PH 35 Hospital Pharmacy
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| Work collaboratively with medical staff and hospital administration to assure quality patient care and to improve pharmacy operations and management. | Hospital pharmacist |
| Give 1 Pennsylvania Hospital what year? 2 First Hospital Pharmacist? | . 1) 1752 2 Jonathan Roberts |
| History of Pharmacy in the Philippines | 1 Hospital Militar in Cebu (1565) 2 Hospital Militar in Manila (1571) 3 Hospital San Juan de Dios (1577) 4 Hospital de San Lazaro (1577) 5 Hospital de San Gabriel (1588) 6 Chinese General Hospital (1891) 7 Philippine General Hospital (1911) Mnemonic: MilitarSanGen |
| 1 In 1957, the government hospital pharmacist form an association called __ 2 In 1960, the private hospital pharmacists also formed a __ 3 In 1962, these 2 associations combined to form the nucleus of what is now known as the | 1 The Government Hospital Pharmacist Association. 2 Private Hospital Pharmacists Association 3 Philippine Society of Hospital Pharmacists (PSHP) |
| Uniqueness of hospital pharmacy 1 Internal forces affecting the practice of pharmacy in the hospital setting: | . 1) 1 The organizational structure of a hospital or institution 2 Physician-pharmacist-nurse-patient relationship |
| Uniqueness of hospital pharmacy 1 External forces which affect the practice of pharmacy in hospital | . 1 Accreditation agencies – hospital association 2 Licensing agencies –DOH,FDA,PDEA,DDB 3 Government agencies imposing standards and regulations –ex: medicare, PHIC 4 Third-party agencies, (insurance) 5 Social agencies and govt. welfare . Ex. DSWD 6 Governing board and the public opinion . Ex. BOD |
| 1 Minimum standards for pharmacies in Hospitals Taken from _____ 2 Under __, harmonization and streamlining of system and processes in one strategy that the DOH undertook to make health regulation more rational and client responsive. | 1) AO No. 56 s.1989 2 FOURmula One for Health Programs of DOH |
| Minimum standards for pharmacies in Hospitals (Taken from AO No. 56 s.1989) 1 was established for the LICENSURE of hospitals and other health facilities. A single license will be issued to the health facility that covers ancillary and other hospital facilities. | . 1) One Stop Shop (Administrative Order No. 2007-0021, Harmonization and Streamlining of the Licensure System for Hospitals) |
| General requirements 1 Application with FDA | . 1.1Standard petition form 1.2 Proof of registration as an establishment 1.3 Valid certificate of registration 1.4 Certificate of attendance to FDA licensing seminar 1.5 Affidavit of undertaking (change of establishment name, display of LTO, notify FDA if there is a change in location of RPh in charge. 1.6 Tentative list of products intended to be sold 1.7 Contract of Lease 1.8 Self-Assessment ToolKit (SAT-K) 1.9 Credential of Pharmacists and Pharmacy assistants |
| Specific requirements | 1 Premises 2 Books, references, documents 3 Record Books duly registered with FDA 4 Utensils, apparatus and other equipment 5 A full-time valid registered pharmacist physically present during office hours. If Pharmacist Assistant is present, NC 3 Training certificate is required |
| Specific requirements 1 Premises | 1.1 a signboard 1.2 a well-ventilated area not less than 15 sq.m. 1.3 Place for suitable compounding prescription, washing area and sterilizing bottles 1.4 suitable and proper place for adequate storage of drugs and biological products as specified in the label 1.5 a suitable cabinet for poisons and/or dangerous drugs 1.6 adequate water supply 1.7 New Philhealth Accreditation Standards specifically requires that directional signage be prominently posted to help locate service areas within organization |
| Administrative Sanctions | 1 Temporary Closure - absence of pharmacist on three (3) inspections by FDA inspector 2 Suspension of LTO - Failure to produce invoices, etc - Failure to properly record and keep the file for prescriptions in the last 2 years - Refusal to allow entry of FDA inspectors 3 Revocation of LTO - Sale of adulterated, expired, samples, misbranded drugs and the likes - Failure to record properly the dangerous drugs as determined by DDB - Lack of pharmacist - Failure to take necessary remedial or corrective measures during prescribed period by FDA |
| Optional Reference Copies of the Follow Republic Acts: | RA 4226 (HOSPITAL LICENSURE ACT) RA 7394 (CONSUMER ACT OF THE PHILIPPINES) RA 7432 (SENIOR CITIZEN'S ACT) RA 7581 (PRICE ACT) RA 9184 (GOVERNMENT PROCUREMENT ACT) RA 9165 (COMPREHENSIVE DANGEROUS DRUGS ACT OF 2002) RA 9502 (UNIVERSALLY ACCESSIBLE CHEAPER AND QUALITY MEDICINE ACT OF 2008) |
| There should be a well-established Pharmacy Service organized in accordance with ethical and professional practices and has complied with One Stop Shop requirements of __ for the issuance of hospital License to Operate (LTO), and with the __ to acquire S3 License | 1 Bureau of Health Facilities Services (BHFS) 2 Comprehensive Dangerous Drugs Act of 2002 (RA 9165) |
| __ on the operations of hospital pharmacy must be maintained and updated as it serves as guide and ready reference for al hospital pharmacy staff | Standard Operating Procedures (SOPs) |
| There should be a __ of licensed pharmacy whenever a hospital pharmacy is open to render service | Physical presence |
| 1 The required equipment and facilities should be __ 2 There should be a __ for the formulation of policies and selection of quality, safe, affordable medicines | 1 maintained 2 PTC (Pharmacy and Therapeutic Committee) |
| 1 Drug products to be procured should conform to the specifications of __ 1 There should be a __ for the procurement of drugs in accordance with current government procurement law | 1 PNF (Philippine National Formulary) 2 Project Procurement Management Program (PPMP) |
| 1 The pharmacist must prepare a __ 2 There should be a proper classification of __ for free or discounted price of medicines | 1 Purchase Request (PR) 2 inpatient |
| - absence of pharmacist on three (3) inspections by FDA inspector | Temporary Closure |
| Duties of the governing board | 1 Responsible for the selection of competent personnel and medical staff 2 Control of hospital funds 3 Supervision of the physical plant |
| Internal organization of governing body | 1 President or chairman 2 VP 3 Secretary 4 Treasurer |
| Is appointed by the governing board and must produce a TWO-WAY CHANNEL of communication between the board and the hospital staff and personnel. | CEO of the hospital |
| Departments in the hospital | 1 Professional care of the patient 2 Business management or administrative of the hospital |
| Professional care of the patient | 1 Ambulatory care 2 Anesthesia 3 Blood bank 4 CSS- central sterile supply 5 Clinical lab 6 Dental service 7 Dietary and nutrition service 8 ECG/EEG 9 ER 10 Medical Library 11 Medical records |
| Business management/Administrative | 1 Accounting 2 Admitting 3 Biomedical engineering 4 Business office 5 Cafeteria/coffee shop 6 Central transportation 7 Credit and collection 8 Computer Services 9 Engineering and maintenance |
| Supports and approves all requirements necessary for the operation and management of the hospital pharmacy | Chief of Hospital |
| Supervises the overall all operations and regulatory compliance of the hospital pharmacy | Supervises the overall all operations and regulatory compliance of the hospital pharmacy |
| Closely coordinate with the pharmacists through the PTC on the selection, rational drug use and other drug and pharmacy related matters | Medical Officers and staff |
| Provides the pharmacists with drug information and database on Patient’s Medication record whenever necessary | Hospital Health Information/Medical Records Offices and Staff |
| SUPPORTS and APPROVES all requirements necessary for the operation and management of the hospital pharmacy | Chief of Hospital |
| SUPERVISES the OVERALL ALL OPERATIONS and regulatory compliance of the hospital pharmacy | Administrative Officer |
| Closely coordinate with the pharmacists through the PHARMACY THERAPEUTIC COMMITTEE on the selection, rational drug use and other drug and pharmacy related matters | Medical Officers and staff |
| Provides the pharmacists with DRUG INFORMATION and database on PATIENT’S MEDICATION RECORD whenever necessary | Hospital Health Information/Medical Records Offices and Staff |
| Provide the pharmacists information on anti-microbial resistance and susceptibility necessary for drug procurement and dispensing. | Chief Medical Technologist and staff (laboratory service) |
| Provides referrals (on request) for TPN and information on any DRUG-FOOD INTERACTIONS. | Head and Staff of the Dietary Service |
| Provide information on FINANCIAL CAPABILITY of the PATIENTS and availability of sources for the pharmaceutical requirements of the patients in the service wards. | Head and staff of the Medical Social Work Service (Medical Social Service) |
| Analyzes the FINANCIAL REPORTS submitted by the pharmacists thaT are uses as basis for the hospital pharmacy BUDGET ESTIMATE | Chief Accountant and Staff (Accounting Section) |
| Statements of accounts for drugs and medicines are prepared at the __ based on charge slips issued by the pharmacist to the patients | Billing section |
| Facilitates PROCUREMENT OF SUPPLIES and materials needed in the hospital pharmacy. | Property and Supply Section |
| 1 one of the dominant factors in the development and expansion of hospitals 2 through urgent need for care of the wounded in the battlefield | 1 Religious influence 2 Military influence |
| 1 revolutionized medical education and internship 2 revolutionized nursing care | 1 Flexner Report on medical education (1910) 2 Florence Nightingale |
| Provide federal funds for hospital construction. From 1946-1973, hundreds of other hospitals have undertaken major expansion through this Act | Hill Burton Program - Hospital Survey and Construction Act (USA) |
| In 1983, Congress developed __ to reimbursed hospitals at specific rate based on diagnosis of the patient. | Prospective Payment System |
| Classification of Hospitals | 1 General Hospital 2 Special Hospital |
| 1 provides care to patients thru medical,surgical,pediatric, psychiatric.,etc 2 provide restricted care in special conditions such as cancer or psychiatric only | 1 General Hospital 2 Special Hospital |
| 1 has average length of stay of less than 30 days Ex.acute disease conditions 2 average length of stay of more than 30 days ex. Psychiatric, drug addiction | 1 Short-term 2 Long-term |
| Ownership 1 Government hospitals | . a. Federal - owned and operated by federal govt. ex. Armed Forces, Veterans b. State – owned by a state and controlled by a board c. County – usually general hospital caring for indigents d. City – (Municipality)controlled by city gov. e. District |
| Ownership 1 Non-governmental Hospital | . 1 a. Non-profit – church related or operated b. For profit – Individual, partnership, corporation |
| Bed Capacity | Under 50 beds 50-90 beds 100-199 beds 200-299 beds 300-399 beds |
| 4 Fundamental functions of hospitals | 1 Patient care 2 Education 3 Research 4 Public health |
| Where hospital is charged with maintaining and restoring health to the community which it serves | Patient care |
| To assist the community in reducing the incidence of illness and improve general health of the population | Public health |
| New Classification of General Hospitals in the Philippines Based on Functional Capacity, Effective August 18, 2012 (Level 1, Level 2, Level 3) | Administrative Order No. 2012-0012 |
| 2 Main types of Hospital Staff | 1 Open staff 2 Closed Staff |
| Are residents who are full time employees of the hospital. They provide specific services, for which they receive education and experience. | Resident medical Staff |
| Are residents who are full time employees of the hospital. They provide specific services, for which they receive education and experience. | Resident medical Staff |
| Categories of the Medical Staff | 1 Honorary staff 2 Consulting Medical Staff 3 Active or Attending Medical Staff 4 Associate medical Staff 5 Courtesy medical Staff 6 Resident medical Staff AA CC HR |
| Consist of specialists who are recognized as such by right of passing specialty boards and who serves as consultants to other members of the medical staff | Consulting Medical Staff |
| The group primarily concerned with regular patient care. It is the group most actively involved in the hospital. | Active or Attending Medical Staff |
| Composed of junior or less experience members of the staff | Associate medical Staff |
| Composed of physicians who desire the privilege of attending private patients but who do not desire active staff membership | Courtesy medical Staff |
| Are RESIDENTS who are full time employees of the hospital. They provide specific services, for which they receive education and experience. | Resident medical Staff |
| Means the RPh as healthcare member | Practitioner |
| Pharmaceutical care process involves three major functions: | 1. Identifying potential and actual drug-related problems. 2. Resolving actual drug-related problems. 3. Preventing potential drug-related problems. |
| Essential Components of Pharmaceutical Care | 1 Pharmacist-patient relationship 2 Pharmacist’s workup of drug therapy (PWDT) |
| 1 a collaborative effort between pharmacist & patient Empathy Caring 2 Provision of pharmaceutical care is centered around this, although the methods used for this purpose may vary. | 1 Pharmacist-patient relationship 2 Pharmacist’s workup of drug therapy (PWDT) |
| Components of PWDT (Pharmacist’s workup of drug therapy ) | I. Data collection II. Develop or identify the CORE pharmacotherapy plan III. Identify PRIME Pharmacotherapy Problems |
| Documentation of pharmaceutical care it describe or document the interventions needed or provided by pharmacist | Formulate a FARM progress note or SOAP progress note F- FINDINGS A- ASSESSMENT R- RESOLUTION M- MONITORING - a pharmacist equivalent of a physician’s progress note S- SUBJECTIVE FINDINGS O- OBJECTIVE FINDINGS A- ASSESSMENT P- PLAN - Traditional documentation primarily by physicians. |
| Seven types of medication-related problems have been identified. | 1. Unnecessary drug therapy 2. Needs additional drug therapy 3. Ineffective drug 4. Dosage too low 5. Adverse drug reaction 6. Dosage too high 7. Noncompliance |