SECTION 2: PHARMACY PRACTICE ROTATIONS

DRUG DISTRIBUTION
Overview
A clear understanding of the drug distribution system, from the receipt of drugs
by the institution through their administration to the patient, is fundamental to
your role as a hospital pharmacist. In this rotation, you will increase your
knowledge of drug distribution systems and the roles of various health care
providers within them. You will develop necessary skills to function in key areas
of the drug distribution system, and begin to solve problems related to drug
distribution issues.

Objectives
At the end of the rotation, you will be able to:

• describe all legal requirements and professional standards that pertain to the
distribution and control of drugs in health care organizations

• demonstrate evidence of understanding of policies and procedures relating to

drug distribution and administration in your institution

• explain the principles, advantages, and disadvantages of various drug

distribution systems used in health care organizations

• describe the role of drug distribution as a component of the provision of

pharmaceutical care

• identify potential drug-related problems that could occur as a result of your

organization’s drug distribution system, and identify ways to prevent their
occurrence

• describe the role of pharmacy technicians and other support personnel in the
functioning of the drug distribution system
• demonstrate an acceptable level of performance in all areas of the program
hospital’s pharmacy drug distribution system

• demonstrate an ability to work productively with support personnel in the

pharmacy, and with other health care providers when addressing drug
distribution system issues

• explain the process of medication incident reporting and analysis

• use dispensary references to solve drug distribution system-related problems,

and drug-related problems identified through profile review

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SECTION 2: PHARMACY PRACTICE ROTATIONS

• describe the implications and role of technology in supporting drug distribution

system processes

• Site specific Learning Objectives:

• Resident’s Personal Learning Objectives (knowledge, skills, scheduling

issues, etc:

Activities
To achieve the objectives of this rotation, you should complete the following
activities, and other additional activities suggested by your preceptor:

• tour the pharmacy department and all other areas in the hospital where
pharmacists are located

• tour the main areas of the hospital, noting where applicable, components of
the drug distribution system in each area

• if possible, tour other hospitals to observe different drug distribution systems

• complete your department’s general staff orientation activities

• observe the main steps in the drug distribution system, from the time a
medication order is written, to the time when the medication is administered to
the patient and recorded by the nurse

• review the references available in the pharmacy, and note how they are used
to solve drug distribution system problems

• review the departmental policies and procedures for each of the activities that
you observe and/or participate in during the rotation

• observe and assist technicians in their various assignments within the drug
distribution system, including all record-keeping :
• purchasing/inventory control
• dispensary
• narcotics
• prepackaging/bulk manufacturing
• unit dose picking/filling cassettes
• wardstock/night cupboard
• nonsterile compounding
• returns

• observe and assist pharmacists and/or technicians in all dispensary functions,

including record-keeping where required:

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SECTION 2: PHARMACY PRACTICE ROTATIONS

• computer order entry and profile review

• verify orders/clarify problem prescriptions
• interim doses, stat medications and/or individual patient
prescriptions (new, refills)
• nonformulary drugs/unavailable drugs
• automatic substitutions
• restricted drugs
• investigational/emergency release drugs
• pass medications
• patient’s own medications
• borrowing/lending medications
• observe and assist pharmacists in their supervisory role in various areas of the
department

• assist with maintaining workload measurement records in each area of the

department

Readings/Resources
1. Refer to internal department documents, such as staff orientation manuals,
and policy and procedure manuals, as needed throughout your rotation.

2. Review the CSHP Standards of Practice 2003 that relate to drug distribution
activities.

3. Review the following CSHP Guidelines, Statements and other documents

pertaining to drug distribution:
Guidelines for Bulk Compounding of Products in Hospitals 1992
Guidelines for Drug Packaging and Labelling for Manufacturers 2001
Guidelines for Handling and Disposal of Hazardous Pharmaceuticals (Including Cytotoxic
Drugs) 1997
Guidelines for Medication Incident Reporting and Medication Incident/Discrepancy Prevention
1999
Guidelines for Preparation of Sterile Products in Pharmacies 1996
Guidelines for Preparing Medications for Natural Rubber Latex (NRL) Sensitive/Allergic
Patients 2001
Guidelines for Repackaging Products in Health Care Facilities 1998
Guidelines for Use of Drugs in Clinical Trials in Health Care Facilities 2001
Statement on Responsible Environmental Practices for Hospital Pharmacy 2001
Statement on Size, Shape & Colour of Medications 1995
Statement on the Role of the Pharmacy Technician 2001
Statement on the Role of the Pharmacist as Head of Hospital Pharmacy Services 2006
Statement on Unit Dose & IV Admixture Drug Distribution 1998
Information Paper on the Role of the Pharmacy Technician 2001

4. Complete additional assigned readings for this rotation.

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