Submitted to: Dr Huma Naeem

Submitted by: Hafiza bibi

Subject: Pharm-D-401 PHARMACY PRACTICE-IVA
(Hospital Pharmacy)
Roll No: 70058873
Pharm D 7th semester
Department of pharmacy
Topic: DISPENSING TO IN PATIENTS

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Contents
INTRODUCTION ............................................................................................................................................. 3
DISPENSING:.............................................................................................................................................. 3
DISTRIBUTION: .............................................................................................................................................. 3
ADMINISTRATION ......................................................................................................................................... 3
METHODS OF DRUG DISTRIBUTION.............................................................................................................. 3
INDIVIDUAL DRUG ORDER SYSTEM .......................................................................................................... 3
Benefits: .................................................................................................................................................... 3
Drawbacks: ................................................................................................................................................ 3
Floor stock system: ....................................................................................................................................... 4
Charge floor stock system:............................................................................................................................ 4
Dispensing of floor stock drugs: ................................................................................................................ 4
Non-charge floor stock drugs: ...................................................................................................................... 4
Mobile dispensary unit ................................................................................................................................. 4
Mobile dispensary unit ................................................................................................................................. 5
Combination of individual and floor stock system ....................................................................................... 5
UNIT DOSE DISTRIBUTION SYSTEM............................................................................................................... 5
Advantages:............................................................................................................................................... 5
Methods of Unit-dose dispensing ................................................................................................................. 5
Methods of Unit-dose dispensing ................................................................................................................. 6
Decentralized unit dose drug distribution system (DCUDD): ................................................................... 6
Sequence of drug dispensing to in patients.................................................................................................. 6
A typical sequence of the drug dispensing to the patient is as: ............................................................... 6

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 DISPENSING TO IN PATIENTS
INTRODUCTION
A patient who is admitted to a hospital or clinic for treatment that requires at least one overnight stay.a ho
spital patient who occupies a bed for at least one night in the course of treatment, examination, or
observation.

DISPENSING, DISTRIBUTION AND ADM INISTRATION

DISPENSING:
Dispensing is a pharmacy act and consists of the removal of two or more doses from a bulk drug
container and placing them in another (dispensing) container/envelop for subsequent use by a patient.

DISTRIBUTION:
The supply, delivery and transitory storage of drugs at patient care areas (nursing stations) other than
main hospital pharmacy for subsequent patients' utilization is called distribution.

ADMINISTRATION:
The administration is a nursing act consisting of removal/withdrawal of a single dose from drug container
and its administration to a patient on the order of a prescriber. A nurse may administer drugs after the
prescription has been dispensed by a licensed person (pharmacist).

METHODS OF DRUG DISTRIBUTION

Generally there are following four systems of drug distribution to inpatients used in various hospitals
according to their size, availability of professional personnel and budgets.

INDIVIDUAL DRUG ORDER SYSTEM

This is also termed as individual prescription order system and is used generally by the small and private
hospitals due to desirability of an individualized service and for availability of a reduced manpower.

Benefits:
1. Possibility of a direct review of medication orders by the pharmacist.

2. Provides a better interaction among pharmacist, doctor and the patients.

3. Provides a closer control of inventory.

Drawbacks:
1. Results in a delay in obtaining the required medication.

2. Increased cost to patients.

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Floor stock system:
Under this system, the drugs are given to the patient through the nursing station and the pharmacy
supplies from the drug store of a hospital.

• Drugs on the nursing station or ward may be divided in to.

• A. Charge floor stock drugs

• B. Non charge floor stock drugs.

Charge floor stock system:

Medicines which are stocked on the nursing station at all times and charged to the patient’s account
after they have been administered to them.

Dispensing of floor stock drugs:

 The patient is charged for every single dose administered to him.
 Selection of these drugs in various wards is decided by PTC
 Once the floor stock list is prepared ,it becomes the responsibility of the hospital pharmacist to
make the drugs available

Non-charge floor stock drugs:

• These drugs represent group of medications that are placed at the nursing station for use in
inpatient-care area without direct charging to the patients' account but costing in the per day cost
of the hospital room.

• Following methods are used for the dispensing/distribution of non-charge floor stock drugs:

 Drug basket method.

 Mobile dispensary unit.
 Drug basket method

• Under this system, night nurse checks medicine cabinet, utility room and drug refrigerator
inventory of supplies against a master list provided by pharmacy. The checking nurse places,
check mark on the number required for each drug on the requisition for floor stock supplies.
Where there is an empty container, she places it in a drug basket. On completion of procedure, the
drug basket containing empty containers and requisition for floor stock supplies is then sent to
pharmacy. Immediately upon opening in the morning, the pharmacy staff fills each container and
dispenses requested ampules and vials as ordered. Once the basket is complete, it is delivered to
the floor via a messenger service.

Mobile dispensary unit

• A mobile dispensing system also called as medication cart system utilizes a specially constructed
stainless steel truck with appropriate dimensions to hold all sorts of the drugs.

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 • One mobile Unit is in use while the second is being serviced. The frequency and delivery time
can be selected in cooperation with the nursing service. In this system of distribution, it is not
necessary for the night nurse, as in basket method to check the pharmacy inventory or have the
empty containers transported to the pharmacy. It is the duty of a pharmacist or of his nominee to
check the inventory of the cabinets in all inpatient care area and check off items and quantity of
supplies left.

Mobile dispensary unit

This method provides the following benefits:.

1. Conserves the nurse time.

2. Pharmacist has better supervision and control over drugs and nursing station drug cabinets.

3. Due to routine checking of drugs by the pharmacist, the deteriorated and out-dated drugs may
quickly be removed.

Combination of individual and floor stock system

o This system is followed in the government and also in private hospital that run on the
basis of no profit and no loss.

o Individual prescription or medication system is followed as a major means.

o Requirement of drugs or surgical items are given to the patient who purchase and deposit
these items in hospital wards or rooms under supervision of registered nurse.

UNIT DOSE DISTRIBUTION SYSTEM

• Under this system medications are ordered, packaged, handled, administered and charged in
multiples of single dose units containing a predetermined amount of drug sufficient for one
regular dose. The unit dose concept was derived from the pharmaceutical Manufactures preparing
and selling pre-filled, single-dose disposable syringes, single-dose vials and single-unit foil or
cellophane wrapped capsules and tablets.

Advantages:
o Better financial control.

o It prevents the loss of partially used medications.

o It does not require storage facilities at the nursing station.

Methods of Unit-dose dispensing

• The unit dose dispensing method can be introduced in the hospital in either of two ways:

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 o Centralized unit dose drug distribution system (CUDD).

o Decentralized unit dose drug distribution system (DCUDD).

o Centralized unit dose drug distribution system (CUDD):

• All in-patient drugs are dispensed in unit doses and all the drugs are stored in main pharmacy and
dispensed at the time the dose is due to be given to the patient.

• Drugs re transferred from the pharmacy to the indoor patient by medication carts

Methods of Unit-dose dispensing

Decentralized unit dose drug distribution system (DCUDD):

• The decentralized unit-dose system, unlike the centralized system, operates through small satellite
pharmacies (a pharmacy associated with a hospital or clinic or drug store at a separate location.
Just like major universities have satellite campuses at various locations - a mini version of the
original) located on each floor of the hospital. The main pharmacy in this system becomes a
procurement, storage, manufacturing and packaging center serving all the satellites. The delivery
system is accomplished by the use of medication carts. This type of system can be used for a
hospital with separate buildings.

Sequence of drug dispensing to in patients

A typical sequence of the drug dispensing to the patient is as:

o Sending of the medication orders to the pharmacist.

o Entering of the medication order on to the patient profile card.

o Checking of the medication order for allergies, drug-interaction, drug laboratory test
effects and rationale of therapy.

o Coordination of dosage schedules with the nursing station.

o Picking of medication order by the pharmacy technician and placing drugs in bins of the
transfer cart per dosage schedule.

o Checking of the carts by the pharmacist before release for transfer to the inpatient care
area.

o Administration of the medication by the nurse and making of the appropriate entry on the
nurse medication record.

o Rechecking of the cart on returning to the pharmacy.

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o Throughout the entire sequence, the pharmacist is available for consultation by the
doctors and nurses.

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