INTERNSHIP REPORT POF HOSPITAL

SESSION: JUNE 2018- JULY 2018

SUBMITTED TO:
DR. MEHFISHAN FEROZ

SUBMITTED BY:
ROHAIL BHATTI
 SELF-INTRODUCTION
My name is Rohail Bhatti and I am a student of Pharm-D (5th year) at Riphah International University,
Islamabad.
On 13th June 2018 Wednesday, I have started my internship in POF hospital. This internship was
supervised by Dr. Ayesha Rehman (RPh).

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 ACKNOWLEDGEMENTS
First of all, I am thankful to Almighty ALLAH and then my parents. The internship opportunity I
had with POF hospital was a great chance for learning and professional development.
Subsequently, I see myself as an exceptionally fortunate individual as I was given a chance to be
a part of it. I am additionally appreciative for having an opportunity to meet such a large number
of great individuals and experts who drove me through this period, where I served as an internee.
I wish to express my sincere gratitude to Brig. Commandant, and Deputy. Commandant, at POF
hospital for giving me the opportunity to do my internship at this highly esteemed organization.
I am grateful to Dr. Mehfishan Feroze, MO I/C of Medical store and Dr. Ayesha Rehman (RPh).
for their valuable guidance, advice, suggestion and encouragement rendered to me at every stage.
I am also extremely thankful to all the staff members of medical store for giving me guidance
during the period of internship.
The guidance and support received from all the members who contributed to this internship
program was vital for the completion of this study. I am grateful to all of them for their constant
support and guidance either directly or indirectly towards completion of my internship.

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CONTENTS
Self-Introduction.........................................................................................................................................1
Acknowledgements.....................................................................................................................................2
About Hospital.............................................................................................................................................4
Objectives:...................................................................................................................................................5
Rotation summary:......................................................................................................................................5
Medical store:..............................................................................................................................................6
OT drug store:..............................................................................................................................................8
Wards:.........................................................................................................................................................9
Medical Unit I/II/III (Male and Female):..................................................................................................9
Surgical wards (Male and Female):..........................................................................................................9
Child ward:..............................................................................................................................................9
ICU (Intense care unit):............................................................................................................................9
CCU (critical cardiac unit):.....................................................................................................................10
Emergency (ER):........................................................................................................................................10
Pathology department/ Labs:....................................................................................................................11
Machines...................................................................................................................................................13
ECG machine:........................................................................................................................................13
Needle cutter:........................................................................................................................................13
Nebulizer:..............................................................................................................................................13

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 ABOUT HOSPITAL
POFs Hospital was established in 1962 with an initial capacity of 103 beds. Hospital capacity
increased 200, 400 and 500 beds in 1963, 1969 and 1987 respectively. Existing bed strength is
676 due to introduction of new departments over successive years. It is now a modern tertiary
care hospital providing teaching facilities to Wah Medical College. The hospital is recognized
for house job and postgraduate training in various disciplines. The hospital is responsible to
provide health care facilities to serving/ retired POF’s employees, army personnel posted to POF
and employees of allied departments (CMA, IDA etc.) The hospital also extends diagnostic and
treatment facilities to general public residing in the area on payment.
Different departments of POF hospital are mentioned below:
 Department of Radiology
 Department of ENT
 Department of Psychiatry
 Department of Ophthalmology
 Department of Rehabilitation medicine
 ICU (Intense Care Unit)
 CCU (Critical Cardiac Unit)
 Department of Medicine
 Department of Surgery
 Department of Obstetrics and Gynecology
 Department of Pediatrics
 Department of Dentistry
 Family Planning and Child Welfare Centre
 Accident & Emergency

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OBJECTIVES:
My major aim was to explore each and every level of workflow in hospital pharmacy and learn
clinical aspects of my field in the hospital. This whole session that I spend in the hospital as an
internee, turned out to be a fruitful as it helped me gain confidence in my field and build my
character. As an internee I worked in medical store for IDP (In patient Dispensing) and
dispensed medicines, disposables and surgical items to the wards.
I gained number of skills in my tenure of internship in the organization. I shall write it according
to departments.

ROTATION SUMMARY:

WARDS ROTATION DATE

MEDICAL OPD

CHILD WARD

FEMALE MEDICAL UNIT I & II

MALE MEDICAL UNIT I & II

MALE SURGICAL

ICU

CCU

EMERGENCY

OT / ITC

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MEDICAL STORE:
Medical store is the major area of expertise in field of pharmacy. In my internship at POF
Hospital’s store I learned about dispensing of medical towards wards and out patients. I also
made extemporaneous preparation including different topical ointments and creams.
Medical store in POF hospital is divided into different sections to maintain the workflow
smoothly and briskly making it possible to increase the supply of medication and other items to
the patients on time.
Whenever a signed demand is received from the ward, it is counterchecked and approved by the
Head Pharmacist and then indent is divided and filled in three areas.
1. Tablets, capsules, sachets, ointments and syrups are released from retail section
2. General injectable, syringes, extemporaneous preparations, cannulas are released from
second section of retails
3. The remaining intend which includes IV fluids/infusions, disposables and surgical items
are released from the store. Store also dispenses toiletries and costly medications
including Intra-Globin’s for IV use. Lab reagents and chemotherapy are stored and
dispensed from major store as well.
The dispensing system used is UNIT DOSE DISPENSING SYSTEM.
Some of the items that are not available in the store are locally purchased and LP forms are
generated. Hospital has a contract with the local drug store and patients get the medication from
the local pharmacy and hospital lately pays the charges. For ward patients local purchase
medications are purchased and delivered to the ward by the store staff.
Each item released from the stock is recorded, to maintain the stock data and calculate the
turnover rates.
All the Data is recorded on the
summary sheets and a number is
allotted to each demand slip and
number of items released against
slip are recorded. All the data entry
in the store is done manual over
hard paper backups. One of the
major lacking of the store is manual
management of stock. Manual
record keeping is tedious task and
requires number of labor.
All items in store are kept
according to the storage conditions
described on the label and approved
by the ISO standards.

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The general layout of the store includes:

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Medical store activities:
Activities that I performed in store are enlisted below
 Reading of prescriptions
 Prescription filling
 Brands and generic names
 Alternative brands
 Strength of drugs
 Doses of drugs
 Counseling patient about medicine
 Dispensing pastes, creams and ointments
 Filling of wards medication
 Inventory management
 Indent Completion
 Interaction with injectable
 Cold room (vaccines, anti-cancerous, anti-sera)

OT DRUG STORE:
OT store is meant to dispense medication and surgical items to individual patient.
Major items dispensed include:
 Anesthesia: local, general and inhalation
 IV sets, transfusion sets
 Catheters
 Antibiotics
 Surgical gloves, bandages
 Sutures: vicryl, prolene and silk

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WARDS:
Medical Unit I/II/III (Male and Female):
Medical unit wards are meant to keep the patient with generalized and more common complaints
including Diabetes, Infections, respiratory track disease (i-e: Asthma, COPD, Pneumonia).
Patients from ICU and CCU are also shifted to medical wards after recovery, but kept under
observation in ward.
In my rotations to these wards, I learned theoretical aspects of the major community diseases. In
addition, on:
 X-rays evaluation
 Case studies
 History taking
 Dialysis protocols (Procedure, Dialysis fluids & equipments)
 TB clinic (For follow up of Tuberculosis patients)

Surgical wards (Male and Female):

Child ward:
Child ward is specified from pediatrics and ward is fully equipped with all the facilities. Ward
walls are colored and painted with different cartoon character to intrigue the child and make
them feel better.
 Theoretical learning about seizures and its treatment.
 History taking
 Physical examination

ICU (Intense care unit):

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CCU (critical cardiac unit):
CCU keep patients with severe cardiac conditions including Myocardial infarction (STEMI,
Non-STEMI), IHD, Mitral stenosis, Angina, LBBB, Stroke etc. Our rotation in CCU was under
the supervision of Dr. Abdul Rasheed (Cardiologist) and he was most supportive and
motivational person throughout our sessions in wards.
Theoretical learning of cardiac diseases.
Medical protocols for cardiac diseases.
 ACS protocol
 Streptokinase protocol
 CVS DRUGS: Anti-Angina/ Anti-Hypertensive/ Diuretics/ Anti-arrhythmic/Anti-
Coagulants
 Antibiotics
 Anti-Diabetic
 Anesthetics
 Anti-Malarial
 Anti-Tuberculosis
 Anti-Parkinsonism
Procedures learned:
 Nasogastric intubation
 Internal Urinary catheterization
 ABG’s sampling and evaluation
 Making discharge slip
 Patient education on using Rota halers
 ECG evaluation
 Palpating the patient for heart sounds

EMERGENCY (ER):
Emergency is divided into 3 sections namely: critical, non-critical and child emergency.
 Emergency treatment of various diseases
 Filling of injections
 Administration of I.V cannulas, S.C, I.M & I.V injections
 Preparing I.V drips
 Taking blood samples
 Checking blood glucose & blood pressure
 Nebulization
 Performing ECG
 Proper disposal of injectable
 Emergency medication
 Sutures in Minor OT of ER

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PATHOLOGY DEPARTMENT/ LABS:
Sections:
 Recipient
 Sample counter. Phlebology area
 Clinical Pathology
 Chemistry
 Hematology
 Special chemistry
 Sample distribution room
 Microbiology labs
 Histology labs

Recipient: Data entry & Allocation of ID number against each patient profile
Sample collection: Sample tubes with color coding, additives, sample Qty.
Clinical pathology section: Tests performed Urine R/E and stool R/E
Chemistry: Tests performed in this section are:
Lipid profile, RFT’s, LFT’s, Cardiac enzymes
Analyzers are calibrated every morning against the reference samples.
Analyzers used:
 COBAS C311
 BECKMAN AU480
Hematology: Tests performed in this section are:
Blood CP, PT/PTT, INR, CSF R/E, Bone Marrow examination, Anybody fluid
Analyzers for Blood CP:
 SYSMEX KX-21 (03 PARTS)
 SYSMEX XT-2000i (05 PARTS)
 SYSMEX XN-7000 (07 PARTS)
Special chemistry:
Tests performed: ELISA for: HBV, syphilis, HIV, HCV
Analyzers:
COBAS e411: used for HBC, HIV, Syphilis and HCV

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ARCHITECT i1000: used for Hormonal tests (LH, TSH) Thyroid (T 3, T4), carcinogenic tests,
HbA1c
Microbiology:
Theoretical learning about Growth media, differential medias. Preparation and dispensing of
media.
Equipments: Incubator, Autoclave, Biosafety cabinet
Histology department:
Tissues are received in histology department after surgical removal and following protocol is
followed for preparation of the slide.

REPRESENATTIVE
GROSS
TISSUE SAMPLE FIXATION POTION
EVALUATION
DISECTION

DEPHYDRATION,
BLOCKING IN
CLEARING AND FREEZING MICROTOME
WAX
EMBEDDING

LABELING AND
INCUBATION FOR
STAINING MOUNTING FORWARDED TO
WAX REMOVAL
PATHOLOGIST

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MACHINES
ECG machine:
 Purpose: to find electrical activity of heart
 Duration of Operation: 1-2 min
 Wires attachment sites: chest and limbs
 Total no. of leads: 10

Needle cutter:
 Purpose: To discard used syringes
 Sample: Used syringes
 Working: Pressing the ends of the cutter by placing the needle between the two ends

Nebulizer:
 Purpose: Used for inhaling a medicinal drug
 Duration: 10 min
 Working: It produces fine spray of medicinal liquid which patient can inhale easily

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Thank you 

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