Institutional Drug Distribution Systems

Institutional Drug Distribution Systems

Learning Objectives
  • Explain the goal of hospital pharmacy.
  • List services that hospital pharmacy departments provide.
  • Examine the scope of practice and professional responsibilities of a hospital pharmacy technician and pharmacist.
  • Compare the benefits and risks of various institutional drug distribution systems.
Overview of Drug Distribution Systems
  • Vary across institutions.
  • Create a safe and effective system of drug supply and distribution.
  • Address dispensing processes that pharmacy technicians and pharmacists perform.
Types of Institutional Drug Distribution Systems
  • Traditional Drug Distribution (Patient Prescription System): Individual patient orders, multiday supply dispensed from pharmacy.
  • Unit-Dose Cart Exchange: Medications prepared in single doses.
  • Floor Stock System: Stock on nursing units for immediate access.
  • Automated Dispensing Cabinets: Electronic cabinets for dispensing medications.
Role of Pharmacy Technicians
  • Prepare and deliver medications.
  • Maintain inventory, including controlled substances.
  • Perform medication order entry and verify for accuracy.
Hospital Overview
  • Hospitals provide a range of medical care.
  • Types of hospitals differ based on services offered and size (bed capacity).
  • Two pharmacy organization types: central and satellite.
Goals and Responsibilities
  • Primary Mission of Hospital Pharmacy: Manage medication use to optimize patient outcomes.
  • Includes selecting, procuring, delivering, and reviewing medication.
Services Provided by Hospital Pharmacy Departments
  • Satellite pharmacies for patient care units.
  • Clinical pharmacists provide monitoring and consultations.
  • Outpatient services and medication delivery to units.
  • Emergency protocols for medication and IV admixture programs.
  • Educational support for pharmacy students.
Scope of Practice
  • Hospital Pharmacy Technician:
    • Processes medication orders, maintains profiles, prepares medications.
    • Inventory management and controlled substance handling.
  • Hospital Pharmacist:
    • Provides drug information, final verification, and oversees medication plans.
Responsibilities of Pharmacy Technicians
  1. Medication Preparation and Filling: Accurate labeling and dispensing of medications.
  2. Administrative Functions: Reporting and managing inventory records.
  3. Narcotics Management: Controlled substances handled with strict guidelines.
  4. Inventory Management: Ordering/purchasing of medication supplies.
  5. Prepackaging: Preparing unit doses from bulk supplies.
Independent Double Check Process
  • Technicians certified to check work for accuracy before dispensing to ensure safety.
Comparing Distribution Systems
  • Benefits: Improved drug control and reduced errors.
  • Risks: Potential for errors with floor stock systems, less oversight.
Automated Dispensing Systems (e.g., Pyxis and Omnicell)
  • Enhance security and access to medications.
  • Systems require unique identification to use.
  • Reduce errors and improve efficiency in medication distribution.
Emergency Drug Procedures
  • Crash Carts: Stocked with emergency medications, monitored for content accuracy.
Inventory Management
  • Inventory Control Concepts: Visual short lists, minimum/maximum systems, perpetual systems.
  • Pharmaceutical Suppliers: Drugs sourced from wholesalers or directly from manufacturers.
  • Group Purchasing Organizations: Facilitate bulk purchasing agreements for cost savings.
Key Points on Controlled Substances
  • Strict regulations govern the management of controlled substances in hospitals:
    • Must be securely stored and tracked.
    • Inventory should be regularly audited.
    • Waste and disposal of controlled substances must follow legal regulations.
Diversion Prevention Strategies
  • Continuous monitoring of inventory, audit trails, and secure storage measures are crucial to prevent the misuse of controlled substances.
Conclusion
  • Understanding the various institutional drug distribution systems is vital for pharmacy technicians and professionals to ensure safe, effective medication management within hospitals.