HOSPIPHAR LEC MEDICATION DISTRIBUTION SYSTEMS
DRUG DISTRIBUTION SYSTEM
A system that has its purpose in selection, acquisition, control, storage, dispensing, delivery, preparation, and administration of drug products in health care institutions in response to the order of an authorized prescriber
TYPES OF DRUG DISTRIBUTION 1. 2. 3. 4.
FLOOR STOCK SYSTEM
Steps of Drug Distribution
12 steps
Manufacturer: 1. Order processing 2. Production and filling 3. Shipping Pharmacy: 4. Ordering/receiving 5. Storing 6. Preparation for dispensing (compounding, measuring, packaging, labeling) 7. Dispensing 8. Transportation to nursing unit Nursing Unit: 9. Ordering/receiving 10. Storing 11. Preparation for administration 12. Administration to patient
Floor Stock System Individual Prescription Order System Unit-Dose Dispensing System Pharmacy-coordinated unit-dose dispensing and administration system
Medications are stocked by the pharmacists in nursing units The nurses are responsible for preparing the patient-specific medications 1. Read the order 2. Drug room 3. Prepare 4. Administer
Drugs in the nursing unit may be divided into
Charge Floor Stock Drugs Medications that are stocked in the nursing station at all times and are charged to the patient’s account after being administered Non-charge Floor Stock Drugs Group of medications that are placed in the nursing station for the use of all patients in the ward for which there may be no direct charge to the patient’s account Cost of these group of drugs is usually calculated in per diem cist
Types of Medications
Lacorte, Aries S. 3D-PH | PHAR 5
Advantages of the Floor Stock System 1. 2. 3.
Ready availability of the required drugs Elimination of drug returns Reduction in number of drug order transcriptions for the pharmacy
UNIT-DOSE DRUG DISTRIBUTION SYSTEM (UDDDS) Unit Dose
Disadvantages of the Floor Stock System 1.
2.
3. 4. 5. 6. 7.
The pharmacist would likely never see the physician order and would stock the medications on the floor solely from the nursing request Medication errors may increase OF MEDICATIONS IS REVIEW ELIMINATED Increase drug inventory in the wards Greater opportunity for pilferage Increased hazards associated with drug deterioration Lack of proper storage facilities in the wards may require capital outlay to provide them Greater inroads are made upon the nurse’s time
PATIENT PRESCRIPTION SYSTEM
Medications are dispensed by a pharmacist on a receipt of individual medication orders Pharmacist would prepare a 2- to 5-day supply of medications, which are then stored in the nursing unit
A physical quantity of a drug product ordered by a prescriber to be administered to a specified patient at one time, in readyto-administer form with no further physical or chemical alterations required
Unit Dose Package
A package containing one dose
Single Unit Package
A package which contains one discrete pharmaceutical dosage form
Unit-Dose Drug Distribution System (UDDDS)
A pharmacy-coordinated system of dispensing and controlling medications in health care institutions Medications are contained in single unit packages and are administered in ready-toadminister form Not more than a 24-hour supply of doses is delivered at the patient care area Medication profile is maintained for each patient
Process of UDDDS
Advantages of Patient Prescription System 1. 2. 3.
All medication orders are received directly by a pharmacist Provides interaction of pharmacist, physician, nurse, and patient Closer control of inventory
Disadvantages of Patient Prescription System 1. 2. 3.
Pharmacist have no direct access to pertinent patient information Possible delay in obtaining the required medication Increased cost to the patient Empty drug containers and unused drugs are returned to the pharmacy and are charged to the patient
Patient Medication Profile (PMP)
Primary record used by pharmacists to document patient medications
Lacorte, Aries S. 3D-PH | PHAR 5
Medication Administration Record (MAR)
Record of all current medications prescribed for each patient Used by the nurse to know what medication each patient should receive
Pharmacists work directly with physicians in the nursing unit to carry out pharmacy’s funtion of safe and appropriate use of drugs in patients Reduced incidence of medication errors
Advantages of UDDDS 1.
Patients receive improved pharmaceutical service 24 hours a day and are charged for only those doses which are administered to them 2. All doses of medications required ar the nursing station are prepared by the pharmacy, thus allowing the nurses more time for direct patient care 3. Allows the pharmacist to interpret or check a copy of the physician’s original order, thus reducing medication errors 4. Eliminated excessive duplication of orders and paper works at the nursing station and pharmacy 5. Eliminates credit 6. Transfers IV preparation and dry reconstitution procedures to the pharmacy 7. Promotes more efficient utilization of professional and non-professional personnel 8. Reduces revenue losses 9. Conserves space in nursing units by eliminating bulky floor stock 10. Eliminates pilferage 11. Extends pharmacy coverage and control throughout the hospital from the time the physician writes the order to the time the patient receives the unit dose 12. The pharmacist can get out of the pharmacy and into the wards where they can perform their intended functions as drug consultants and help provide the team effoet that is needed for better patient care
PHARMACY-COORDINATED UNIT-DOSE DISPENSING AND ADMINISTRATION SYSTEM
MODELS OF UNIT DOSE DELIVERY Centralized Pharmacy Services
All drugs are stored in a central pharmacy and dispensed at the time the dose is due to be given to the patient Order processing, drug packaging, cart fill, and medication dispensing occurs there Advantages 1. All resources can be localized into one area 2. Minimized drug inventory Disadvantages 1. The pharmacist is not able to directly interact with the physician and the nurse 2. Clinical services are limited
Decentralized Pharmacy Services
Operates through satellite pharmacies Satellite Pharmacy “Sub-pharmacy” that receives supplies from the main pharmacy Advantages 1. Direct interaction of the pharmacists with physicians and nurses (which can lead to increased physician and nurse satisfaction) 2. Pharmacists can provide clinical services to patients 3. Faster order filling 4. Fewer dispensing errors 5. Decreased need for floor stock medications
Pharmacy technicians have been trained to administer the drugs instead of nurses Pharmacy technicians assist in unit-dose dispensing and administration phases which is directly controlled and supervised by registered pharmacists
Lacorte, Aries S. 3D-PH | PHAR 5
SOURCES OF MEDICATIONS IN NURSING UNITS
RISE OF TECHNOLOGY Automated Dispensing Cabinets (ADCs)
Point-of-use medication storage devices located in patient care areas designed to allow nurses to have quick but accountable access to medications
Robotic Fill System
Centralized automated dispensing devices which automatically fill medication carts
Bar Code Technology
Help pharmacists track medication use and ensure that patients receive the correct medication
Lacorte, Aries S. 3D-PH | PHAR 5
