Chapter 2 Hospital pharmacy and its organisation

Chapter 2:
Hospital Pharmacy and its

Organisation
Contents
• Definition of Hospital Pharmacy
• Functions of Hospital Pharmacy
• Organisation Structure
• Location
• Layout
• Floor Space Requirements
• Staff Requirements
• Responsibilities and Functions of Hospital Pharmacists
Definition of Hospital Pharmacy
• Hospital pharmacy functions for receiving, storing and dispensing drugs

and medicines to patients.
• The department provides a range of pharmacy services for the hospitalised
and ambulatory patients, including purchase, manufacture,
compounding, storage, dispensing, distribution, and maintaining
record for the same.
• Hospital pharmacy is the health care service, which comprises the art,
practice, and profession of choosing, preparing, storing, compounding,
and dispensing medicines and medical devices, advising healthcare
professionals and patients on their safe, effective and efficient use.
Functions of Hospital Pharmacy
Attains
supply
Provides Inspects
Discusses Dispenses
Keeps a
Implements
record
Manufacture
Demand
s
Organisation Structure
Location
The pharmacy should be situated at the ground7) Narcotic vaults,
floor or the first floor to ease its accessibility and
to provide adequate service to various8) Radioisotope storage & dispensing area,
departments and nursing stations.
9) Central sterile supply area,
A complete unit of the hospital pharmacy
includes the following areas: 10) Cold storage area,
1) Office of the chief, 11) Research wing,
2) Out-patient dispensing unit, 12) Pharmacy store room,
3) Bulk compounding area, 13) Library, and
4) Manufacturing unit for sterile and non - sterile14) Waiting room.

preparations,
5) Packaging and labelling area,
6) Alcohol and volatile liquid area,
Layout
Structural Design
1. Wall: The walls should be of non -porous material and plastered on both sides.
2. Floor: The floor should be of concrete and smoothly plastered. The floor
finishing should be of a non -slippery
3. Ceiling: The ceiling should be of fire -retardant, asbestos -free, and non –
shedding materials or mineral fibres.
4. Roof: The roof should be pitched or sloped to prevent heavy rain damage.
5. Door: The doors should be of fire -retardant material.
6. Window: The windows should be available at workstation, office and staff areas,
but not in storage areas.
Receiving Area
1. Loading and Unloading Area: This area should be adequately spaced and properly sheltered by taking care of the
vehicle height.
2. Receiving Counter: It should have adequate waiting space and should be equipped with suitable office furniture and
equipment.
3. Sorting and Unpacking Area: This area should be adequately spaced to enable sorting and checking of goods. The
space should be sufficient for the utilisation of lift.
4. Transit/Holding Area: The transit/holding area should be adequately spaced for storing:
• Items requiring further clarification/investigation before receiving,
• Transit items not requiring special storage conditions, and
• Pallets.
5. Disposal Room: This room should store discarded items

Storage Area
1. General Storage Requirement: The storage area should be provided with air -
conditioning facilities. Its temperature should be effectively controlled. The
electrical supply to refrigerators, freezers, cold room and air conditioning facilities
should be linked to the hospital emergency power supply.
2. Drug Store: sufficient storage area
3. Dangerous Drugs/Psychotropic Substances Store: This area is meant for storing
dangerous drugs/psychotropic substances, thus should be kept under lock and key
in special room/cabinet with alarm system.
4. Cold Room/Pharmaceutical Refrigerator/Freezer Area: This area
should be provided based on the functionality of hospital. It should
be present within the drug store for storing drugs that require low
storage temperature.
5. Intravenous (IV) Fluid Store: Adequately spaced to accommodate
haemodialysis and peritoneal dialysis solution, and intravenous
solutions.
6. Surgical Store: This area is designed for storing bulk surgical /
consumable/disposable items/X -ray films.
7. Non-Drug Bulk Store: This area is designed for storing dispensing
bottles, containers, labels, and envelopes..
Store with Special Requirement
1. Inflammable Store: located at minimum 10 feet distance away from other

adjacent buildings.
It should be designed for storing inflammable items (ethanol, methanol, acetone,
etc.) and should be equipped with fire fighting equipments, smoke detectors, and
exhaust fans for proper ventilation.
The location and design of inflammable store should provide maximum air
circulation so that accumulation of fumes or gases can be avoided. Spark-proof
switches should be present outside the room.
2. Corrosive Items Store: This area should be designed for the storage of corrosive
items ( such as phenols and hypochlorites). It should be equipped with special
plumbing and drainage system, and eye wash station.
3. Medical Gas Store: This area should be designed for the storage of portable medical
gas cylinders
4. Quarantined Item Store: A designated area or cabinet should be provided and clearly
labelled.
5. Non-Conformance Store: Designated store/cabinet for expired, obsolete or damaged
items should be provided prior to disposal.
Issuing Area
• Temporary Holding Area: Supply to various departments is
carried out in this area.
• Issuing Counter: should be equipped with appropriate office
furniture and equipment
Administrative Area
1. Pharmacist In-Charge Office:
2. Pharmacist Work Station:
3. General Office:
4. Meeting/Discussion Room:
5. Document Room:
6. Reception Counter and Customer Waiting Area:
Ancillary Area
1. Personnel/Staff Rest Room:
2. Wash Room:
3. Housekeeping/Utility Room:
4. Security Guard Post
Floor Space Requirements
• Hospital pharmacy floor area depends on the
• Range of its operations,
• Number of divisions,
• Medicaments manufactured,
• Number of patients served (out -patient pharmacy),
• Number of indoor patients,
• Strength of the pharmacy staff, etc.
• The floor space should be in

• Accordance to the norms laid down by the drugs and cosmetics act (under schedule M).
• The floor area should be minimum 250m 2.
• The area requirements increase at 10 m2 per
• 10 m2 / Bed for 100 beds, 6m 2 per bed for 200 beds, and at least 5m 2 per bed for larger
hospitals.
Staff Requirements
• A hospital pharmacy should appoint the following staff

personnel:
1. One member as the Chief pharmacist or Director.
2. At least 4 registered pharmacists in smaller hospitals so that
one pharmacist handles 60 patients. Total patients involve
(both in-patients and out-patients).
3. Sufficient number of assistants, attendants, and sweepers.
4. Pharmacist-cum-clerk or clerks depending on the hospital
size
5. A hospital pharmacy manufacturing drugs and
formulations should have manufacturing chemists
and analytical chemists supported by additional
assistant pharmacists.
Bed Pharmacist
50 3
100 5
200 8
300 10
500 15
Qualification
• The Chief Pharmacist or Director should be a post graduate degree holder in
pharmacy (preferably in pharmacology or hospital pharmacy).
• The manufacturing chemist is required to have graduated in pharmacy and
hold experience in manufacturing drugs and formulations for at least 18
months.
• The analytical chemist should be a post graduate in pharmaceutical
chemistry or analytical chemistry.
• Registered pharmacist and pharmacist - cum-clerk require diploma in
pharmacy and registration in state pharmacy council.
In-Patient Pharmacist
Responsibilities
Dispensing Area: The responsibilities of the pharmacist in dispensing area are:
1. Policies: Framed hospital policies and procedures
2. Accuracy: Maintains proper control on the accuracy of dosages prepared
3. Maintenance of Records: Maintains records of drugs supplied, returned bills of investigational drugs
and intravenous admixtures, etc.
4. Storage: Adequate control over the stocked drugs.
5. Working: All the laws and rules, and that compounding is done by adequate techniques.
6. Coordination: Manages all the conducts of dispensing area.
7. Drug Information: Updated about the drugs in the hospital in terms of their side effects, therapeutic
efficacy, stability, etc.
• Patient Care Area:This area indicates any site of a hospital where patients are
examined. Parts of the patient care area where pharmacists are involved are:
1. Coordination
2. Communication:
3. Technical:
4. Supervisory:
Direct Patient Care: Health care of a patient , like treatments, counselling, self -care,
patient education, and drug administration. Parts of the direct patient care area involving
pharmacists are:
1. Patient’s Medication History:
2. Identification of Drugs:
3. Patient Monitoring:
4. Patient Counselling:
5. Selection of Drug:
6. Cardiopulmonary Emergencies:
Out-Patient Pharmacist
Responsibilities
1. Central dispensing area:
1. Maintains adequate record and billing
2. Records of tentative drugs, records of out -patient’s bills and maintaining and preparing all
reports.
3. Keep up with the prescription files.
2. Patient Care Area:

1. Regularly visits and checks the medication areas
2. Ensures adequate supply of required drugs
3. Pharmacist records the patient’s medication history
4. Selecting right drug products
5. Patient counselling for use of medication
3. General Responsibilities
1. Makes sure that all drugs are properly managed
2. Education and training to pharmacists
3. Takes part in emergencies.

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Chapter 2 Hospital pharmacy and its organisation

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Chapter 2:

Hospital Pharmacy and its

• Hospital pharmacy functions for receiving, storing and dispensing drugs

1) Office of the chief, 11) Research wing,

2) Out-patient dispensing unit, 12) Pharmacy store room,

3) Bulk compounding area, 13) Library, and

4) Manufacturing unit for sterile and non - sterile14) Waiting room.

5. Disposal Room: This room should store discarded items

1. Inflammable Store: located at minimum 10 feet distance away from other

• The floor space should be in

• A hospital pharmacy should appoint the following staff

1. Policies: Framed hospital policies and procedures

2. Accuracy: Maintains proper control on the accuracy of dosages prepared

4. Storage: Adequate control over the stocked drugs.

6. Coordination: Manages all the conducts of dispensing area.

2. Patient Care Area:

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