the vendor with the needed approvals.
 Selection of the supplier will be based on the quality of service, payment discounts,
distance from the hospital, business rapport and economy of the product.
 The approved Pharmacy consignment must be kept according to the consumption,
otherwise, the request must be evaluated and only the required quantity to be kept in
the ‘Pharmacy and in the user department
 The Pharmacy Main store must be in contract with the vendor regarding the return
policy in case of non-moving items or items nearing expiry
 The minimum quantity of the item to be kept in the hospital must be approved by the
HOD of Pharmacy and the HOD of departments concerned and same must be
documented appropriately The consignment Pharmacy product must be supplied as
per the confirmed purchase request orally (only in case of exceptional emergencies)
of by mail for a fixed quantity.
16.1 Checking at GRN Counter
The consignment items received In the GRN counter must be checked far the following,
a) Copy of the purchase request mail or verbal order details.
b) Confirm with the Pharmacy purchase team for the authenticity of the order.
c) Name of the item required and supplied.
d)Quantity of the item as per the request.
e) Delivery chalan with serial number.
f) Expiry of the items (as per the pharmacy policy, normally more than 6 months)
g) Batch number of the item.
h) Cost price / GST % / MRP of the item [In the DC and on the product must be checked

16.2 Process after receiving the items

 The pharmacy will put an item received seal in the Delivery challan with name of the
receiver, date and time of receipt and signature
 The consignment items (implant section) received by the Pharmacy will be informed
to the department concerned and documented.
 The prefixed quantity of an item can be issued to the departments concerned with
copy of the delivery for the utilization.
 The Staff who is receiving the item from the Pharmacy Main Store must have signed
the logbook kept in the Pharmacy Main Store
 Pharmacy Main Store will prepare the purchase order as per the consignment item and
specifications with same quantity used,
 Send the Purchase Order copy to the vendor to generate the Tax invoice.
  Pharmacy implant section will receive the tax invoice against the D.C number (the
Consignment item used) / put a department seal on the tax Invoice 1" and 3" copies
and document as “INVOICE RECEIVED".
 Assigned 3rd copy of the tax invoice will be returned to the vendor and 2 and 3 copies
will be preserved in the Pharmacy,
 Pharmacy to prepare a G.R.N based on the Purchase Order number in the system and
the tax invoice.
 Pharmacy to fill all the fields in the GRN (batch number, expiry, GST) and a
document number is generated while saving.
 The P.O details such as name of the item, Cost, MRP, Quantity, GST, etc., will pop up
upon typing the P.O number on the system.
 Verify the GRN copy and the tax invoice, sign on it, write the GRN number legibly in
the Tax invoice and document it. After completion of all these, it must be sent to the
scrolling section.
 Charge the patient according to the prescription, GRN and tax invoice.
 The consignment items are cost effective items Therefore, the inventory and stock
Verification of these items as per the class A category inventory practice must be
under taken carefully
 These items are financially controlled drugs, so minimum quantity of these stems
should be kept in the Pharmacy Henceforth, the utilization of these items must be
informed to the Pharmacy Main Store without fail
 Pharmacy Main store is fully responsible for the Storage, inventory and all
transactions related to these items including loss, breakage, or mismatch to the
inventory, should the item be kept in the Pharmacy,
 In all other cases, the departments concerned are fully responsible for the Storage,
Inventory and all transactions related to these items including loss, breakage, of
mismatch in the inventory for the items kept in their custody, they should also ensure
that utilization of each of these consignment items is charged for the patient.
 Expiry of these drugs must be intimated HOD Pharmacy through implant section,
well in advance latest within 6 months before the expiry date and follow the
instructions.
 A logbook is to be maintained for these items and updated after each usage. The same
must be produced at the time of receiving the replacement from the Pharmacy Main
Store along with the bill.
 The physical appearance of these items and the label must be well maintained
according to the Drugs and Cosmetic Act and mules.

16.3 Billing
 Any pharmacy item which is used for the patient must be charged through the
Pharmacy, (Cost +GST %+HANDLING CHARGE) before the patient is discharged.
 10 years back, the criterion for charging the patient was implemented in a letter head
which is duly signed by ADH.
17. Policies and Procedures for the use of Medical Supplies and Consumables
17.1 Policy
Based on the inventory levels and consumption patterns, materials will be purchased fom the
nominated vendors. Purchase order to be raised for each supply
17.2 Purpose
To clarify the obligations of the designated manager with respect to the development of
policies and standard operating procedures related to the procurement and management of
drugs and medications in the pharmacy

17.3 Principles
Patient safety is a priority in procurement and Inventory management
 An effective procurement process ensures the availability of drugs and medications
that are appropriate to the patient's circumstances at recognizable standards of quality
 Good inventory control supports procurement and utilizes appropriate systems to
track shipment inventory, ensure that patents and forecast needs to ensure that
patients continue to have reasonable access to pharmaceutical products for their
health and well-being
 All members in the pharmacy who have a role in medication procurement and
inventory management must receive training with respect to their legal obligations
and expected standards of practice
17.4 Procurement
 The Purchase Manager ensures that all drugs and medications purchased for use or
sale are of an acceptable standard and quality.
 The designated manager ensures that the policies and procedures that support
procurement follow provisional legislation.
 All drugs shall be purchased from authorised dealers processing GMP (Good
Manufacturing Practices) certificates
 All drugs before purchasing check for bio-availability and bioequivalence.
17.5 storage
Medical supplies and Consumables are stored in such a manner recommended by the
manufacturer.
18. Inventory control techniques
ABC Analysts: Always Better Control Analysis of the store (store items based on cost criteria
A: items represent the highest cost
B: Items represent immediate cost centres
C: Items represent low-cost centres
FSN- Fast and Slow Moving and Non-moving); Based on consumption of the items
SDE (Scarce, Difficult, Easy)
VED ANALYSIS (Vital, Essential, Desirable)
Analysis based on their criticality of the item.
VITAL: Items without which treatment comes to a standstill tolerated that is, non-availability
cannot be tolerated.
ESSENTIAL: Items whose nonavailability can be tolerated for some time (hours) because
similar or alternate items are available.
DESIRABLE: Items whose non-availability can be tolerated for a long period. Although t
proportion of vital, essential, and desirable items vary from hospital to hospital depending |
the type and quantity of workload
Maximum, Minimum and recorder level
 It is maintained for all items in all pharmacies. This is developed by averaging 3
months for slow moving items and 1 month sale for fast moving.
 Purchase process
Vendor section
Vendor evaluation
Indent Process
Generation of purchase order and receipt of goods
 Inventory control practices
mechanism to verify condition of consumables
use of medical supply and warehouse Management
18.1 General procedure for procurement of medication or consumables