To Contact physicians by telephone, direct meeting or through a written report if clarification or correction is needed for any medication orders orders/Prescriptions.
Documentation of all corrections / Physician action should be followed by the pharmacist using the pharmacy intervention form
Dress code is a term used to describe an acceptable standard of dress.
Uniforms: Are clothes of a specific color and design that shall be wearied by Pharmacy employees during their duties and to be provided to employees by their hospital
Dress code is important to:
Supervisor shall ensure that personnel under him/her supervision adhere to the standards.
The unit dose system of medication distribution is a pharmacy-coordinated method of dispensing and controlling medications in organized health-care settings.
It is a system of drug distribution in which a portable cart (medication trolley) containing a drawer for each patient’s medications is prepared by the hospital pharmacy with a 24-hour supply of the medications.
It is safer for the patient, more efficient and economical for the organization, and a more effective method of utilizing professional resources.
How to order a medication for a patient?
The requested medications will be prescribed in the patient Medication Administration Record (MAR) with clear handwriting. With full medication information including: patient name, drug name, strength, dosage in metric units, route of administration, frequency, start and stop date, and time of administration.
All orders for Medications are transcribed & entered electronically on an automated unit dose order with full patient’s information and the name of the nursing unit. A print out of the order will be generated then checked, signed and stamped by an Authorized Licensed physician.
Electronic Medication orders should include: date and time ordered, Diagnosis, Allergy history, drug name, and doses in metric units, route of administration, frequency, start and stop date, and time of administration.
-Unit dose Medication orders will be received in the pharmacy for verification ,checking and reviewing medications before dispensing and must confirm that: the prescribed
medications shall be matched with the diagnosis ,the dosage is appropriate, No allergy history, No drug or food interaction and no incompatibilities.
Medication Reconciliation form must sent to the Pharmacy upon patient admission, in order to review the pre medication list for the patient and compare it with the admission medication.
-When a patient is transferred to/from a different level of care (e.g. MICU, SICU) all medications should be Hold in MAR and the computer system. Then medication shall be Revived in the MAR and the computer by an Authorized Licensed Physician or his designee.
All Medications that are ordered for admitted patients are subjected to automatic stop process to ensure that the potent drugs are reviewed in a timely fashion.
If the physician decides to continue the medication after the stop date, he /she should initiate a Re-order that is authorized by his signature and stamp.
Types of orders:
An order, for an urgently required medication, which is filled immediately within 20 minutes from the time of ordering (e.g. Aspirin 300mg tablet STAT means: one dose immediately)
An order contains new medication prescribed to the patient in a regular frequent manner. (e.g. Aspirin 300mg tablet PO TID for (7days)
An order allowing the continuation of the same medication for the same patient after reaching the discontinue date.
A notification order to stop the medication.
Order given by telephone when the doctor is unable to be present in the nursing unit to write then enter the formal order, this includes reporting of critical test results.
Verbal Orders :
Order given verbally when the doctor is unable to write the actual order in the patient’s file.
The order of PRN must have the followings:
PRN Doses Dispensed by Unit Dose Section:
Sufficient doses will be dispensed to cover the patient until the next scheduled refill. In case where the order written by the physician is not a fixed schedule, the following policy will be adhered to:
Automatic Stop Orders (ASO) shall be enforced for all antibiotics unless the exact numbers of doses have been clearly specified by the treating physician.
All Antibiotics orders should be written in the Antibiotic order form, which is part of the MAR.
Restricted antibiotics Dispensing of restricted antibiotics have to be approved by the microbiology consultant.
PHARMACY SECURITY MEASURES
To insure that pharmacy is operating under strict security measures
SCOPE OF SERVICE
Management will support the Pharmacy through the appropriate channel to utilize their professional judgment and extend their responsibilities, to include participation in programs dealing with the safe handling of medication throughout the hospital, whilst working with other members of the health care team and Participate in medication use review and patient care audits. Also provide safe and effective use of medicines in the hospital. And ensure their legitimate role in each step of medication therapy in the hospital, which includes the promotion of rational therapeutics and improvement of patient care. The pharmacy department is to implement clinical intervention program and redefine the role of Pharmacists in minimizing preventable adverse drug events and applying cost-effectiveness drug therapy. This program deals with Medication interactions, Poor patient compliance and Patient counseling.
PROCEDURES & RESPONSIBILITIES
Licensed Pharmacists, Pharmacy Technicians and Pharmacy Supportive Staff
Pharmacy Director, Pharmacy Supervisor
Obstetric Anesthesia care
A significant number of women require advice and care from anaesthetists before, during or after childbirth. The requirement is often urgent and may occur at any time.
Obstetric Anaesthesia is providing safe skilled analgesia and anesthesia for pregnant patients. This includes:
Obstetric Unit provides 24-hour service for the analgesic, anaesthetic and resuscitation requirements of women admitted to the hospitals with conditions associated with childbirth. Whenever available a named consultant should have responsibility for the organization and management of the service. Specialist has to be assessed as competent by a consultant anaesthetist with responsibility for obstetric anaesthetic services before undertaking obstetric anaesthesia care.
Mothers may require specialist consultation, assessment and advice. Anaesthetists are responsible for analgesia, anaesthesia, resuscitation and intensive care. An on call anaesthetist, is available for the provision of anaesthesia for an instrumental oroperative procedure.
The on call anaesthesia consultant will cover the obstetric unit when the on call specialist is busy. Pre and post procedure visiting of patients for assessment and explanation, early detection of complications. Written notes and records of all visits and clinical procedures undertaken should be documented.
Maternity unit must have access to an appropriately staffed ICU for transfer of patients, either pre- or post- delivery as required. That whilst in the ICU, patients will continue to receive obstetric care from the obstetric team involved.
Training and Education
NEONATE: 0 -30 DAYS
INFANTS: 1 MONTH-12 MONTHS
CHILD: 12 MONTHS — 14yrs
Anesthesia for children requires specially trained staff and special facilities. Provision should be made for parents to be involved in the care of their children. The service will be led at all times by ANAESTHETIST who anaesthetizes children regularly. Adequate assistance for the anesthetist by staff with pediatric training and skills must be available. Pediatric anesthesia equipment must be available where children are treated.
Anesthesia for children demands specifically trained staff and special facilities. Neonates may require treatment in a specialist center. Where appropriate, provision should be made for parents to accompany their children at all times. Day case surgery is increasing and appropriate arrangements must be made to treat children separately from adults. Consent to treatment should, where possible, be obtained from both the child and the parent or guardian as per the hospital consent policy. Provision of anesthesia for children undergoing elective surgical and allied procedures. The service will include preoperative assessment and preparation of Patients, and care during and after anesthesia.
Provision of high dependency and intensive care services appropriate to the type of surgery and arrangements for the stabilization and transfer of children requiring more specialized intensive care. Provision of a service for the relief of acute pain. Provision of resuscitation services. Parents will be encouraged to be involved in the care of their children.
Who does what!