1

ORGANIZATION AND STRUCTURE

Syllabus
Organization of a hospital and hospital pharmacy.
Responsibilities of a hospital pharmacist.
Pharmacy and therapeutic committee.
Budget preparation and implementation.
DEFINITION
1. "Hospital" means any institution, place, building or agency, public or private, whether organized for profit or not;
devoted primarily to the diagnosis, treatment or care of patients admitted for overnight stay or longer in order to obtain
medical care, surgical care, obstetrical care, or nursing care for illness, disease, injury, infirmity, or deformity.
2. "General hospital" means a hospital maintained for the purpose of providing hospital care in a broad category of
illness and injury.
3. "Specialized hospital" means a hospital maintained for the purpose of providing hospital care in a certain category, or
categories, of illness and injury.
4. Hospital pharmacy is defined as the practice of pharmacy in a hospital setting including its organizationally related
facilities and service.
ORGNIZATION OF HOSPITAL PHARMACY

Hospital Administrator
Director of Pharmacy
Executive and Administrative Operations
Professional and
Clinical Services

Educational and
Technical Services

Research and
Support Services

Nuclear Pharmacy
Service Division

Drug information and poison

control services division

Pharmaceutical and clinical

research division

Unit Dose Dispensing

Division

Education and training division

Assay and quality control

division

Ambulatory care
and Home care
Services Division
Intravenous admixture
Division
Sterile products
division
Clinical Pharmacy
Services Division

Professional staff development

Residency training program

Drug kinetics and

bioavailability laboratory

Technician selection and

training division

Manufacturing and
packaging division
Purchasing and inventory
control division
Departmental services
division
Investigational drug
studies division

S2 / Hospital Pharmacy / Chapter 1 / Organization of Hospital Pharmacy / A. Samanta

RESPONSIBILITIES OF HOSPITAL PHARMACISTS

The responsibilities of hospital pharmacists can be summarized as follows:
I.
In-patient Pharmacists responsibilities
A. Dispensing area
B. Patient care area
(i) Supervision of drug administration
(ii) Direct patient care
(iii) General responsibilities
II.
Out-patient Pharmacists Responsibilities
A. Dispensing area
B. Patient care area
C. General responsibilities
I. In-patient Pharmacists responsibilities
A. Dispensing area
1. Insures that established policies and procedures are followed
2. Checks for accuracy of doses prepared:
a. Intravenous admixtures
b. Unit dose
3. Provides for proper drug control:
a. Insures that drugs are stored and dispensed properly (e.g. investigational drugs)
b. Insures that all the drug laws are followed.
4. Insures that proper techniques are used in compounding intravenous admixtures and extemporaneous preparations.
5. Provides for proper record keeping and billing
a. Patient-medication records
b. Extemporaneous compounding records
c. Intravenous admixture records and billing
d. Reports (e.g monthly workload report)
6. Maintain professional competence, particularly in knowledge of drug stability and incompatibilities.
7. Insures that new personnel are trained properly in the policies and procedures in the dispensing area.
8. Coordinates the activities of the area with the available staffs and resources.
9. Keep the dispensing area clean and orderly.
10. Communicates with all pharmacy staff regarding new developments in the area and assists in employee evaluations.
11. Provides drug information as necessary to pharmacy ,medical and nursing staffs.
B. Patient-Care area
1. Supervision of drug administration
a. Reviews and interprets each unit dose and IV admixture medication order (prescription) to ensure that it is
dispensed correctly.
b. Reviews each patients drug administration form periodically to ensure that all doses are administered and noted
in a chart correctly.
(i) Reviews all the doses missed, reschedule the doses as necessary and put signatures on all drugs not given
notices.
(ii) Insures that new drug-administration forms are transcribed accurately for continuity of drug therapy.
c. Confirms periodically that administered doses are noted correctly on the patients chart.
d. Keep records of narcotic administered to the patients.
e. Acts as liaison between the nursing and other medical staffs.
f. Periodically inspects the medication area to insure adequate stock of drugs in the patient-care area.
2. Direct patient care (Wards, operation theatre etc.)
a. Identify the drugs brought into the hospital by the patients.
b. Obtains patient medication history and produce it to the physician.
c. Assists the physician in selecting dosage regimens and schedules and then assign drug-administration times
for this schedules.
d. Monitors patients total drug therapy
(i)
Effectiveness / ineffectiveness
(ii)
Side effects
(iii)
Toxicities
(iv)
Alergic drug reactions
(v)
Drug interactions

S2 / Hospital Pharmacy / Chapter 1 / Organization of Hospital Pharmacy / A. Samanta

e.
f.

(vi)
Drug interactions
(vii)
Appropriate therapeutic outcomes.
Counsels patients on
(i)
Self medication in hospital
(ii)
Discharge medication
Participates in cardiopulmonary emergencies by
(i)
Procuring and preparing required drugs
(ii)
Charting all medications given.
(iii)
Performing cardiopulmonary resuscitation, if necessary.

3. General responsibilities
a. Provides education to
(i)
Pharmacists, students and residents.
(ii)
Nurses and nursing students
(iii)
Physicians and medical students
b. Provides drug information to physicians, nurses and other health-care personnel.
II. Out-patient pharmacists responsibilities
A. Dispensing Area
1. Insures that established policies ad procedures are followed.
2. Checks for the accuracy in the work of supportive personnel.
3. Insures that proper techniques are used in the compounding of the drug.
4. Provides for record keeping and billing
a. Patient medication records
b. Investigational drug records
c. Outpatient billing
d. Reports
e. Prescription files
5. Insures that new personnel are trained properly in the policies and procedures of the ambulatory patients.
6. Keeps the ambulatory pharmacy area neat and orderly at all times.
B. Patient Care Area
1. Inspects periodically the medication areas on the nursing unit to insure an adequate supply of stock drugs and
their proper storage.
2. Identifies the drugs brought by the patients.
3. Obtain patient-medication histories and conveys the information to the physicians.
4. Assists the physician in selecting dosage regimens and schedules.
5. Monitors the patients total drug therapy for effectiveness, side-effects, toxicities, allergic drug reactions, drug
interactions etc.
6. Counsels the patients on proper use of the medication.
7. Prepares medication for intravenous administration.
8. Provides medication for patients home care.
C. General Responsibilities
1. Provides drug information as necessary to the pharmacy, medical and nursing staffs.
2. Provides adequate drug control.
a. Insures that drugs are handled properly (e.g. investigational new drug)
b. Insures that all laws are followed.
3. Participates in cardiopulmonary emergencies by
4. Provides in-service education to
a. Pharmacists, and students.
b. Nurses and nursing students.
c. Physicians and medical students.