ASSIGNMENT 1

ON

PHARMACY SERVICES

SUBMITTED BY: SANDEEP SINGH

MHA (1ST SEM)

DEPARTMENT : SPORTS MEDICINE AND PHYSIOTHERAPY

SUBMITTED TO: DR. B.R.NANDA

CONTENTS

1) Layout and Physical Facilities For Medical Store Designing a Drug Store Location and Layout of the Hospital Pharmacy Layout Flow charts for Materials and Members

General Flow Chart Out Patients General Flow Chart In Patients General Flow Chart for Materials

Selection of Site Space, Layout & Design For Community Pharmacy Plan an Ideal Retail and Whole sale Store Legal Requirements

General Licenses Restricted Licenses

Physical Facility Personal and Floor space Requirement including Equipments

2) Staff Selection Of Staff Compensation

3) Receipt of drugs What is a Drug? Requisition, Supply and Receipt of Drugs

Drug request Completing Stores Requisition/ Delivery (issue) Form

Supply of Drugs from Medical Stores Store Requisition / Delivery (issue) Form Receipt of drugs at Dispensary

4) Disposal of Expired Drugs5) Drug Safety6) Unit dose dispensing

What is UDD ADVANTAGES

7) Guidelines To Minimize Pilerage of Drugs8) Hathi Committee Recommendation For Hospital Pharmacy

Layout & Physical Facilities for Medicine StoreHospital pharmacy is one of the most important departments among the several departments of the hospital. Hospital pharmacy may be defined as that department of the hospital which deals with procurement, storage, compounding, dispensing, manufacturing, testing, packaging and distribution of drugs.

Designing a Drug Store

Designing a drugstore needs to provide both convenience for the people working there and those shopping there. The layout must be welcoming, have inviting department colors, convenient navigation and easy-to-identify signage. The pharmacy must provide a complete shopping experience for customers needing health aids ranging from prescriptions to toiletries.

Location and layout of the Hospital Pharmacy

It should be located in hospital premises so that patients and staff can easily approach it. In multi- storied building of the hospital, the pharmacy should be preferably located on the ground floor especially the dispensing unit.

Outpatient pharmacy should give pleasant appearance and must have enough space for seating of patients who have to wait for medicines. It should have educative posters on the health and hygiene and light literature for reading.

Space must be provided for routine manufacturing of stock solution, bulk powder, ointments etc. The manufacturing room should be adjacent to the pharmacy.

Medical stores of a pharmacy should be adjacent to the pharmacy itself or should be directly connected to pharmacy. Pharmacy receives materials from two sources :

1. Medical stores2. Manufacturing division of the hospital

Layout

Typical layout of hospital pharmacy

Flow charts for materials and men

a) General flow chart out patients

b) General flow chart for In patients

c) General Flow chart for Materials

Selection of Site Space, Layout and Design for community pharmacy

Various factors should be considered during the selection of a site for a new pharmacy. Such as population in the trading area, distribution of the income among the population, type of industry and the competitive climate.

During the selection of a site for new pharmacy following factors should be considered:

A needy town or city should be selected. Site of pharmacy in a particular city should be most suitable among those available. Site of pharmacy should be convenient and accessible to the majority of consumers. For this purpose site

location should be centre to population to be served. Pharmacy site should be equipped with adequate free parking facility. If possible then site should be in neighborhood of a community shopping centre for the convenience and

accessibility of the consumers. An island type of location, where the pharmacy sites by itself in a main traffic artery and surrounded by

adequate parking facility, should be preferred. Usually, a bargain location in terms of rent proves to be a liability rather than an asset in the long run.

Plan of an Ideal Retail and Whole Sale Drug Store

One of the main factors responsible for the success of a drug store its location and proper layout design. An ideal plan for proper layout design of a retail drug store and whole sale drug store.

Objective of layout design

1. To attract a large number of customer.

2. To increase the sale of a store.

3. To reduce the selling expenses to a minimum.

4. To provide the customer satisfaction.

5. To have space for reserve for stock, office and resting place for the employees.

6. To have a proper entrance for coming goods.

7. To project a professional image and improve general appearance.

8. To minimize the movement of customers within the premises of the drug store.

A modern drug store should fulfill all the requirements in schedule ‘N’ of the drug and cosmetic rules, 1945. To start a retail drug store a minimum of 150 sq. meter area is required similarly to whole sale drug store a minimum of 200 sq. meter area is required.

The legal requirements for the establishment of retail drug store. For retail sale two types of licenses are issued.

1. General licenses

2. Restricted licenses

General licenses: General licenses are granted to persons who have the premises for the business and who engage the services of a qualified person to supervise the sale of drug store.

Licenses for retail sale of drugs other than those specified in schedule C,C1 and X are issued in form 20 for drug specified in C, C1 excluding those specified in schedule X in form 21 and for schedule X drugs in form 20F.

Condition for general licenses:

1. The licenses should be displayed in prominent place in a part of premises open to the public.

2. The licenses should comply with the provisions of drugs and cosmetics act and rules there under in force.

3. Any change in the qualified staff should be reported to the licensing authority within one month.

4. Precaution prescribed by the licensing authority for the storage of schedule C and C1 drugs should be observed.

5. For the sale of additional categories of drugs listed in schedule C, C1 excluding X the licensee must take prior permission of the licensing authority.

Restricted licenses: The licenses for the restricted sale of drug other than those specified in schedule C, C1 and X and those specified in schedule C and C1 but not in schedule X are issued in form 20A and 21A respectively.

Condition for restricted licenses:

1. The licensee must have adequate premises equipped with facilities for the proper storage of drugs to which the licenses applies provided that this condition does apply to vendors.

2. Licensee should be complying with the provisions of the drugs and cosmetics act and rules there under in force.

3. Drugs only purchased from a duly licensed dealer or manufacturer.

4. The licenses can deal only in such drug as can be sold without the supervision of qualified person.

5. Drugs should be sold in their original container.

Physical facility

The extent of pharmacy’s physical facility is determined by the size and the services provided. A large pharmacy department might have the following sections

Administrative office Bulk storage Narcotic or dangerous drug locker Manufacturing and repackaging Intravenous solution compounding Inpatient dispensing Outpatient dispensing In case of Hospital Pharmacy Medicine information resource centre Emergency medicine storage

Personnel and floor space requirements including equipments based on individual and basic needs

There are variations in the size of floor space devoted to the pharmacy in hospitals of the same size and type.In smaller hospitals with one pharmacist only one room is usually required for the pharmacy having a combination of dispensing, manufacturing, administrative and all other sections of complete pharmaceutical services. When sterile products are to be prepared there should be separate room or area for such work. An area of this type is required for reconstitution of lyophilized injections into syringes and for the preparation of intravenous admixture, all of which must be sterile.Hospitals with 200 or more beds provide the opportunity for departmentalization of pharmacy activities. There should be a separate area for in-patient services and unit dose dispensing, out-patient services, an office for the chief pharmacist, a compounding, pre packing and labeling room, a store room, sterile product and IV admixture room. A separate area for drug information services and space assigned on various nursing units for unit dose drug administration and clinical pharmacy service.

Floor space requirement

The pharmacy requires a minimum of 250 sq. feet for any sized hospital. From that point onward, basic requirements from 10 square feet per bed in 100 bedded hospital, 6 square feet in 200 bedded hospitals and an average of at least 5 square feet per bed in large hospital.

The floor of pharmacy should be smooth, easily washable and acid resistant. In manufacturing sections, drains should be provided; walls should be smooth, painted in light colour. The wooden cabinets are enameled or laminated. Fluorescent lamps are placed immediately above the prescription counter. Gas outlets are required on the work table or counter for the Bunsen burners.

Equipments

The usual equipments are:1) Prescription case2) Drug stock cabinets with proper shelves and drawers.3) Sectional drawer cabinets with cupboard bases.4) Work tables and counters for routine dispensing.5) Sink with drain board.6) Cabinet to store mortars and pestles.7) Cabinet for glass utensils, flasks, funnels and beakers.8) Refrigerator of suitable capacity.9) Narcotics safe with individually locked drawers.10) Office desk with telephone connection and file cabinet.11) Shelf space for pharmacy library.12) Dispensing window for nurses and out- patient.

The parenterals are prepared in separate room in large hospitals. They are equipped with water still, workbench, cabinets, resistant glass storage tanks, burettes, sintered glass filters, bottle racks, adjustable metal shelves, double sink with drain boards, pressure sterilizer etc.

Depending upon the type of manufacturing undertaken in hospital equipments such as ointment mills, mixing machines, collapsible machines, fibers, powder mixtures, granulators, tablet compressing machines and filter presses may be considered for installation in a hospital.

Personnel

The organized hospital department has an integrated set up consisting of dispensing section, manufacturing section, quality control section and clinical pharmacy.

1) There are no standard rules regarding the requirement of personnel for in-patient pharmacy department and it is the nature and quantum of services to be provided that governs the personnel requirement.

2) The number of pharmacists required for a hospital is calculated on the basis of workload, like the number of prescription received and dispensed number of beds available. For a very small hospital minimum of 3 pharmacists are required. As the number of beds increase, the number of pharmacists also increases.

3) The pharmacist should possess adequate pharmacy qualification and experience. The overall charge of the in-patient department should remain with the chief- pharmacist.

4) The following is suggested staff pattern of pharmacists.

Pharmacist requirement

Bed strength No. of Pharmacists requiredUpto 50 beds 3Upto 100 beds 5Upto 200 beds 8Upto 300 beds 10Upto 500 beds 15

5) If the pharmacy is also involved in the manufacture of drugs an adequate number of pharmacy technicians, assistants, peons etc may be required.

6) Both measurable and non measurable workload should be taken into consideration for determining the personnel requirements of pharmacy department.

StaffStaff (Personnel): Personnel or staff selection is one of the most important aspects of developing an

efficient operating community pharmacy. Success of a community/hospital pharmacy depends upon proper selection training, and maintenance of employees (staff).

Selection of staff: Following criteria should be followed during the selection of the staff for community pharmacy:

Minimum standards for qualification of employees should not be allowed to fall below the minimum standards “under here” for a given position will result in fall in reputation of pharmacy.

“Over hiring” means superior people should not be hired for inferior jobs; this type of selection may result in an adverse effect on staff moral and efficiency.

For the proper selection of staff for a specific job, the manager should develop a job description and a job specification for each position in pharmacy. This job description should contain such detail as scope of job, its relation to other jobs, working hours, and pay scale, etc. It prevents misunderstanding about the nature of the duties of a particular job.

Promotion within a pharmacy staff may be appropriate. But in most of the cases external source must be used such as employment agencies, placement offices of schools and universities or classified news paper advertising.

Co–op–work study program may prove as a big source of part time employees. An availability file (a record of qualified peoples who applied for job) should be maintained in pharmacy which serves when no opening existed.

Owner or manager of pharmacy should design an application form to assist in the selection process. Although an application form serves basically to provide information about the applicant, it also serves in following way:

Helps in observing the applicant’s ability to follow simple written instruction.

Serves as a guide during interview.

Serve as a permanent record of employee and a source of information of social security and withholding tax reports.

All the employment policies and procedures must be consistent with applicable federal state laws governing equal employment opportunity. In general such laws prohibit discrimination in selection and hiring process.

Orientation and training of staff: After proper selection needs to be followed by adequate orientation and training of the employee, which results in increase productivity and reduced employee turnover. During the orientation process, discussion should be on the basis of give and take basis on the following points:

Basic goal and philosophy of the pharmacy. Expected working hours from the employee (evening, weekends & holidays). Duration of lunch hours. Overtime rules and compensation. Policy of coffee break. Rules about punctuality. Uniform rules and paying schedule for uniform purchase and maintenance. Safety and security regulations. Telephone usage and answering authority of telephonic questions. Personal telephone usage. Vacation policy Policy regarding leave (sick or personal business) Opportunities and procedures for advancement or promotions. Policies on employees purchase and discount.

These points concern to both the employer and the employee so a clear discussion about them prevents, reduces problems between employers and the employee.

After a general orientation to the pharmacy, the employee needs specific training in the duties and responsibilities of the job. Sink–or– swim method of training is insufficient to pick up knowledge on the job, for this purpose a community pharmacy should arrange a sophisticated training program. There are effective simple training methods that can be used. The sponsored system of training is most suitable for a pharmacy. A new employee is assigned to a capable experienced employee who explains and demonstrates the job in questions. Conference method can also be used, by itself of sponsored system.

Compensation: Retaining good employees is one of the most difficult problems faced by the community pharmacy manger. Many factors decides keeping of employees but most important factor is the compensation plan. Adequate compensation is necessary, not only to retain employee but also to encourage them to work toward the overall goals and objectives of the pharmacy.

Receipt of Drug

What is a drug?

A drug can be given three possible operational definitions: a chemical substance that affects the processes of the body or mind; any chemical compound used on or administered to humans or animals as an aid in the diagnosis,

treatment or prevention of disease, or other abnormal condition, for the relief of pain or suffering, or to control or improve any physiologic or pathologic state;

A substance used recreationally for its effects on the central nervous system. Since the advent of the essential drug concept, essential drugs have been defined by WHO as those that are indispensable and necessary to satisfy the health care needs of the majority of the population. They should therefore be available and accessible at all times, in the appropriate dosage forms and at prices affordable to all. This definition does not in any way diminish the usefulness of any drug that may not be on any given essential drug list. It is a conscious attempt to utilize available resources on the most important drugs of benefit to the majority of the population while recognizing the competition in the public sector.

Requisition, supply and receipt of drugs

Drug request

Drugs that are ordered for use in the health centre must be approved for use in the centre. Drugs in the health centre should be relevant to the pattern of endemic diseases as well as the type of services being provided in the health centre.

It is advisable to request drugs on a regular basis to prevent shortages. If drugs are not always available, patients may lose confidence in the health centre and will be discouraged from visiting it. It is important to make requests on a regular basis, as drugs will only be delivered when requested. The delivery time should be taken into consideration in ensuring that drugs are not in short supply.

I m p o r t a n c e o f R e q u e s t i n g R e g u l a r l y

Completing stores requisition/delivery (issue) form

It is advisable to make a request on a standard stores requisition/delivery (issue) form. The stores requisition/delivery (issue) form should be produced in four copies. The original and two other copies of the form will be sent to the central store when completed. The fourth copy is kept in the dispensary to remind the health worker in charge of drugs or items requested.

Ensure that the following items are filled in correctly

o Name of drug and dosage form;o Unit of issue and quantity requested;o The requisition number (it is preferable to begin with a new number each year, e.g. 1/00);o The name of the dispensary and the date the requisition was made;o The name and signature of the health worker making the requisition;o Where the stores requisition/delivery (issue) form is designed to contain all the items listed,

fill in only the quantities of those items needed;o Write down the approximate unit price of each requested item and the approximate total

cost of each item;o Name and signature of the health worker making the requisition;

Model Drug Stores Requisition/Delivery (Issue) Form

Request no. ______________________________________________________________________ Institution: ____________________________________________________

Name of health worker: ______________________________________________________ Date: ____________________________________________________________

Delivery note: __________________________________________________________________ Total number of packages: __________________________________

Packed by (name): ____________________________________________________________ Date ____________________________________________________________

Checked by (name): __________________________________________________________ Date ____________________________________________________________

Handed over by (name): ______________________________________________________ Date ____________________________________________________________

Received by (name): __________________________________________________________ Date ____________________________________________________________

For official use only

Item Unit of Unit Quantity Total Quantity Total Signature Remarksdescription issue Price Required price delivered price

1. Acetylsalicylic acid 1,000 tab500 mg tab

2. Magnesium trisilicate 100 tab

3. Chloroquine 100 mg b 1,000 tab

4. ORS sachets 50 sachets

5. Procaine penicillin vial 1 vial

To be completed in four copies.

■ Period for which supply is required, from _______________ _______________ to _______________ _______________

■ The dispenser should comment on excess or short supply in the remarks column.

Name and signature of dispenser at health centre: _____________________________________________________________________________________________

Name and signature of member of health committee: _____________________________________________________________________________________________

Name and signature of head of heath centre:

________________________________________________________________________________________________________________________________________

Supply of drugs from medical stores

Stores requisition/delivery (issue) form

A stores requisition/delivery (issue) form should accompany any supply made from the medical stores. Health centers normally receive their drug supplies from central, regional or health services area medical stores. In very rare cases they may obtain drugs from other sources.

Supplies are issued on the basis of request made to the medical store by the health centre on an approved stores requisition/delivery (issue) form.

The request should not be excessive and should preferably ask for quantities that can be used in between delivery times.

The quantity of drugs requested is made in the appropriate column of the form and is sent to the medical store from which drugs are supplied.

The request is made on the basis of approved delivery time, time frame or in emergency.

The quantities of drugs delivered or issued from the medical stores should be entered in the appropriate column of the form.

The records of requisition and receipt of drugs from the medical store are kept in the health centre in an approved manner.

The delivery note from the central medical store should indicate what has been supplied as indicated in the stores requisition/delivery (issue) form

Receipt of drugs at dispensary

The consignment must come with two copies of the stores requisition/delivery (issue) form.

Check that the quantity issued actually corresponds to the quantity indicated on the stores requisition/delivery (issue) form.

Check off each drug after checking. Take note of the unit price of each drug and compare it to the previous unit price. Check that all original boxes, tins or bottles are unopened and are in good condition. Check the labels and ensure that there are no expired drugs being received. Any drugs already expired or soon to expire that cannot be consumed before

expiration or drugs not in good condition should be returned for destruction or redistribution to other centers.

Sign two copies of the stores requisition/delivery (issue) forms if the above procedure has been completed.

Return one copy of the signed stores requisition/delivery (issue) form to the medical stores, and place another copy in the “drug order” file.

Place drugs with shorter expiration dates in front of the shelf so that they can be reached and used first.

Remember to record the new stock on the respective stock (bin) cards and appropriate forms.

Disposal of expired drugs

o Take unused, unneeded, or expired prescription drugs out of their original containers and throw them in the trash.

o Mix the prescription drugs with an undesirable substance, like used coffee grounds or kitty litter. Putting them in impermeable, non -descript containers, such as empty cans or sealable bags, will further ensure the drugs are not diverted.

o Throw these containers in the trash. o Flush prescription drugs down the toilet only if the accompanying patient information

specifically instructs doing so. o Take advantage of community pharmaceutical take-back programs that allow the public to

bring unused drugs to a central location for proper disposal. Some communities have pharmaceutical take-back programs or community solid- waste programs that allow the public to bring unused drugs to a central location for proper disposal. Where these exist, they are a good way to dispose of unused pharmaceuticals.

o Expired medicines cannot be used in any form either externally or internally as the components of those medicines may lose their chemical nature. Sometimes these chemical compounds after their expiry may attain toxic nature will harm us if we consume. The better way to use them beneficially is to mix the content of these medicine into the soil of our garden plants. Some of the nutrients present in these medicines will act as growth promoters and if antibiotics are there will help to protect plants from diseases. The other method of disposing them is throw them in a pit and cover with soil. Keep medicines always out of reach of the children.

o We cannot use Expired medicine, but people throughout it in Dustbins, but that is very dangerous to our health, the best way to dispose of Capsules or Tablets is dig a hole on earth and keep it in that hole and fill the sand on that.Please avoid using polithin.

Drug safety

Specifically, new scientific discoveries are generating an emerging science of safety that will help prevent adverse events by improving the methods used in the clinic to target a specific drug for use in patients for whom benefits relative to risks are maximized. This new science will also give us the tools to prevent adverse events by rapidly identifying drug safety problems before they can cause injury. This new science combines a new understanding of disease and its origins at the molecular level (including of adverse events resulting from treatment) with new methods of signal detection, data mining, and analysis that are enabling researchers to generate hypotheses about and confirm the existence and cause of safety problems, as well as about the unique genetic and biologic features of the person that will determine how he or she responds to treatment. This science of safety encompasses the entire life cycle of a product, from premarket animal and human safety testing to widespread clinical use beyond original indications. This kind of life-cycle approach to benefit and safety should be used for all medical products so that safety signals generated at any point in the process will robustly inform regulatory decision making.

New drugs, devices, and diagnostics present the greatest opportunity currently available to improve healthcare and the way medicine is practiced; but all medical products pose potential risks.

Pharmacovigilance is the pharmacological science relating to the direction, assessment, understanding

and prevention of adverse effects, particularly long term and short term side effects of medicines. Pharmaceutical companies are required by law in almost all countries to perform clinical trials, testing new drugs on people before they are made generally available. These trials are important to avoid the following risks.

While medicines have led to major improvement and control of diseases, they also produce adverse effects on the human body from time to time.

Purpose of clinical trials is to discover : If a drug works and how well If it has any harmful effects Its benefit-harm-risk profile

SPECIFIC SAFETY INITIATIVES

A. Strengthening the science that supports our medical product safety system at every stage of the product life cycle from premarket testing and development through post market surveillance and risk management

B. Improving communication and information flow among all stakeholders engaged in promoting the safe use of medical products

C. Improving operations and management to ensure implementation of the review, analysis, consultation, and communication processes needed to strengthen the drug safety system

Educating patients and family members about Safe Medication :

The hospital identifies the importance of educating patients and family members about safe medication and food drug interaction for facilitating quick recovery of the patient.

The patient/relatives are clearly explained about the required dosage, the time interval at which the medicine is to be taken, special precautions in terms of food like whether the medicine is to be taken on an empty stomach or any diet restrictions, special diet schedule to followed etc by the treating doctor at the time of prescribing the medicine. The same is indicated in the prescription/patients case record in clear legible writing by the treating doctor.

In the hospital dispensary at the time of dispensing medicine the concerned pharmacist re-educates patients /relatives about safe medication practices in relation to the prescribed medicines. In case any special precautions to be taken in terms of food the same is explained to the patient/relatives.

Patients are encouraged to get the drug verified from the concerned consultant doctor or the intern doctor after collecting it from the dispensary.

For in-patients , the ward nurse must verify the medicine properly prior to its administration.

In the respective wards the concerned nursing staff also educates the patient/relatives about safe medication practices including dosage of the prescribed drug, time interval at which medicines is to be taken, special precautions in terms of diet if any to be followed etc.

Adverse Drug Events

An Adverse Drug event can be defined as any unfavorable and unintended signs including an abnormal laboratory findings symptoms or disease temporarily associated with the use of drugs.

Adverse reaction may be:

1. Dermatological reaction like mild skin rashes

2. Respiratory like brocho spasm, respiratory depression

3. Blood, blood dacryasis

4. Congenital Anomaly

5. Hepatic liver enzyme elevation, liver cirrhosis

6. Death.

Adverse Drug Reactions, if any are reported immediately to the patient’s attending Doctor, Nursing matron and Nursing incharge, pharmacy incharge. The incident is immediately recorded in the Adverse Drug Events Reporting form (ref #) available in every patient care area of the hospital.

The reported formats are forwarded to the Drug and Therapeutic Committee who meet at periodic intervals to evaluate such events in order to analyze such adverse drug events to monitor the risk, rate and trend of such reactions and suggest measures to prevent such events in future. Incase unacceptable trends are reported the Drug and Therapeutic Committee in consultation with the Chief Medical Superintendent can modify the policy as per the need of the situation to reduce such Adverse Drug events.

Unit Dose Dispensing

What is UDD?

Drugs distribution system for inpatients in hospitals Drugs which are packed in single dose and single package Drugs which are given in one unit or one time using Drugs which are available to use in 24 hours

Advantages

A reduction in the incidence of medication error. Decrease in total cost of medication related activities. A more efficient usage of pharmacy and nursing personal, allowing for more direct

patient care involvement by pharmacists and nurses. Improved overall drug control and drug using monitoring. More accurate patient billings for drugs. The elimination or minimization of drug credits. Greater control by the pharmacist over pharmacy work load pattern and staff

scheduling. Reduction in the size of drug inventories located in patient care areas. Greater adaptability to computerized and automated procedures.

Guidelines to Minimize Pilferage of Drugs

As a pharmacist has a great role to play in society. It is one of his duties to see that drugs are not being misused. Drugs which are used to improve the health of individual also act as poison in the cases where they are pilfer aged or misused. There are proper laws present in our constitution in case drugs are misused and provision of punishment in also there.

To avoid pilferage of drugs following

1) Proper education of drugs and its effect should be spread.2) Pharmacist and other responsible should understand their ethical values.3) Proper actions should be taken against the culprits as per Indian constitution.4) Proper record of the medication should be maintained so there should be check on such

record.5) Prescription should be checked studied and verified before dispensing the drug6) Proper handling of drugs7) Narcotics and high risk medicines should be kept in lock so as to avoid a tragedy.

Hathi Committee recommendation for Hospital Pharmacy

Hospital pharmacy is important department of any hospital. It should have competent persons, well trained in the profession of pharmacy. Hospitals mainly depend upon the services of diploma holder in pharmacy. The head of hospital pharmacy department should be post graduate in pharmacy. He acts as a coordinator for the pharmacy and non pharmacy staff in the hospital. He reports to the administrator and interacts with other medical departments.

Hathi committee was recomemded that I.V fluid manufacturing should be done under the supervision of M. Pharm assisted by B. Pharm and D. Pharm holders.

1) Technical Ability

He should have thorough knowledge of basic sciences pharmacology, toxicology, route of administration, stability etc. A hospital pharmacist should provide information regarding proper handling of drugs.

2) Ability to develop a manufacturing section

Manufacturing within a hospital requires control over supply, quality, equipment and raw material cost. Hospital pharmacy has to organize manufacturing function by doing proper cost analysis. Although quality maintenance is essential because considerable quantities of drugs are required for treatment of patients.

3) Administrative Ability

Hospital pharmacist should be able to plan, organize and control various functions of hospital pharmacy. He should prepare work schedule for his staff. He should frame various policies and procedures to get the work done. He should interact with his staff daily. He should maintain legal and administrative records properly. Where patients are charged for drugs the hospital pharmacist must develop charging policy. Chief pharmacist is usually responsible for interviewing, selecting and evaluating the staff members for work in pharmacy.

4) Ability to control inventory

He has to exercise his duties on inventories of drugs which are lying at nursing stations, supply rooms and clinical units etc. He has to communicate with suppliers of drugs. He must check the quality of drugs and other supplies.

5) Ability to Conduct and Participate in Research

He is required to maintain information about pharmaceutical journals. He must advise about new methods of preservation, preparation and to improve taste and efficacy of the preparation. He must have the basic understanding of scientific methods so that he can properly evaluate the research data.

6) Ability to Conduct teaching Programmes

The pharmacy staff can act as trainers for the nursing staff. He must prepare suitable teaching materials for the nursing staff covering various aspects like storage of drugs, proper use of drugs, dosage forms, conversions and percentage calculations of dosages.