Hospi lablec M4

• Medication Distribution

  • Responsibility of the pharmacy department

  • P&TC, pharmacy and nursing department

  → develop comprehensive policies and procedures: –Safe distribution of medicines and related supplies to inpatients and outpatients
• Medication Distribution

  • Preferred distribution system: UDDDS

  – Differs in form that depends on the specific needs, resources, and characteristics of each hospital

  –But, 4 characteristics are similar to all hospitals/institutions
• UDDDS – What is common?

  1. Contained and administered from, single unit or unit dose packages
  2. Ready-to-administer
  3. NMT a 24-hour supply of doses is provided to or available at the patientcare area
  4. Patient medication profile is concurrently maintained in the pharmacy
• Dispensing

  • Act of the pharmacist in supplying one or more drug products to a patient, usually in response to an order from a prescriber, utilizing his/her professional knowledge, judgement and skills
• Dispensing

  • Also includes: Planning, developing, controlling, monitoring, delivery, proper storage, administration and education
• Drug Distribution System • Manner in which medications/drugs are provided from the pharmacy department to the clinical unit

  • Includes the period of time from when the drug is dispensed until it is administered
• Responsibilities of the Pharmacist in drug distribution

  • 24 hour DISTRIBUTION and CONTROL of all medicines

  • Ensure AVAILABILITY and SUPPLY of medicines for the patients of the hospital

  • Ensure RATIONAL DRUG USE and PATIENT PHARMACEUTICAL CARE

  – By applying: Rule of Right
• Types of Drug Distribution System

  1. Floor Stock System
  2. Individual System
  3. Unit Dose Drug Distribution System (UDDDS)
• Floor Stock System • AKA: Ward Stock System• Advance storage of some drugs are stored in the nursing station

  • nurse - responsible for unit dose

  preparation, administration and refill
• Floor Stock System

  • Issuances of medicines for emergency use must be in controlled quantities
• Floor Stock System

  ADVANTAGES:

  • Readily available medicines for the patient

  • Less responsibility for the pharmacist
• Floor Stock System

  DISADVANTAGES

  • Increase hazards associated with dug deterioration

  • Added funds for proper storage of drugs patient care area

  • Additional nurse’s time required for handling medicines

  • Inaccurate patient charges
• Floor Stock System

  DISADVANTAGES

  • Increase mediation errors incidents

  – pharmacists has lesser chance to review medication orders

  • Increase drug inventory at each nursing station or other patient care areas

  • Pilferage
• Individual/Patient Prescription System

  • AKA: Patient Prescription System

  • Antiquated or old system

  • Patient-specific containers with 2 to 5 day supply of drugs delivered to and stored on nursing units
• Individual/Patient Prescription System

  • Medication orders:

  –Transcribed by: nurse

  – Reviewed by: pharmacist

  • No patient information is available to the pharmacist
• Individual/Patient Prescription System

  • Dispensing by individual medication order

  + limited floor stock items

  • Floor stock items are restricted to reduce errors
• Unit Dose Drug Distribution System (UDDDS)

  • Pharmacy coordinated method of dispensing and controlling medications

  • Applicable to all medications and for any route of administration
• Unit Dose Drug Distribution System (UDDDS)

  ADVANTAGES:

  • Improved pharmaceutical service

  • 24 hour doses of medication are issued and charged to patients

  • Nurses have more time for direct patient care
• Unit Dose Drug Distribution System (UDDDS)

  ADVANTAGES:

  • Creates double check system:

  – 1st check: Pharmacists can interpret and check medication, then dispenses

  – 2nd check: Nurses double checks medications, then administers

  – Reduces medication errors
• Unit Dose Drug Distribution System (UDDDS)

  ADVANTAGES:

  • Transfers responsibility of intravenous preparations and drug reconstitution to the pharmacy

  • Extends pharmacy coverage and control starting from time of prescribing up to the administering time
• Unit Dose Drug Distribution System (UDDDS)

  ADVANTAGES

  • Removes:

  – Duplication of order

  –Paper works at the nursing station and pharmacy

  – Revenue losses

  –Pilferage and wastage

  – Returns and credits
• Unit Dose Drug Distribution System (UDDDS)

  ADVANTAGES

  • Ensures identification of a drug product from the prescribing to administering

  • Pharmacist acts as a drug consultant through provision of professional advises needed for better patient care
• Unit Dose Drug Distribution System (UDDDS)

  • Can be applied following any of the 3 methods

  – centralized

  – de-centralized

  – Centralized + de-centralized
• Centralized - drug products are distributed to patients taken from central pharmacy
• Centralized + De-centralized

  • Start and emergency doses are taken from satellite pharmacy

  • Refill doses are taken from central pharmacy

  • All other operations such as packaging and IV additive preparation are from the central pharmacy
• Technology in drug distribution

  • Pneumatic Tube System

  • Automated Dispensing Cabinet

  • Robotic Drug Dispensing
• Pneumatic Tube System

  • AKA:

  - PTT

  - Air lift

  - Air transport

  - Pneumatic Transit System
• Pneumatic Tube System

  • Fast, simple, secure and reliable way of transporting small objects such as drugs

  • Transported across a building or between buildings, uses underground or overground pipes
• Pneumatic Tube System

  ADVANTAGES

  • Moves things up, down, or sideways

  • Soft, air-cushioned ride for fragile items

  • Less personnel, time and money

  • Secure connections between different parts of a building, reducing theft and accidental damage in transit
• Automated Dispensing Cabinet

  • Computerized drug storage device or cabinet

  • Provides the following at nursing stations:

  –Proper storage

  – Inventory control

  –Security
• Automated Dispensing Cabinet

  • Used only by authorized users who are authenticated by passwords

  • Locations:

  – wards

  – ICU
• Automated Dispensing Cabinet

  ADVANTAGES:

  • Commonly needed drugs are at point of care

  • Reduce nurse’s workload

  • Multifactor authentication for controlled substances

  • Improve patient safety by providing:

  – Drug allergy alerts

  – Drug-drug interaction

  – Advice on high risk medications
• Robotic Drug Dispensing

  • Stores up to 35,000 medicines

  • Dispenses around 12 prescription in less than a minute

  • Reduced patient’s waiting time
• Robotic Drug Dispensing

  • Dispensing process is paper free,

  – Robot stores the prescription as soon as a doctor documents it electronically

  • Pharmacist focuses on giving the correct instructions on taking the drug
• Unit Dose Drug Distribution System (UDDDS)