Pharmacy 155

Hospital Pharmacy
The Hospital
Health Care Institutions

Magaling na, magalang pa.

1. Long Term Health Facility

o for in-patient other than a hospital, with an
organized medical staff and continuous
nursing service
o provides medical, comprehensive,
preventive, rehabilitative, social, spiritual
and emotional in-patient care to individuals
o e.g. nursing homes, rehabilitation centers
2. Resident Treatment Facility
o provides safe, hygienic, living
arrangements for residents
o regular and emergency health services
o other support services
o provide therapy for

substance abuse

mental illness

other behavioral problems

3. Clinic
o facility or area where ambulatory patients
are seen for special study and treatment by
a group of physicians practicing together,
and where the patient is not confined in a
hospital
4. Health Maintenance Organization
o public or private organization that provides
comprehensive
health
services
to
individuals
enrolled
with
such
an
organization on a per capita prepayment
basis
o pioneer
in
the
Philippines:
Health
Maintenance Inc.
The Hospital

It is an organized structure which pools

together all the health professionals, the
diagnostic and therapeutic facilities, equipment
and supplies and the physical facilities into a
coordinated system for delivering health care
to the public.

pools together:
o healthcare professionals
o facilities
(diagnostic,
therapeutic,
equipment and facilities)
o physical facilities
Philippine General Hospital
Vision
Center of excellence and leadership
Mission
1. quality healthcare through effective
teamwork
2. train healthcare professionals to become
competent

Morano, KMS

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Hospital Pharmacy
Functions of the Hospital

1. Patient Care
The Medical City
Institute of Personalized Molecular Medicine
o
o
o
o
o
o

diagnosis and treatment of illness or injury

preventive medicine
rehabilitation
convalescent care
dental care
personalized care

2. Education
o education of medical and allied health
professions
o education of the patient
3. Research
o advancement of medical knowledge
o improvement of hospital services

1. Category A: Primary Care Facility

o first contact healthcare facility that offers
basic services including emergency service
and provision for normal deliveries

Classification of Hospitals
A.O. No. 2012-0012 (Rules and Regulations
Governing the New Classification of Hospitals and
Other Health Facilities in the Philippines)

b.

all kinds
injuries

specializes in a particular disease or

condition or in one type of patient

2. Functional Capacity
a. General Hospital

level 1

level 2

level 3
b. Specialty Hospital
c. Trauma Capability of Hospitals

Trauma-Capable Facility
Las Pias
designated as a trauma center

Morano, KMS

a.

with in-patient beds

infirmary

birthing home

b.

without beds

medical out-patient clinic

medical facility for overseas workers

and seafarers

dental clinic

of
or

Specialty
National Kidney and Transplant Institute
(NKTI)
Philippine Lung Center
Quezon institute
San Lazaro Hospital for Infections and
Communicable Diseases
Philippine Childrens Medical Center
Dr. Jose Fabella Maternity Service

3. Ownership
a. Government

created by law
b. Private

owned, established and operated with

funds through donation, principal,
investment or other means by any
individual, corporation, association or
organization
Classification of Other Health Facilities

4. Wellness
o reduction of incidence of illness
o improvement of general health of the
people

1. Scope of Services
a. General

provides services for

illnesses,
diseases,
deformities

comprehensive emergency medical

services
24/7 on-site trauma surgery
Trauma-Receiving Facility
within the trauma service area
which receives trauma patients for
transport to the point of care or a
trauma center

2. Category B: Custodial Care Facility

o provides long term care
a.

Custodial Psychiatric Care facility

National Center for Mental Health

b.

Substance/Drug Abuse Treatment

Rehabilitation Center
DDB Treatment and Rehab Center
NBI Treatment and Rehab Center

c.

Sanitarium/Leprosarium
Tala Hospital
Dr. Jose Rodriguez Memorial Hospital

d.

Nursing Home

and

3. Category
C:
Diagnostic/Therapeutic
Facility
o examines the human body or specimens
from the human body for the diagnosis,
sometimes treatment of diseases
a.

Laboratory Facility

clinical laboratory

HIV testing laboratory

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Hospital Pharmacy

b.
c.

drug testing
blood service facility
newborn screening facility

Radiologic Facility
Nuclear Medicine Facility

regulated by PNRI (Philippine Nuclear

Research Institute)

4. Category
D:
Specialized
Out-Patient
Facility
o performs highly specialized procedures on
an out-patient basis
a.
b.
c.
d.
e.
f.
g.

Dialysis Clinic
Ambulatory Surgical Clinic
In vitro Fertilization Center
Stem Cell Facility
Oncology Chemotherapeutic Center/Clinic
Radiation Oncology Facility
Physical
Medicine
and
Rehabilitation
Center/Clinic

Supporting Services
1. Nursing Service
o direct patient care
o nursing care
2. Dietary Service
o procurement, planning and preparation of
food for the patient and hospital staff
3. Central Supply Service
o supplies sterile linen, or packs and other
medical surgical supplies
4. Medical Record Service
o serve as basis for planning and continuity
of patient care
o provide data for use in research education
o serve as basis for review and evaluation of
the care rendered to the patient
5. Medical Social Service
o very important liaison between the hospital
and the patient and his community
o charity programs
6. Blood Bank
7. Pathology
o cytological and gross anatomical analysis
o clinical laboratories

anatomic pathology

clinical pathology

molecular pathology
8. Radiology
o diagnostic and therapeutic application of
radiant energy
9. Anesthesia
o sedation and anesthesia
Hospital Organization
1. Board of Directors
o provides the overall mission and goals of
the hospital
2. Hospital Director

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Hospital Pharmacy
o
o

responsible for implementing directives of

the board
manages all aspects of hospital operations

3. Chief Executive Officer

o responsible for day-to-day operations
4. Chief Finance Officer
o manages all revenues and expenses

given privileges to admit an occasional

patient to the hospital
may neither vote nor hold office in the
medical staff

6. Resident Medical Staf

o receiving specialized clinical training,
usually after completing an internship

5. Director of Nursing
o manages the nursing department which
handles direct patient care
6. Department Heads
o manage all aspects of a particular hospital
service
7. Medical Staf
o responsible for the quality of all medical
care provided to patients
The Medical Staf
1. Open Staf
o one which certain physicians are allowed to
use the private room facilities, provided
that they comply with all rules and
regulations of the institution
2. Closed Staf
o one in which all professional services,
private and charity are provided and
controlled by the attending physician
Diferent Groups of Medical Staf
1. Attending Medical Staf
o active medical staff
o responsible for taking care of patient and
who has direct involvement with the staff
organizational and administrative duties
o common attending physician
2. Consulting Medical Staf
o medical practitioners of recognized
professional ability
3. Honorary Medical Staf
o former staff members, retired or emeritus,
and of other practitioners whom the
medical staff chooses to honor
4. Associate Medical Staf
o future attending physician
o being considered for advancement to the
active medical staff
5. Courtesy Medical Staf
o consists of practitioners who are:

eligible for staff membership

Morano, KMS

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Pharmacy 155

Hospital Pharmacy
The Hospital Pharmacy

aka institutional pharmacy

practice of pharmacy in a hospital setting

including its organizationally related facilities
or services

department or division of the hospital wherein

the procurement, storage, compounding,
manufacturing,
packaging,
controlling,
assaying,
dispensing,
distribution
and
monitoring of medications through drugtherapy management for hospitalized and
ambulatory patients are performed by legally
qualified,
professionally
competent
pharmacists

area
and
assists
in
employee
evaluations
provides drug information as necessary
to the pharmacy, medical and nursing
staffs
coordinates the overall pharmaceutical
needs of the patient-care areas with
the dispensing area

Pharmacists Responsibilities
1. Central Pharmacists responsibilities
a. Dispensing Area

ensures that established policies and

procedures are followed
policies: what must be done
procedures: how to do the thing
that must be done

checks for accuracy of dose prepared

IV admixture
unit dose

provides for proper drug control

poisonous drugs: locked cabinet
biologicals: bioref
narcotics: double lock

ensures that good techniques are used

in compounding IV admixtures and
extemporaneous preparations

provides for proper record keeping and

billing
patient medication records
extemporaneous
compounding
records
IV admixture records and billing
investigation-drug records
reports
*Prescription book (2 yr)
*Dangerous Drugs book (1 yr)
*Poison book (5 yr)

maintains professional competence,

particularly in knowledge of drug
stability and incompatibilities
ensures that new personnel are trained
properly in the policies and procedures
of the dispensing area
coordinates the activities of the area
with the available staff to make the
best possible use of personnel and
resources
keeps the dispensing area neat and
orderly
communicates with all pharmacy staff
regarding new developments in the

Morano, KMS

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Hospital Pharmacy
b.

Patient-Care Area

supervision of drug administration

reviews and interprets each unit
dose and IV admixture medication
order to ensure that it is entered
accurately into the unit dose or IV
admixture system
confirms
periodically
that
administered doses are noted
correctly on the patients chart
ensures
that
records
from
administered narcotics are kept
correctly and that the physician is
informed of all automatic stop
orders

*ASOP (Automatic Stop Order Policy) when

the patient will undergo a procedure or when
the patient is transferred to another service

ensures
that
proper
drug
administration,
techniques
are
used
acts as a liaison between the
pharmacist and the nursing and
medical staffs
communicates with nurses and
physicians concerning medicationadministration problems
periodically
inspects
the
medication areas on the nursing
units to ensure that adequate
levels of floor stock drugs and
supplies are maintained
ensures that drugs and supplies
are procured from the dispensing
area as required
ensures that the other supportive
services
performed
by
the
department
of
pharmacy are
carried out correctly
coordinates all pharmacy services
on the nursing unit level
ensures that the medication area is
neat and orderly
ensures that proper security is
maintained in the medication area
to prevent pilferage
charge nurse: senior nurse on duty

direct patient care

identifies drugs brought into the
hospital by patients

Morano, KMS

A.O. No. 63 s. 1989

Patients have the choice if they want to
purchase medicines from the hospital
pharmacy or from outside the pharmacy.

obtains
patient
medication
histories and communicates all
pertinent
information
to
the
physician
assists in drug-product and entity
selection
assists the physician in selecting
dosage regimens and schedules,

then assigns drug-administration

times for these schedules
monitors
patients
total
drug
therapy
for
effectiveness/ineffectiveness, side
effects, toxicities, allergic drug
reactions, drug interactions, and
appropriate therapeutic outcomes
counsels patients on:
medications
to
be
selfadministered in the hospital
discharge medications
participates in cardiopulmonary
emergencies by:
procuring
and
preparing
needed drugs
charting all medications given
performing
cardiopulmonary
resuscitation, if necessary

2. Ambulatory Pharmacists responsibilities

a. Dispensing Area

Ensures that established policies and

procedures are followed

Checks for accuracy in the work of

supportive personnel

Ensures that proper techniques are

used in extemporaneous compounding

Provides for adequate record keeping

and billing: patient medication records,
investigational drug records, outpatient
billing, reports, and prescription files

Maintains professional competence

Ensures that new personnel are trained

properly in the policies and procedures
of the ambulatory pharmacy

Coordinates the activities of the area

with the available staff to make the
best use of personnel and resources

Keeps the ambulatory pharmacy area

neat and orderly at all times
b.

Patient-Care Area

Inspects the medication areas on the

nursing unit periodically to ensure an
adequate supply of stock drugs and
their proper storage

Identifies drugs brought into the clinic

by patients

Obtains patient-medication histories

and
communicates
pertinent
information to the physician

Assists in drug product and entity

selection

Assists the physician in selecting

dosage regimens and schedules

Monitors the patients total drug

therapy for effectiveness, side effects,
toxicities, allergic drug reactions, drug
interactions, and appropriate patient
outcomes

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Hospital Pharmacy

Counsels patients on the proper use of

their medication
Prepares
medications
for
IV
administration
Provides medications and/ or supplies
for patient home care

Divisions
1. Administrative Services
o plan and coordinate departmental activities
o develop policies
o schedule personnel and provide
supervision
o coordinate administrative needs of the
Pharmacy and Therapeutics Committee
(PTC)
*PTC Secretary: chief pharmacist

2. Education and Training

o coordinate programs of undergraduate and
graduate pharmacy students
o participate in hospital-wide educational
programs involving nurses, doctors, etc.
o train newly employed pharmacy
department personnel
3. Pharmaceutical Research
o develop new formulations of drugs
especially dosage forms not commercially
available and of research drugs
o improve formulations of existing products
o cooperate with the medical research staff
on projects involving drugs
4. In-patient Services
o provide medications for all in-patients of
the hospital on a 24-hour per day basis
o inspection and control of drugs on all
treatment areas
o cooperate with medical drug research
5. Out-patient Services
o compound and dispense out-patient
prescriptions
o inspect and control all clinic and
emergency service medication stations
o maintain prescription records
o provide drug consultation services to staff
and medical students
6. Drug Information Services
o provide drug information on drugs and
drug therapy to doctors, nurses, medical
and nursing students and the house staff
o maintain the drug information center
o prepare the hospitals pharmacy newsletter
o maintain literature files
7. Departmental Services
o control and dispense IV fluids
o control and dispense controlled substances
o coordinate and control all drug delivery and
distribution systems
8. Purchasing and Inventory Control
o maintain drug inventory control
o purchase all drugs
o receive, store and distribute drugs
o interview medical service representatives

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Hospital Pharmacy
9. Central Supplies Services
o develop and coordinate distribution of
medical supplies and irrigating fluids

10. Assay and Quality Control

o perform analyses on products
manufactures and purchased
o develop and revise assay procedures
o assist research division in special
formulations
11. Manufacturing and Packaging
o manufacture wide variety of items in
common use at the hospital
o operate on overall drug packaging and
prepackaging program
o undertake program in product development
o maintain a unit dose program
12. Sterile Products
o produce small volume parenterals
o manufacture sterile ophthalmologics,
irrigating solutions, etc.
o prepare aseptic dilution of lyophylizal and
other unstable sterile injection for
administration to patients
13. Radiopharmaceutical Services
o aka nuclear pharmacy
o centralize the procurement, storage and
dispensing of radioisotopes used in clinical
practice
14. IV Admixtures
o centralize the preparation of IV solution
admixture
o review each IV admixture for physicchemical incompatibilities

Morano, KMS

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Hospital Pharmacy

Morano, KMS

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Hospital Pharmacy
Hospitals

Level 1
Consulting Specialists in:
Medicine, Pediatrics, OBGyne, Surgery

Level 2
Level 1 plus all:

Level 3
Level 2 plus all

Departmentalized
clinical services

Teaching/training with
accredited residency
training program in the 4
major clinical services
Physical Medicine and
Rehabilitation Unit
Ambulatory surgical
clinic

Clinical services for

In-patients

Ancillary Services

Emergency and outpatient services

Isolation facilities

Respiratory unit

Dental clinic
Secondary clinical
laboratory
Blood station
1st level X-ray

NICU
Tertiary clinical
laboratory
Blood station
2nd level X-ray with
mobile unit

General ICU

Tertiary lab with

histopathology
Blood bank
3rd level X-ray

Pharmacy

Morano, KMS

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