[1.2] Healthcare as a System: Hospital Pharmacy_LONG

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 practice of pharmacy in a hospital setting and in any of its facilities or services, wherein legally qualified and professionally competent pharmacists perform procurement, storage, compounding, manufacturing, packaging, controlling, assaying, dispensing, and distribution.

Drug Therapy Management

The systematic monitoring of medications conducted by pharmacists for hospitalized and ambulatory patients.

Central Pharmacist

One of the two primary types of hospital pharmacists, whose responsibilities encompass both the dispensing area and patient-care areas.

Policy Statement

An official directive within the hospital pharmacy that dictates all that must be done.

Procedure

A detailed operational protocol within the hospital pharmacy that answers how exactly a task or policy shall be carried out.

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, but cannot compound drugs in liquid dosage forms.

Biorefrigerator

A dedicated cold storage unit utilized specifically for the storage of biological substances in the pharmacy.

Double-Locked Cabinet

A storage cabinet secured with two separate locks, designated for medications requiring strict legal 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 where the manufacturer does not focus on who the individual recipient of the batch is.

Extemporaneous Compounding

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

Dispensing Pharmacist

An entry-level hospital pharmacy position for a registered pharmacist, typically provided with training for the first $2\text{ weeks}$.

Graveyard Shift

The hospital pharmacy dispensing shift operating from $10\text{ PM}$ to $6\text{ AM}$, noted for having the most available time to perform cleaning.

Regularization

The transition of a pharmacy employee from probationary status to regular status upon passing the employee evaluation at $6\text{ months}$, securing long-term employment.

Supervision of Drug Administration

The division of responsibilities in patient care where the hospital pharmacist supervises drug administration, while the registered nurse performs the actual administration.

Pre-Compounding Verification Call

The practical routine where the registered pharmacist telephones the ordering clinical unit to double-check medication orders prior to compounding.

Medication and Treatment Record (MTR) Form

The official bedside chart document wherein the bedside nurse must record every administered dose.

Uncharted Dose

A medication administration failure and demerit that occurs when a bedside nurse fails to document an administered dose on the MTR form.

Unit Dose Pharmacist

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

Automatic Stop Order Policy (ASOP)

A policy mandating that standing medication orders are automatically discontinued when a patient goes to the operating room or is transferred to another hospital service.

Antibiotic Automatic Stop Order

A clinical policy mandate under which antibiotic orders are automatically stopped on day $7$ unless the prescribing physician explicitly orders their continuation.

Wrong Administration Technique Error

A clinical citation issued when a registered nurse fails to adhere to established, correct techniques during drug administration.

Floor Stock Drugs

Medications stored directly within nursing units for immediate access, requiring continuous $24/7$ replenishment and 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 (Floor Stock Custody)

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

Clinical Pharmacist

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

Formulary Drugs

Medications acquired directly from the hospital pharmacy department and charted on the official Medication and Treatment Record (MTR).

Non-Formulary Drugs

Medications brought into the hospital from outside by the patient, administered by a private RN, and recorded on an unofficial chart to clear the hospital of accountability.

Patient Medication Profile (PMP)

A clinical record that tracks a patient's standing, PRN, and nebulization medications, alongside working diagnoses and known allergies.

Daily Antibiotic Accounting

The pharmacy practice in patient-care areas where antibiotics are specifically counted on a daily basis.

Medication Reconciliation (MedRec)

The formal process where a clinical pharmacist systematically obtains and reviews the complete medication history for each and every patient.

Patient Medication History Form

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

Clinical Pharmacy Service Coverage

Continuous clinical pharmacy care provided $24/7$, with morning (AM) shift pharmacists ideally joining the attending physicians' medical rounds.

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 specific drug that is displaced or adversely affected during a drug-drug interaction.

Precipitant

The drug that displaces or alters the disposition of the object drug in a drug-drug interaction.

Shared Accountability Documentation

The procedure where accepted pharmacist recommendations are written directly into the patient's chart alongside both the pharmacist's and physician's names.

Rejected Recommendation Protocol

The clinical documentation requirement where an attending physician must record the specific reason directly on the assessment form if a pharmacist's recommendation is rejected.

Self-Administered Medication Counseling

Direct patient education provided by clinical pharmacists regarding instructions and precautions for drugs that patients must administer themselves.

Discharge Medication Counseling

Clinical counseling provided to patients upon hospital discharge to ensure proper adherence, regimen understanding, and home medication safety.

DIS/Rx Acknowledgement

A signed form verifying that a Drug Information Sheet or home medication directions were explained by the pharmacy and acknowledged by the patient or their representative.

Patient Counseling Sticker

An official sticker placed on the patient's chart serving as documentation and proof that patient counseling service was provided by the pharmacy department.

Emergency Medication Double-Check

A safety requirement mandating that all drugs utilized during cardiopulmonary emergency cases be double-checked immediately by the pharmacist.

Pharmacist Cardiopulmonary Resuscitation Role

The emergency role wherein hospital pharmacists procure and prepare emergency drugs, chart all administered medications, and perform pulmonary resuscitation if necessary.

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.

PhilPSP 2.0

Philippine Practice Standards for Pharmacists 2.0, published by the Philippine Pharmacists Association, Inc. (2025), establishing common competencies and standards across five pharmacy practice areas.

Common Competency 1 [CC 1]

PhilPSP 2.0 standard stating that the pharmacist places client and patient's welfare at the center of practice.

Common Competency 2 [CC 2]

PhilPSP 2.0 standard stating that the pharmacist practices in an ethical, legal, and professional manner.

Common Competency 3 [CC 3]

PhilPSP 2.0 standard stating that the pharmacist displays leadership, management, and entrepreneurial skills.

Common Competency 4 [CC 4]

PhilPSP 2.0 standard stating that the pharmacist demonstrates cultural competence and communicates effectively.

Common Competency 5 [CC 5]

PhilPSP 2.0 standard stating that the pharmacist exhibits effective collaboration.

Common Competency 6 [CC 6]

PhilPSP 2.0 standard stating that the pharmacist commits oneself to continuing professional development.

Common Competency 7 [CC 7]

PhilPSP 2.0 standard stating that the pharmacist engages actively in health product vigilance activities.

Common Competency 8 [CC 8]

PhilPSP 2.0 standard stating that the pharmacist performs the role of an educator to support the professional development of colleagues and future pharmacists.

Common Competency 9 [CC 9]

PhilPSP 2.0 standard stating that the pharmacist optimizes digital health to deliver pharmaceutical services and advance pharmacy research.

Academic Pharmacy (Practice Area No. 1)

The first major competency practice area identified under the PhilPSP 2.0 common standards framework.

Industrial Pharmacy (Practice Area No. 2)

The second major competency practice area under PhilPSP 2.0, focusing on pharmaceutical product lifecycle management, QMS, vigilance, and regulatory affairs.

Community and Institutional Pharmacy (Practice Area No. 3)

The third major competency practice area categorized under the PhilPSP 2.0 framework.

Hospital Pharmacy (Practice Area No. 4)

The fourth major competency practice area under PhilPSP 2.0, encompassing clinical services, formulary management, dispensing, compounding, and antimicrobial stewardship.

Public Health Pharmacy (Practice Area No. 5)

The fifth major competency practice area recognized under the PhilPSP 2.0 common standards framework.

Industrial Pharmacy Standard 1 [IP 1]

PhilPSP 2.0 industrial standard: Contributes to pharmaceutical product lifecycle management.

Industrial Pharmacy Standard 2 [IP 2]

PhilPSP 2.0 industrial standard: Participates in quality management system (QMS).

Industrial Pharmacy Standard 3 [IP 3]

PhilPSP 2.0 industrial standard: Participates in health product vigilance programs.

Industrial Pharmacy Standard 4 [IP 4]

PhilPSP 2.0 industrial standard: Represents the organization to regulatory authorities.

Industrial Pharmacy Standard 5 [IP 5]

PhilPSP 2.0 industrial standard: Participates in the development and implementation of regulatory guidelines.

Hospital Pharmacy Standard 1 [HP 1]

PhilPSP 2.0 hospital standard: Works in collaboration with other healthcare providers to optimize patient care in the hospital setting.

Hospital Pharmacy Standard 2 [HP 2]

PhilPSP 2.0 hospital standard: Manages the hospital formulary and pharmaceutical inventory inside the hospital.

Hospital Pharmacy Standard 3 [HP 3]

PhilPSP 2.0 hospital standard: Manages drug information services in the hospital setting.

Hospital Pharmacy Standard 4 [HP 4]

PhilPSP 2.0 hospital standard: Distributes medicines and other health products appropriate to the needs of clients and patients.

Hospital Pharmacy Standard 5 [HP 5]

PhilPSP 2.0 hospital standard: Compounds products in a manner that ensures product quality, safety, and efficacy in the hospital setting.

Hospital Pharmacy Standard 6 [HP 6]

PhilPSP 2.0 hospital standard: Provides client- and patient-centered clinical pharmacy services at the point of care.

Hospital Pharmacy Standard 7 [HP 7]

PhilPSP 2.0 hospital standard: Leads antimicrobial stewardship to prevent antimicrobial resistance and to control and prevent infection in the hospital setting.

Hospital Pharmacy Standard 8 [HP 8]

PhilPSP 2.0 hospital standard: Participates in specialized pharmaceutical services in the hospital.

Administrative Services Division

The hospital pharmacy division staffed by Managers, Administrators, and Department Heads that plans departmental activities, develops policies, schedules staff, and coordinates with the PTC.

Chief Pharmacist

The highest ranking pharmacist in the hospital pharmacy, who serves as the secretary of the Pharmacy and Therapeutics Committee (PTC).

In-Patient Services Division

The division responsible for providing medications for all hospital in-patients on a $24\text{-hour/day}$ basis, inspecting drugs in treatment areas, and cooperating with medical drug research.

Education & Training Division

The division that trains newly employed pharmacy personnel, coordinates pharmacy student programs, and participates in hospital-wide educational programs involving doctors and nurses.

Internships

Undergraduate educational training programs coordinated by the Education & Training Division for pharmacy students.

Externships

Graduate educational training programs coordinated by the Education & Training Division for pharmacy students.

Outpatient Services Division

The division responsible for compounding and dispensing outpatient prescriptions, inspecting clinic and emergency stations, maintaining Rx records, and consulting staff and medical students.

Pharmaceutical Research Division

The division primarily led by the Clinical Trial Pharmacist that develops new formulations of research drugs, improves existing formulations, and cooperates with medical research staff.

Clinical Trial Pharmacist

A hospital pharmacist who works directly in the hospital to monitor patients enrolled in clinical trials within the Pharmaceutical Research Division.

Contract Research Organization (CRO)

A third-party organization hired by hospital owners to conduct clinical trials, offering high-paying roles (with salaries reaching $6\text{ digits}$) that may not require a registered pharmacist license.

Drug Information Services Division

The division functioning as the hospital's mini-library facility, preparing pharmacy newsletters, maintaining literature files, and providing drug therapy consultations to health professionals.

Central Supply Services Division

A dedicated pharmacy division, distinct and separate from the hospital's central supply, that coordinates the distribution of medical supplies and irrigating fluids.

Departmental Services Division

The division that controls and dispenses IV fluids and controlled substances, and coordinates all drug delivery and distribution systems throughout the hospital.

Purchasing & Inventory Control Division

The division responsible for purchasing, receiving, storing, distributing, and controlling drug inventory, and the only division permitted to interview medical service representatives.

Medical Service Representatives Interview Rule

The operational rule dictating that only the Purchasing & Inventory Control Division is authorized to entertain and interview medical service representatives.

Manufacturing & Packaging Division

The division that manufactures items in common hospital use, manages drug packaging and prepackaging programs, develops products, and maintains a unit dose program.

Sterile Products Division

The division responsible for manufacturing sterile ophthalmics, irrigating solutions, small volume parenterals, and preparing aseptic dilutions of lyophilized and unstable sterile injections.

Small Volume Parenterals (SVPs)

Sterile injectable solutions manufactured by the Sterile Products Division in volumes up to $50\,\text{mL}$.

Aseptic Technique (No-Touch Approach)

A sterile compounding procedure used in the Sterile Products Division that requires a strict no-touch approach during the manipulation of sterile components.

Bunny Suit

A specialized full-body sterile garment donned in sterile processing that must remain sterile at all times by minimizing touches and keeping it completely off the floor.

Assay and Quality Control Division

The division that performs analytical testing on manufactured and purchased products, develops assay procedures adhering to Pharmacopeial standards, and assists research formulations.

Radiopharmaceutical Services Division

The division (also called Radio Pharmacy or Nuclear Pharmacy) that centralizes the procurement, storage, and dispensing of radioisotopes, ensuring the efficacious use of radioactive materials.

IV Admixture Division

The division that centralizes the preparation of intravenous solution admixtures, screens each order for physicochemical incompatibilities, and houses the IV Pharmacist within the Clean Room.