Hospital Pharmacy Standards: Infection Control, Formulary, and More

Posted on Feb 16, 2025 in Other university degrees and diplomas

Infection Control Committee

The Infection Control Committee generally comprises members from various disciplines within the healthcare facility.

• Representation may include physicians, nursing staff, infection control practitioners, quality assurance personnel, risk management personnel, and representatives from microbiology, surgery, central sterilization, environmental services, etc.
• Every healthcare facility uses interdisciplinary task forces such as the Safety Committee and the Infection Control Committee to minimize patient and employee risk.
• Although its existence may not be widely recognized by patients, the Infection Control Committee plays an integral part in the care of every patient.

Pharmacist’s Role in Preventing Antimicrobial Resistance

• Pharmacists’ responsibilities for antimicrobial stewardship and infection prevention and control include promoting the optimal use of antimicrobial agents, reducing the transmission of infections, and educating health professionals, patients, and the public.
• The Impact of Pharmacists on Antimicrobial Stewardship Teams in a Community Setting.
• Pharmacists Improve Patient Outcomes after Emergency Department Discharge.
• Pharmacists Play a Key Role in Educational Interventions.
• Pharmacist-Led Antimicrobial Therapy Significantly Decreases Duration of IV Treatment.

Hospital Formulary Development Procedure

Procedure for development:

• Identify the most common diseases being treated in the hospital by consulting all medical departments. For each disease, an appropriate first choice of treatment should be identified using standard treatment guidelines.
• An expert committee can be brought together to identify the appropriate treatment for each of the common health problems.
• Alternatively, reviewing the WHO model list of essential medicines may also be used as a starting point.
• The capability of the hospital and its staff to handle specific drugs should not be forgotten during the selection process.
• A draft of the list must be prepared and given to each department for comment.
• The Drugs and Therapeutics Committee must deliberate on their comments and provide feedback.
• All information should be discussed with evidence-based reviews where possible.
• After preparing the final list, monographs for each drug should be prepared, containing unbiased information.

FIP Basel Statements for Hospital Pharmacy Standards

The International Pharmaceutical Federation (FIP) Basel Statements:

• The International Pharmaceutical Federation (FIP) is a global organization that represents pharmacy, pharmaceutical sciences, and pharmaceutical education. It was established in 1912 in The Hague, Netherlands, with its headquarters in The Hague.
• The main aim of FIP is to represent and assist pharmacy and pharmaceutical sciences worldwide.
• In 2008, a conference was conducted in Basel, Switzerland, by the FIP, which included hospital pharmacists from all over the world to discuss the future of hospital pharmacy.
• In 2014, another conference was held in Bangkok to launch a revised Basel statement that included 65 statements.

Organizational Structure of Hospital Pharmacy

• Location of Hospital Pharmacy:
  • The pharmacy should be situated on the ground floor or the first floor to ease accessibility and provide adequate service to the various departments and nursing stations.
  • If the hospital has an outpatient department, the pharmacy or its branch should be near it.
  • The layout of floor pharmacies should be such that a continuous flow of personnel and materials is maintained.
• Layout of Hospital Pharmacy:
  • The design and construction of the hospital pharmacy should be done considering its functionality.
  • Its location and size should support personnel and inventory movement, work processes, and activities.
  • Built-in storage and fixed equipment for storing documents, bulk supplies, portable medical gas cylinders, etc.

Professional responsibilities, qualification and experience requirements, job specifications, workload requirements, and interprofessional relationships.

Role of Pharmacists in Hospital Pharmacy

1. Review Prescriptions
2. Dispense Prescription / Non-Prescription Medicines
3. Provide Patient Counseling / Education
4. Hospital and Community Pharmacy Management
5. Expertise on Medications
6. Proficiency on drugs / pharmaceuticals
7. Entrepreneurship and Leadership
8. Deliver Primary and Preventive Healthcare
9. Professional, Ethical, and Legal Practice
10. Continuing Professional Development

Good Pharmacy Practice (GPP) in Hospitals

Good Pharmacy Practice (GPP) is at the very heart of the profession of Pharmacy; indeed, it is the very essence of the profession. Moreover, it expresses our covenant with the patient not only to “do no harm” but also to facilitate good therapeutic outcomes with medicines. GPP is the practice of pharmacy that responds to the needs of the people who use the pharmacists’ services to provide optimal, evidence-based care. To support this practice, it is essential that there be an established national framework of quality standards and guidelines.

Expiry Drug Disposal and Removal Techniques

Expiry: There is a time period and condition in which a drug is good for use, and ending this time period or missing the specific condition (temperature, darkness) in which a drug is good, is called Expiry.

Removal and Handling of Expired Drugs: It is a process of store management to remove the expired drugs from the store and to handle them properly so that they should not be given for use.

Following actions can be taken for handling expired drugs:

• The expired drugs must be separated from usable drugs.
• Where these drugs are kept, there should be a notice like “Out of Use.”
• The expired drugs must be destroyed as recommended by local waste management.

Disposal of Expiry: Disposal of expiry drugs means destroying the expired drugs so they cannot be used.

Disposal methods recommended by the International Authorities:

1. Returning to the Manufacturer: The Manufacturer has good disposal methods at its disposal.
2. Landfill: This is the oldest and best way for disposal of solid waste. In this method, the waste materials are placed into the land. The municipal waste should be used to cover this site.
3. Waste Immobilization (Encapsulation): In this method, the pharmaceuticals are packed in a plastic or steel drum, solid and semi-solid materials are filled to 75% of the drum, then a mixture of lime, cement, and water in a 15:15:5 ratio is filled, then the mouth of the drum is sealed and placed in a landfill and covered with municipal solid waste.
4. Sewer: Syrups and IV fluids are diluted with water and flushed into the sewer in small quantities over a time period.
5. Incineration: In this method, the waste material is given high-temperature heat to be destroyed.
6. Chemical Disposal: In this method, chemicals are used to destroy the expired drugs.

Inventory Management Techniques

Inventory refers to a company’s goods and products that are ready to sell, along with the raw materials that are used to produce them. Inventory can be categorized in three different ways, including raw materials, work-in-progress, and finished goods.

Techniques of Inventory Control

1. ABC Analysis: It is an inventory management technique that determines the value of inventory items based on their importance to the business.
2. VED Analysis: It is also an inventory management strategy that classifies the materials according to their importance.

   	No. Goods	Expenses	Rs	Need of Care
   V. Vital	A 10%	70%	70 Rs	Good care, Good Storage, Evaluation
   E. Essential	B 20%	20%	20 Rs	General care, general storage no evaluation
   D. Desirable	C 70%	10%	10 Rs	No care, no storage, no evaluation

   ABC = Always Better Good

3. Economic Order Quantity (EOQ): It is a method to purchase the appropriate quantity of raw material for manufacturing at one time to minimize ordering and caring costs.
   • Ordering Cost: It includes all those expenses related to ordering, like traveling cost expenses during traveling, etc.
   • Caring Cost: It includes all those expenses related to goods like transportation charge, insurance, room rent, storage expenses, etc.

   Formula: EOQ = √ (2 x A.D. x O.C.) / C.C.

   A.D. = annual demand, O.C. = ordering cost, C.C. = Caring Cost