DRUG DISTRIBUTION:

Pointers for newbies

 Deals with drug distribution from the Main pharmacy to the

various pavilions (nursing stations, wards etc).
Methods :
Individual prescription method
Floor stock system
Individual prescription method + Floor stock system
Unit Dose Dispensing (UDD).
INDIVIDUAL PRESCRIPTION METHOD :
In smaller hospitals w/ inpatient facility.
Prescription written by the prescriber is carried to the wards.
Advantage Pharmacist directly handles the prescription.
FLOOR STOCK SYSTEM :
2 types of drugs Charge floor stock drugs, Non-charge floor stock
drugs.

Charge Floor Stock Drugs :

Drugs given to the patient, that are charged to the patients OWN
account.
Non-charge Floor Stock Drugs :
No direct charge to the patient.
Charges are levied to the daily ward bill.
Advantages :
Ready availability of required rugs.
Elimination of drug returns.
Reduction in the number of drug-ordered transcriptions for the
pharmacy.
Reduction in the number of pharmacy personnel required.
Disadvantages :
Medication errors may increase (medication orders are NOT reviewed
by the pharmacist).
Increased drug inventory on the pavilions

Disadvantages (contd.)

Greater opportunities for pilferage and wasting.

Increased hazards associated with drug deterioration.
Increased work load for the nurses.
More capital required (in the absence of proper storage facilities).

INDIVIDUAL PRESCRIPTION METHOD + FLOOR STOCK SYSTEM :

Followed in some hospitals.
Drug stock in the wards will be less.

Selection of Charge floor stock drugs :

PTC makes the decision.
Pharmacist must ensure that the selected / approved drugs are
available in the various pavilions ASAP.
Examples
Injectable charge floor drugs (Antiallergenic injectables; antibiotics;
anticoagulants; antihypertensives; CV agents; antiepileptics;
antinauseants).
Selection of Non-charge floor stock drugs :
Following considerations are to be made
Cost of preparation
Frequency of use.
Quantity used.
Effect upon the hospital budget.

PRESCRIBING FLOOR STOCK DRUGS

Physician writes the prescription.
A carbon copy of the prescription is sent to the pharmacy.
The physicians order is transcribed by the hospital personnel
assigned to the nursing station.
LABELLING
Charge floor stock drugs
TO WARD ___________ (Name or Number)
NAME OF THE PREPARATION
FORMULA
NAME OF HOSPITAL
Non-charge floor stock drugs
TO WARD ___________ (Name or Number)
NAME OF THE PATIENT
NAME OF THE PREPARATION
NAME OF HOSPITAL

PHARMACISTS ROLE
1] Envelope method :
Envelope is the carrier for the drug.
Name and quantity of drug; patients name is written on the
envelope.
Nurse dispenses from this envelope to the patient, if prescribed by
the physician.
Envelope is sent back to the pharmacy and the charges levied
accordingly.
2] Drug basket method :
Requires an inventory of the nursing units to which the drugs are
sent.
Nurse takes inventory of the all the drugs in the nursing unit (at
days end).
This report is placed in the basket, which is then sent to the
inventory.
Next day pharmacist refills it and sends it back to the nursing
units.

3]

Mobile Unit :
Nursing unit send a copy of drug requisition order to the pharmacy.
Drugs are dispensed via the Mobile Unit.
Mobile Unit
Stainless steel; ht. (60 in.); width (48 in.); depth (25.5 in.).
Main body is mounted on six 8 in. balloon wheels (central wheel is
stationary; other wheels are rotating type).
2 locking, sliding doors w/ handle for pushing.
4] Unit Dose Dispensing (UDD):
All those medications which are ordered, packed, administered,
charged in multiples of single doses, and which contain a predetermined amount, needed for a single application.
2 types Centralized Unit Dose Dispensing (CUDD)
Decentralized Unit Dose Dispensing
(DUDD)

CUDD
No flow or satellite pharmacies.
Only central pharmacy.
Drugs are dispensed via mobile carts and dumb waiters.

DUDD
Satellite pharmacies (storage for the drugs).
Advantages :
Improved pceutical care to the patient.
Patients are charged only for the medications administered to
them.
Pcist packs all the medications which are required in the nursing
stations (this allows the nurse more time for patient care).
Eliminates credits; reduces pilferage, drug wastage and revenue
costs.
Reduces the storage space in the nursing units.

Introducing UDD in hospitals :

Purchase all equipments needed to pack UDD.
Adjusting w/ other hospitals.
Purchasing all the drugs in UD packages.

UDD PROCEDURE
Admission

Patient details are entered in patient profile card

Physician orders the medication, after examinations

Pcist receives copies of the medication order

Medications are entered into the patient profile

card
Pcist checks the medications ordered ( for allergies; DIs and
rational Tx)

Drugs are sent to the nursing stations via medication

carts
Nurse administers the medication and enters into medication
records.
Cart is re-checked by the pcist upon return to the
pharmacy
(if the drugs ordered were administered to the patient
or not)

THANK YOU