HOSPITAL PHARMACY: -

DEFINITION: -
“It may be defined as the practice of Pharmacy in a
Hospital setting”.
OR.
It may also be defined as: -
“That Department of the Hospital where as the
Procurement, Preservation, Storage, Manufacturing,
Packaging, Controlling, Analyzing, Dispensing and
Distribution of Medications to Hospitalized and
Ambulatory patients are performed by
professionally competent and legally qualified
Pharmacist”.
 1- Role of Hospital Pharmacist/Pharmacy
Specialist:
 The role of hospital pharmacist few years ago was
thought to dispense the medications but this act of
dispensing was mere superficial activity of the
pharmacist which does not involve knowledge or skills
basic to professional recognition.
 The task force on prescription drugs made the
recommendations on the new role of hospital
pharmacists.
“The pharmacy profession currently faces a dilemma in
many aspects of health care system as the practice of
medicines and surgery, hospital operations and
particularly drug manufacture have developed
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 and adopted new devices and techniques which require
improved provisions of health services. In contrast, the
number of important new methods introduced to
enhance the efficiency of retail pharmacy operations”.
These responsibilities are lying on the shoulders of
today’s pharmacists to play their role in the
improvement of health care system.
 A few years ago it was thought that the role of
pharmacist is confined to the transferring of pills and
tablets from large containers to small containers and to
manufacture cosmetics but now it is recognized that the
role of pharmacist is too much beyond this i.e.
manufacturing, sterilizing, distribution and providing
information of the drugs. He is a specialist on drugs.
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2- PHARMACY AIDE:

 These are individuals who do not have the formal

pharmacy education and can effectively perform many
of the routine activities of pharmacist under the
supervision of licensed and qualified pharmacist. Such
individuals are termed as pharmacy aides.

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3- PHARMACY TECHNICIAN:
 Pharmacy technician is a person who is well trained
for the distribution of drugs to different units of the
hospital under the supervision of a qualified
pharmacist.
 Pharmacy technician performs many functions in the
pharmacy store room, in drug packaging and
compounding and in controlled drug activities. Their
routine functions include:
1. Maintenance of drug and supply inventories.
2. Routinely checking stock.
3. Ordering from the store room.
4. Restocking when items are received from main store.
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  The technician pick up medication orders from the
wards and deliver the medications to the wards. When
the orders are received in the pharmacy, the technician
interprets and transcribe the order on the patient
medication file. The pharmacist checks each
transcription and interpretation before medication is
dispensed.
 The technician prepare statistical dose charts which
the pharmacist occasionally checks. It means that the
technician confirms the clerical and accounting
functions as well.

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4- PHARMACY TECHNOLOGIST:
 The courses of pharmacy technologist include:
1. Biomedical Science.
2. Sterile Products.
3. Aseptic Techniques.
4. Drug Administration.
 The pharmacy technologist’s role is:
1. Training Activities.
2. Personnel Management.
3. Assistant Management.
 The technologist train new technicians on the job
and present some formal lectures to technicians.
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  The major part of the technologist’s time is spend on
personnel management.
 The technologist also play an important role in
detecting and solving acute problems in the unit dose
and I.V. mixture systems and suggesting long term
improvements.

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5- DRUG INFORMATION SPCIALIST:
 Well qualified and train pharmacist play an important
role in the drug information section i.e. the
pharmacist must give information about already
existing drugs, about their storage conditions, their
stabilization techniques, information about new drugs
and their proper use.
 They may participate in ward rounds with the
physicians and to provide valuable drug information.

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6- PHARMACY EDUCATION:
 The pharmacy education has widened within the last
three decades. This is due to the reason that the
demand for new pharmaceutical products have
increased. For this purpose the pharmacy education
require some modern techniques for the pharmacy
profession.
 The task force therefore recommends that the official
bodies concerned with health education should
support:
1. The development of new and appropriate curricula
for pharmacists, pharmacy aide, technician and
technologists from time to time.

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 1. This curricula should contain new information and
books related to new drug formulations.
2. The courses of broad study of present and future
requirements in relation to the education changes.
3. Specialized training programs and in service
education programs for all heath professionals

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7- JOB DESCRIPTION:
 The federal and provincial governments of every
country have developed/prepared job descriptions for
hospital pharmacists which is a legal document as well
 The job description is the assignment of
responsibilities and duties of a pharmacist which he or
she is bound to follow.
 The job description authorizes a pharmacist to carry
out his/her responsibilities with a hospital and it gives
him/her the power to work freely in the hospital
environment.
 The duties are always written in the job description.
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DETERMINING THE DEPERTMENTAL STAFF:
 Two types of staff is required for pharmacy department
in a hospital.
1. Professional and
2. Lay personnel.
1. Professional staff:
The number of staff in the pharmacy department of
a hospital depends upon the number of beds in the
hospital, the number of in patients, the number of
out patients and depend upon weather the hospital
is involved in manufacturing, weather the hospital
pharmacy is involved in stock and dispense surgical
and medical supplies etc.

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  The main professional staff consists of:
1. Chief Pharmacist
2. Pharmacists and
3. Assistant Pharmacists.
2. Lay personnel:
Personnel falling into this category are:
 Secretarial or clerical workers
 Delivery men and
 Helpers etc.
The number of staff required depend upon the
amount of purchasing, inventory control and
accounting procedures which are assigned to the
Pharmacy.

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  Other factors which influence the need for secretarial
assistance are the number of hospital committees
upon which the pharmacists serve as secretary, the
frequency of departmental publications such as
pharmacy news letter and bulletins, frequency of up-
dating the formulary, weather or not the literature files
are maintained and weather or not the pharmacist is
active in teaching and research programs within the
hospital.
 The helping staff is strongly educated and trained for
jobs other than “dispensing act”. They are prohibited
from all the activities related to drug dispensing and
distribution and handling of any type prescriptions.

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 WORKING PATTERN OF PHARMACY DEPARTMENT
OR
DEPARTMENTAL ACTIVITY/ORGANIZATION CHARTS:
PHARMACY
Dispensing ------------------------------------------------ Manufacturing
Purchasing & Statistics &
Inventory control --------------------------------------- -Reports
Teaching -------------------------------------------------- Control
Research
Out-patient ---------------------------------------------- Bulk
In-patient ------------------------------------------------ Large vol. parenteral
Med, surgic, & lab: services ---------------------------- Small vol. parenteral
Wards & floor stock ------------------------------------ - Surgic. Irrigating fluid
Alcohol -------------------------------------------------- - Allergenic extracts
Narcotics ------------------------------------------------ - Misc.

DEPARTMENTAL ACTIVITY CHART

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 DISPENSING:
In pharmacy departments not only chemicals and
pharmaceuticals are dispensed but also they are filled and
labeled in containers. The pharmacy department:
 Provides dispensing for patients who come out of the
hospitals or are out-patients.
 Especially provide dispensing to patients who are admitted in
hospital or are in-patients.
 Dispenses appliances for medical, surgical and laboratory
services.
 Dispenses drugs either these are stored in nursing units or
floor stock for subsequent administration to the patients or
those are directly carried in the wards for immediate use.
 Dispense narcotics & alcohols on prescription to patients.
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MANUFACTURING:
Manufacturing in the hospital means preparation of
drugs at large scale by using machines. In pharmacy
department of some hospitals machines are used in
manufacturing drugs to reduce the cost and to save the
time. Manufacturing is done:
 Of medicines which are in common use and are
brought into account in bulk, to have good quality
product at low cost.
 Of large volume parenterals such as dextrose etc.
 Of small volume parenterals such as diagnostics fluids.
 Of irrigating & allergenic fluids as cherry extracts etc.
 Of other miscellaneous products.

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PURCHSING AND INVENTORY CONTROL:
Pharmacy department is responsible for:
 Purchase of drugs.
 Preparing inventory control of them.
 Receiving, storage and supply of drugs and related
materials.
 Keep up-to date record of all purchase and supplies.

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STATISTICS AND REPORTS:
 Pharmacy department is responsible for preparing
periodically the annual reports in such a way that it is
not only informative but also analytical.
 A large portion of report comprises statistical
representation to make it easily undertastand able and
comparable.

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 TEACHING:
Pharmacy department:
 Coordinates training programs for under graduates
and post graduate pharmacy students.
 Participates in training programs hospital wide,
involving trainees, nurses and physicians etc.
 Trains new pharmacy personnel in the policies and
procedures of the department.
CONTROL:
Pharmacy department:
 Assays for every drug received or manufactured.
 Develop and revise the assay procedures.

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RESEARCH:
Pharmacy department conduct research for:
 Improving the vehicles and bases.
 Improving the taste of products.
 Increasing the therapeutic efficacy.
 Increase the utility of pharmaceutical products.
 Development of preservation and stability of drugs.
 Making of different and new dosage forms of a new
product.

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 OUT-PATIENT ACTIVITY CHART:
Prescription(Rx)
Written by the physician ---------------------
Prescription(Rx)
Received by the Pharmacist

(Selection…labeling…pricing)--------- Filling of Prescription

Prescription Dispensed
to the Patient
Receipt of Payment --------------------- Prescription filled
(Charge—cash—free) (Regular prescription….Narcotic Prescription)
Statistics & Control

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 IN-PATIENT ACTIVITY CHART:
Prescription(Rx) PHARMACY
Written by the physician ------------------------------Rx copied by Nurse
Returns for credit
In-pt. discharge Medication In-pt. medication order

Rx received by the Pharma Rx received by the Pharma

Credit issued
Filling of Prescription……(Selection..labeling..pricing)………..Filling of Prescription

Prescription Dispensed ----------------------------- Prescription Dispensed

Receipt of Payment ----------------------------------Receipt of Payment

(Charge—cash—free) (Charge—cash—free)

Statistics & Control --------------------------------- Statistics & Control

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DEPARTMENTAL ORGANIZATION CHART:
Associate Director of Pharmacy
Pharmacist- in- chief
Assistant Pharmacist
Secretary------------------------------ Pharmacy Residents
Clerk
Out-pt. Dispensing ----------------- In-pt. Dispensing
Supervisor Supervisor
Messenger
Manufacturing & Control
Supervisor

Departmental Organization Chart of Pharmacy in Small Hospitals.

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 DEPARTMENTAL ORGANIZATION CHART:
Director of Pharmacy
Associate Director of Pharmacy
1. Administrative Service Division 2. Unit Dose Dispensing.

3. Education & Training 4. Pharmaceutical Research Div.

5. In-patient Service Division 6. Out-patient Service Division

7. Drug Information Service Div. 8. Purchasing & Inventory Cont.Div.

9. Assay & Q.C. Division 10. Manufacturing & Packaging Div.

11. Sterile Product Division 12. Radiopharmaceutical Division

Departmental Organization Chart of Pharmacy in Large Hospitals.

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1- ADMINISTRATIVE SERVICE 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.

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 2. UNIT DOSE DISPENSING:
This division is responsible for unit dose dispensing
activities and administration studies.
3. EDUCATION & TRAINING:
 Coordinate programs of undergraduate and graduate
pharmacy students.
 Participate in hospital wide educational programs
involving nurses and doctors etc.
 Train newly employed pharmacy department
personnel.

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 4. PHARMACEUTICAL RESEARCH DIVISION:
 This division is responsible to develop new
pharmaceutical products.
 To improve the quality of existing products.
 To develop new techniques of stabilization.
 Cooperate with medical research involving use of
drugs.
5. IN-PATIENT SERVICE DIVISION:
 This division provide medication for all in-patients
of the hospital for 24 hours.
 Inspect and control drugs for all treatment areas.

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 6. OUT-PATIENT SERVICE DIVISION:
 Compound & dispense out-patient prescriptions.
 Inspect & control all clinics and emergency service
medication stations.
 Maintain prescription records.
 Provide drug consultation services to staff and
medical students.
7. DRUG INFORMATION SERVICE DIVISION:
 Provide information on drugs and drug therapy to
doctors, nurses, medical and nursing students and
house staff.
 Maintain the drug information centre & literature
files.
 Prepare the hospital’s pharmacy news letter.
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8. PURCHASING & INVENTORY CONTROL DIVISION:
 Maintain drug inventory control.
 Purchase all drugs.
 Receive, store and distribute drugs.

9. ASSAY AND QUALITY CONTROL DIVISION:

 Perform analysis on products manufactured &
purchased.
 Develop and revise assay procedures.
 Assist research division in special formulations.

10. MANUFACTURING AND PACKAGING DIVISION:

performs all manufacturing and packaging activities.

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 11. STERILE PRODUCT DIVISION:
 Produce small volume parenterals.
 Manufacture sterile ophthalmology and irrigating
solutions etc.
 Prepare aseptic dilutions of lyophilized and other
sterile injectables for administration to patients.
12. RADIOPHARMACEUTICAL DIVISION:
 This division is responsible for the purchasing,
storage and dispensing of radiopharmaceuticals.

THE ED

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