Dispensing to In-Patients
Amber Shafi
Lecturer
Pharmacology
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unioffaisalabad
A patient who is retained in a hospital so
that he/she occupies a bed in hospital for
Inpatients medical care.
Dispensing is a pharmacy act and
consists of the removal of two or more
Dispensing doses from a bulk drug container and
placing them in another container
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Administration
It is a nursing act consisting of
removal/withdrawal of a single
dose from drug container and
its administration to a patient
on the order of a prescriber.
Distribution
The supply delivery and
transitory storage of drugs at
patient-care areas (nursing
stations) other than main
hospital pharmacy
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● Review the prescriber’s original order.
Guidelines for ● Drugs dispensed should be as ready for administration.
Distribution ● Drug dispensed must bear adequate identification.
● Drugs must be stored so as to be accessible.
● Automated system is in use as pharmaceutical tools
provisions.
● In-house packaging must permit and facilitate drug use.
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unioffaisalabad
Complete
Floor Stock
System
Individual Drug Order METHODS OF DRUG Floor Stock
System DISTRIBUTION
Unit Dose
Distribution
System
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INDIVIDUAL DRUG ORDER SYSTEM
Benefits
It is used generally by the small and or private
Direct review of
hospitals due to desirability of an medication orders.
individualized service and for availability of a
Better interaction.
reduced manpower.
Provide close control of
inventory.
Drawbacks
1. Results in a delay in obtaining the
required medication.
2. Increased cost to patients.
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FLOOR STOCK SYSTEM
The floor stock drug distribution is a traditional
drug distribution system and involves a separate
storage facility in a secured area on each patient
care floor.
The floor stock may include many bulk supplies of
the medication carried out in hospital pharmacy.
However, a limited selection of drugs is approved
by the pharmacy and therapeutics committee.
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Charge Floor Stock The medications that are
Drugs stocked on the nursing station
at all the times are charged to
be patient's account after they
are administered.
Each of these agents is
chargeable to the patient's
account.
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The selection of the floor stopped medication is the
Selection of responsibility of the pharmacy and therapeutics
charge floor committee with the consultation of the representatives
stock drug of nursing service, pharmacy and the hospital
administration
(a)Availability of drug.
Duplicate or triplicate snap out
(b)Enforcement of the season of therapeutic committee.
forms.
(c)Periodically submission of list to the committee for
re-evaluation in light of later expensive and therapeutic
Envelope system trends.
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Non-charge
floor stock
drugs These drugs represent group of medications that
are placed at the nursing station for use inpatient
care area without direct charging to the patients
account but costing in the per day cost of the
hospital room.
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Selection of the non-
charge floor stocked ● Cost of the preparation.
● Frequency of use.
drugs
● The quantity used and effect of the hospital budget
and reimbursement from the third part payers.
● Usually this list is exceptionally small.
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Drug Basket Method
nurse checks medicine cabinet, utility room and drug
refrigerator inventory of supplies against a master list provided
by pharmacy. The checking nurse places check mark on the
number required for each drug on the requisition for floor stock
supplies. Where there is as empty container, she places it is a
drug basket.
Methods of dispensing or
distribution of non-charge
floor stock drugs.
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Mobile Dispensing Unit Benefits
● Conserves the nurse time.
mobile unit is in use while the second is being ● Better supervision and control
serviced. The frequency and delivery time can be
over drugs.
selected in cooperation with the nursing service. ● Availability of a pharmacist for
In this system of distribution, it is not necessary
the on spot consultation by
for the night nurse, as in basket method to check
clinical and nursing staffs.
the pharmacy inventory or have the empty ● Deteriorated and outdated
containers transported to the pharmacy.
drugs may quickly be removed.
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Floor stock system under
supervision of nurse
Complete Floor
Stock System
In a complete floor
stock system the nursing
station pharmacy carries
both the charge and
non-charge patient Floor stock system under
medications supervision of Pharmacist-
Satellite pharmacy
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Floor stock system under supervision of nurse
The supply, delivery and transitory storage of drugs at nursing station are requisitioned by
nursing service and are distributed by pharmacy personnel.
Merits
● Ready availability of required drugs at nursing station.
● Reduction in nursing time consumed by frequent trips to pharmacy to obtain
● Medication supplies.
● No drug returns to the main pharmacy.
● Reduction in the number of drug order for the pharmacy.
● Reduction in pharmacy workload and in number of pharmacy personnel required.
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Demerits
● Increased chances of medication errors due to the elimination of a
pharmacist review on medication orders.
● Increased drug inventory in the patient-care area.
● Increased chances of drug pilferage.
● Increased chances for drug deterioration due to lack of proper storage
facilities.
● Requires excessive nursing time.
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unioffaisalabad
Floor stock system under supervision of Pharmacist-Satellite pharmacy
In some hospitals, the floor stock system is successfully operated as a decentralized pharmacy under
the direct supervision of a pharmacist. The various demerits associated with floor stocking under a
nurse's supervision can be eliminated. In summary, the floor stock system does not allow pharmacists
to review physician's orders for accuracy of dosage and scheduling or potential drug interactions.
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unioffaisalabad
Unit dose distribution system
Under this system medications are ordered, packaged, handled, administered, and charged in
multiples of single-dose units containing a predetermined amount of drug sufficient for one regular
dose. The unit dose distribution system has been developed to reduce medication errors and this
system guarantees pharmacist medication review and individual patient dispensing.
Components:
● A pharmacist reviews all physicians’ medication orders before they are dispensed.
● Medications are dispensed as unit doses.
● The packages are dispensed in as ready-to-administer form as possible.
● Maintenance of patient medication profile.
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Merits Demerits
1-Safer for patients. 1-Delays may occur in initiating new
2-Efficient and economical for the medication orders.
Institution. 2-Pharmacy labor costs are higher.
3-Optimum utilization of professional
resources.
4-Efficient usage of time.
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Accomplishment of unit dose dispensing
● Use of marketed single-dose drugs.
● In-house unit packaging.
● Purchasing of unit dose packaging of all drugs.
● Use of packaging service.
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All drugs are stored in a
Centralized Unit-Dose
central pharmacy and are
Distribution (CUDD) System
dispensed in unit doses.
Methods of unit dose
dispensing
Decentralized Unit-Dose Operates through small
Distribution (DUDD) System satellite pharmacies located on
each floor of the hospital.
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Combined CUDD-DUDD systems
Under this system, some hospitals operate the dispensing of drugs from the main pharmacy as well
as from the satellite pharmacy simultaneously .
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Automated dispensing system
Less Time Consuming
Time is consumed for carrying medication orders from the nursing unit to the pharmacy department.
The checking of the medication order in the pharmacy also requires time.
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Computer aided dispensing
This system utilizes computer networking among physicians, pharmacists, and nurses.
Under this system, the computers of physicians, pharmacists, and nursing stations are
networked with each other. A pharmacist checks this medication order and by using
appropriate computer software, evaluates drug-drug interaction.
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Fewer medication errors
The computer can also notify the doctor if the drug is not in inventory, not prescribed according to
the dose/route of administration recommended in the hospital formulary, and will alert the nurse if
she has failed to administer the drug within a predetermined period.
