Introduction To Hospital Pharmacy Flashcards
Explain what the medical assessment unit is (2)
1) where medical patients are first admitted to hospital
2) main aims are to assess patients, make diagnosis and plan initial treatment
List the staff involved in medicines in a hospital (5)
1) trust chief executive- has overall responsibility for medicines supply
2) chief pharmacist- responsible for ensuring systems in place for all aspects of safe and secure handling of medicines in the trust
3) nurse ward manger - responsible for safe keeping of medicines on the ward
4) responsible pharmacist- if the pharmacy is registered with the GPhC
- hospital pharmacists don’t have to be registered as long as only supply medicines to their own patients
- do need to be registered to wholesale or sell OTCs
- often the screening pharmacist acts as the responsible pharmacist
5) pharmacists
- pre reg trainee, complete post grad diploma, specialise , management and consultant pharmacist
- pharmacy technicians
- pharmacy assistants- not registered with GPhC
- pharmacy porters
Outline the role of a pharmacist on a ward (6)
1) pharmacists visit all new patients:
- asses patients own drugs
- carries our medicines recollection - takes a drug history, compares it to prescription chart , resolves problems
2) carries our clinical assessment and monitoring of treatment
3) counsel patients on ensuring medicines are in date
4) checks inhaler techniques if patient is using an inhaler
5) orders more medicines if the patient is running out
6) supplies medicines ready for patients discharge
- pharmacists also provide advice on anything relating to medicines e.g different formulations if patients are having difficulty swallowing for example.
Outline when hospitals are exempt from the need for prescriptions (3)
1) the sale or supply is made as part of its “normal” business I.e treating patients
2) the medicine is to be given to a specific person in accordance with written directions ( a patient specific direction- can be on drug chart or just an entry in the medical notes)
3) the medicine is to be given to the patient by an appropriate healthcare practitioner (e.g. Nurse, pharmacist, pharmacy technician etc)
- hospital drug charts do not need to conform to the usual legal prescription requirements, unless they are used to supply discharge medicines
Define the term polypharmacy
When a patient is on a lot of drugs
Are patient information leaflets a legal requirement for inpatients. (3, 3)
- no they are not legally required for inpatient items although they are often supplied anyway
- but they should be held in the pharmacy and provided on request for patients/staff
- patient information leaflets (PILs) should be provided for outpatients and TTOs
- other information e.g. Warfarin , steroid , methotrexate cards should be issued where necessary
- additional information e.g for unlicensed medicines
- information for community pharmacists e.g. How to obtain specials
Describe how medicines are supplied to a ward (4)
1) pharmacist or technician transcribes order ( paper or electronic) -sends it to dispensary
2) item labelled and dispensed (technician , assistant or robot)
3) item checked for accuracy ( pharmacist , ACT or robot)
4) item returned to ward via Porter or nurse in a sealed bag
What is the trust formulary
A list of products approved for use in the trust
What are hospital pharmacy stores (3)
HPS’s function as a distribution warehouse for all inventories required for patient care services.
- the ward usually has a stock list of commonly used items, these are topped up regularly by pharmacy assistants and technicians via stores
- effective purchasing is very important:
Cost quality and continuous supply , generic substitutions, purchasing contracts, trust formulary
List the important documents in the development of hospital pharmacy services (5)
1) 1986 the Nuffield report - clinical pharmacy should be practiced in all hospitals, 24 hour cover for pharmacy services, Skills of support staff utilised
2) 2000 pharmacy in the future - one stop dispensing, Self administration, Pharmacist visits to admission wards
3) 2001 a spoon full of sugar - automation of medicines supply, Electronic prescribing, Original pack dispensing, one stop dispensing
4) 2013 Francis report - need to improve openness, put the patient first, strong leadership , high standards of care
5) 2014 RPS standards for hospital pharmacy services
Technical services in a hospital can make items to order . List items that are made to order in the hospital (3)
1) chemotherapy
2) intravenous nutrition/ feeds
3) creams, ointments , eye drops
- special facilities needed to avoid contamination
Describe the process of making chemotherapy (6)
1) pharmacist screens chemo prescription
2) technician writes worksheet, which is checked by another technician
3) assistant sets up the ingredients & equipment needed
4) technician makes chemotherapy
5) pharmacist carries out final check and product release
6) nurse administers chemo
What is an on call pharmacist (3)
- intended for urgent items only , pharmacist is available at anytime
- on call services may be delivered from home or through a residency service
- the need for a 24hour service was highlight By the Nuffield report
Outline what happens to a discharge patients to ensure they have the right medicines (5)
1) when the patient feels better the doctor writes a TTO( to take out)
2) nurse beeps pharmacist to screen it
3) TTO is supplied using the patients own drugs and extra dispensed items
4) medicines are supplied in a green bag
5) pharmacy technician counsels patient on the new medicine
