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DRUG DISTRIBUTION

SYSTEM

JISHNU.R.K
PHARM D (PB)
KMCH COLLAGE OF PHARMACY

DRUG DISTRIBUTION SYSTEM

DEFINITION
Supply of drugs in the hospitals and other
clinics for the treatment of indoor and
outdoor patients by indent system.

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IN-PATIENT SERVICES
Types
Individual prescription order system
Complete floor stock system
charge floor system and
non charge floor stock system
Combination of individual drug order and floor
stock system
Unit dose dispensing system
Charge non-floor stock system

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1. INDIVIDUAL PRESCRIPTION ORDER


SYSTEM
Used by small and private hospitals
because
of
reduced
man
power
requirements.
Physician
writes the prescription for
individual patient who obtains the drugs
prescribed by paying own charges.
Advantages:
Medn. orders are directly reviewed by the
pharmacist.
Provides interaction with pharmacist and
other medical staff and patients.
Provides clear control of inventory.

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2.THE COMPLETE FLOOR STOCK


SYSTEM
Often used in the government hospitals
The drugs are given to the patients
through
nursing
stations
and
the
pharmacy supplies from the drug store of
the hospitals.
Drugs on nursing station or ward may be
divided into
a) Charge floor stock drugs
b) Non charge floor stock drugs

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Charge floor stock drugs:


Medicines (stocked in nursing stations) are
charged to the patients account after they
have been administered.
Selection of charge stock drugs: Decision
as to which drug shall be placed should rest
with the PTC. The list of drugs may vary from
hospital to hospital.
In the same hospital the list of drugs may
change from time to time as per the
recommendations of the PTC.
e.g.
Antiallergics-hydrocortisone
sodium
succinate
Antibiotics-penicillin G.
mannitol injections, dextrose 50%, 25%
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Non charge floor stock drugs:


Used by patients in unit ward and for which
there may be no direct charge to the patients
account .
Cost of this group of drugs, is calculated as, per
day cost of room or ward .
Selection of non charge stock drugs:
Consideration is given to the cost of
preparation, the quantity used, and the effect
on hospital budget and reimbursement from
third party payers (Employees state insurance
scheme).It varies from hospital to hospital.
Ampoules: digoxin, adrenaline
Tablets: aspirin, paracetamol
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Contd
Advantages:
Easy and fast availability of drugs.
Elimination of returns of drugs to the store or
pharmacy.
Reduction in number of drug transcriptions for the
pharmacy.
Reduction in the number of pharmacy staff required.
Disadvantages:
Increase in medication error (due lack of review of
medn. order).
Greater chances of pilferage.
Increase drug inventory in the ward.
Greater work load for nurses.
Increase drug deterioration.
Lack of proper storage facilities
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Contd
Drug basket system:
Used currently by hospitals for stocking non
charge floor stock drugs and selected
products in the wards.
Mobile dispensing unit:
Used in hospitals to take medications to the
patients bedside for carrying out dressings
and also drugs to be administered.

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Mobile Dispensing Unit & Drug basket


system

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3. COMBINATION OF INDIVIDUAL DRUG


ORDER AND FLOOR STOCK SYSTEMS

Uses individual prescription as primary


means of dispensing but also utilize a
limited floor stock.

Most commonly used in hospitals of our


country.

Modified to include use of unit


medications.
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4.Unit dose dispensing system


Those medications which are ordered, packaged,
handled, administered and charged in multiples of
single dose units containing a predetermined
amount of drug or supply sufficient for one regular
dose, application or use.
Procedure
Depending upon the hospital and its pharmacists
choice. They are:

Central unit dose drug distribution system


(C.U.D.D.)

Decentralized unit dose distribution system


(D.U.D.D.)

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Centralized unit dose dispensing:

Inpatient drugs are dispensed in unit doses.


Drugs are stored in a central area of
pharmacy
Dispensed at the time the dose is due to be
given.
Medication carts and dumb waiters are
needed.
Necessary to sent a copy of original medn.
order to the pharmacy for the direct
interpretation and dispensing.
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Decentralized unit dose system


Operates
through
small
satellite
pharmacies (A branch of main pharmacy)
located on each floor of the hospital.
Wards obtain their required drugs instead
of going to the main pharmacy.
Main pharmacy feeds the medicines to the
mini pharmacies.
The delivery system is accomplished by
use of medication carts .

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contd..
Advantages Of Unit Dose Dispn:
Improved pharmaceutical services for the patients.
Allow the pharmacist to interpret a copy of medn.
order there by reducing medn. error.
Eliminates labeling mistakes, duplication of order
and paperwork at nursing area and Pharmacy.
It
transfers
I.V.
preparations
and
drug
reconstitution procedures to the pharmacy.
It eliminates pilferage or drug waste by partial
usage of drugs.
It can save the time both in pharmacy and nursing
service.
Promotes efficient utilization of professional and
non professional personnel.
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Unit dosage system

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5.DISPENSING OF CHARGE NON FLOOR


STOCK DRUGS

Ordering, dispensing and accounting of drugs


consume a lot of time on nursing services and
pharmacy personnel.

One method adopted to identify the patient is


the charge plate prepared on the admission to
hospital where the nursing time is saved .

All newly printed hospital forms usually


reserve a suitable place in the upper right or
left hand corner of the form for information on
the identification plate (plastic or metal card).
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5.DISPENSING OF CHARGE NON FLOOR


STOCK DRUGS

All charge stations are equipped for using this


time saving device which yields an important
by-product viz. legibility of identity.

Items with an extremely heavy demand have


specific card with all the information preprinted.

All that is necessary is the patients identity


which is quickly supplied through the use of the
charge plate.
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THE ENVELOPE SYSTEM

In this system, an envelope may be used


to dispense drug to the wards.

It can also be used to indicate the charges


for the drugs for the patients to pay.

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BED SIDE PHARMACY

They are essentially locked medication


drawers which are located in patient
servers, which are specially designed
supply closets build into the hall wall at
the entrance to each patients room.

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CENTRAL STERILE SERVICES


Operates centrally.
Supplies
entire requirement of sterile
materials of the hospital and all things
needed to the sterile area of the hospital
(operation theatre).
Includes non sterile materials needed to
the operation theatre.

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THANK YOU

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