Professional Documents
Culture Documents
distribution system
Pharmaceutical
Services Offered in
Hospitals
Product Researc Teachin
g
h
Service
Service Service
s
s
s
In-patients
(hospitalize
d)
Outpatients
(ambulatory
)
Suppor Clinical
Services
t
Service
s
In-patients
(hospitalized
)
Out-patients
(ambulatory)
2
Introduction :
storage
Preparation for administration
Distribution to the patient care units
Patient Prescription
System
3
4
Combined System
Unit Dose Distribution
System
Intravenous
Admixture
System
TPN compounding
Service
Oncology Pharmacy
Service
Radiopharmacy
Service
Intravenous Additives
Services
3
4
5
Medication Distribution
Systems
(MDS)
1
2
Floor
Stock
Patient
Distributio Prescripti
n System on System
Combined
Stock-Patient
Prescription
System
Unit Dose
Distributio
n System
6
Floor stock
distribution system :
Floor stock :
Floor stock :
Advantages of floor stock system:
1- Availability of medicine at nursing
site.
2- Reduction in the number of
pharmacy personnel .
3- Reduction in the number of orders
received in the pharmacy
Floor stock :
Disadvantages:
1. High incidence of
medication errors
wrong patient
wrong drug
wrong dose
wrong route
wrong time
Prescription monitoring
Definitions :
Medication error
Drug misadventure
Medication administration record
(MAR)
Inventory
Cost-effectiveness
11
Monitoring ward
stocks
Patient prescription
system :
Advantages of Patient
Prescription System over FSS
:
Starting clinical role for
the
Prescription monitoring
pharmacist
Reduce medication
errors
MAP
Patient prescription
system :
Disadvantages:
Limited
No
Applicable
22
1. Centralized model :
Advantages :
All resources can be localized in one area
Drug inventory can be minimized
Disadvantages : (the biggest one)
The pharmacist is not able to directly interact with the
physician and nurse
23
2. Decentralized model
:
2. Decentralized model
:
Advantages :
Fewer dispensing error (medication error)
Increase nurse and physician satisfaction
The pharmacist-physician interactive role
began to emerge
The pharmacist has a more active role in
the medication cycle
Expansion of clinical services
Decrease floor stock
25
26
Bates et al identified :
530 medical errors
10,070 orders
5.3 error
100 order/51 days
(in 3medical unit)
Of the 530 errors :
5 (0.9%) resulted in an ADEs
Trial (2) :
In a systems analysis of 334 errors (in 2
hospital) causing
264 adverse drug events
130 errors (39%) resulted from physician
ordering
40 (12%) involved transcription and
verification
38 (11%) reflected problems with
pharmacy dispensing
126 (38%) were from nursing
administration
28
Trial (3) :
29
Trial (4) :
Medications use spans multiple stages:
Prescribing and ordering
56%
Dispensing
4%
Transcribing
34 %
Administrating
34%
Monitoring
?%
30