Part 1 [1.2] Healthcare as a System: Hospital Pharmacy

Comprehensive review flashcards on hospital pharmacy systems, pharmacist responsibilities, practice standards (PhilPSP 2.0), and hospital pharmacy divisions based on Pharm Sci 152.

Hospital Pharmacy

The department wherein legally qualified and professionally competent pharmacists perform: procurement, storage, compounding, manufacturing, packaging, controlling, assaying, dispensing, distribution, and monitoring of medications through drug therapy management for hospitalized and ambulatory patients.

Hospital Pharmacy

The practice of pharmacy in a hospital setting and in any of its facilities or services.

Central Pharmacist and Ambulatory Pharmacist

The two main types of pharmacist in the hospital setting

Policy Statement

This dictates all that must be done.

Procedure

This answers how exactly a task shall be done.

IV Admixture

Intravenous fluids mixed with one or more sterile products.

Unit Dose

Ready-to-administer solid dosage drugs prepared for individual patient use, typically packaged using an Automated Dispensing Cabinet.

Automated Dispensing Cabinet (ADC)

An automated machine that repackages solid dosage forms into unit-dose strip packaging.

Biorefrigerator

Storage for biological substances.

Double-Locked Cabinet

Storage for drugs in need of proper security, such as narcotics.

A.O. No. 63 s. 1989

Department of Health rules and regulations implementing dispensing requirements under the Generics Act of 1988 (RA No. 6675), requiring patients or relatives upon admission to indicate in writing whether they submit to hospital drug policies or reserve the option to purchase medicines outside.

Pharmaceutical Manufacturing

Large-scale production of medicine; you do not care who the individual recipient is.

Extemporaneous Compounding

Small-scale preparation of a drug product tailored specifically for a patient or individual.

Dispensing Pharmacist

An entry-level hospital pharmacy position for a RPh, typically provided with training for the first 2 weeks.

Graveyard Shift

The hospital pharmacy dispensing shift operating from 10 PM - 6 AM noted for having the most available time to perform cleaning.

Regularization

Shift from probationary status to regular status upon passing the employee evaluation in 6 months, securing long-term employment.

Hospital Pharmacist

Person who supervises drug administration.

Registered Nurse

Person who performs drug administration.

Medication and Treatment Record (MTR) Form

The official form wherein the bedside nurse must note every administered dose.

Uncharted Dose

When a bedside nurse fails to note the dose administered in the MTR.

Unit Dose Pharmacist

The hospital pharmacist who accounts for all given doses daily and issues medication error forms for uncharted doses.

Automatic Stop Order Policy (ASOP)

Policy implemented when a patient goes to the operating room or is transferred to another hospital service.

7 days

The number of days for an ASOP to apply to antibiotics if the prescribing physician did not order its continuation.

Wrong Administration Technique Error

A citation issued when proper drug administration techniques are not performed.

Floor Stock Drugs

Medications stored directly within nursing units for immediate access, requiring continuous 24/7 replenishment and is subject to surprise inspections.

Inventory Pharmacist

The pharmacist who manages floor stock drugs in each nursing unit, ensures immediate 24/7 replenishment, and conducts surprise inspections.

Senior Nurse

The nursing personnel who holds the lock and key for floor stock drug cabinets to prevent pilferage.

Clinical Pharmacist

A pharmacist who handles direct patient care, conducts medication reconciliation, monitors therapies, and rounds with physicians.

Formulary Drugs

Drugs acquired from the hospital pharmacy department; Written on the MTR, which is an official document under the Patient chart.

Non-Formulary Drugs

Drugs brought into the hospital from outside by the patient; Administered by a private RN, which is recorded on an unofficial chart, usually pasted on the wall; clears the hospital of accountability.

Patient Medication Profile (PMP)

A clinical record that tracks all of the medications taken by a patient.

Antibiotics

Type of drug that is specifically counted on a daily basis in the PMP.

Medication Reconciliation (MedRec)

The formal taking of history of medications by a clinical pharmacist for each and every patient.

Patient Medication History

An official clinical form used to record all past and current prescription, nonprescription, complementary, and alternative medications taken by a patient.

Therapeutic Drug Monitoring (TDM)

A specialized clinical pharmacy service where patient blood samples are analyzed to determine whether drug concentrations are therapeutic, subtherapeutic, or toxic.

Drug Therapy Monitoring & Assessment Form

A clinical documentation form used to evaluate drug-drug interactions, food interactions, adverse reactions, and recommend dosing modifications to physicians.

Object

The drug displaced by the drug-drug interaction.

Precipitant

The drug that displaces the object in a drug-drug interaction.

Self-administered and Discharge medications

Types of medications that a pharmacist must counsel patients on before they leave the hospital.

Drug Information Sheet/Rx Acknowledgement

A sticker placed on the patient’s chart as proof that patient counselling service was provided by the Pharmacy Department to the patient.

Ambulatory Pharmacist

A hospital pharmacist whose unique responsibilities include checking supportive personnel's dispensing accuracy and preparing supplies and IV medications for patient home care.

Pharmacy Aide

Supportive hospital pharmacy personnel whose work in the dispensing area is checked for accuracy by the ambulatory pharmacist.

Philippine Practice Standards for Pharmacists 2.0 (PhilPSP 2.0)

Published by the Philippine Pharmacists Association to establish common competencies and standards across five pharmacy practice areas.

Common Competency 1 [CC 1]

Places client and patient’s welfare at the center of practice.

Common Competency 2 [CC 2]

Practices in an ethical, legal, and professional manner.

Common Competency 3 [CC 3]

Displays leadership, management, and entrepreneurial skills.

Common Competency 4 [CC 4]

Demonstrates cultural competence and communicates effectively.

Common Competency 5 [CC 5]

Exhibits effective collaboration.

Common Competency 6 [CC 6]

Commits oneself to continuing professional development.

Common Competency 7 [CC 7]

Engages actively in health product vigilance activities.

Common Competency 8 [CC 8]

Performs the role of an educator to support the professional development of colleagues and the future pharmacists.

Common Competency 9 [CC 9]

Optimizes digital health to deliver pharmaceutical services and advance pharmacy research.

Academic Pharmacy, Industrial Pharmacy, Community and Institutional Pharmacy, Hospital Pharmacy, Public Health Pharmacy

The five major practice areas of PhilPSP 2.0

Industrial Pharmacy Standard 1 [IP1]

Contributes to pharmaceutical product lifecycle management.

Industrial Pharmacy Standard 2 [IP2]

Participates in quality management system (QMS).

Industrial Pharmacy Standard 3 [IP3]

Participates in health product vigilance programs

Industrial Pharmacy Standard 4 [IP4]

Represents the organization to regulatory authorities.

Industrial Pharmacy Standard 5 [IP5]

Participates in the development and implementation of regulatory guidelines.

Hospital Pharmacy Standard 1 [HP 1]

Works in collaboration with other healthcare providers to optimize patient care in the hospital setting.

Hospital Pharmacy Standard 2 [HP 2]

Manages the hospital formulary and pharmaceutical inventory inside the hospital.

Hospital Pharmacy Standard 3 [HP 3]

Manages drug information services in the hospital setting.

Hospital Pharmacy Standard 4 [HP 4]

Distributes medicines and other health products appropriate to the needs of clients and patients.

Hospital Pharmacy Standard 5 [HP 5]

Compounds products in a manner that ensures product quality, safety, and efficacy in the hospital setting.