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1. ASSIGNMENT 1 ON PHARMACY SERVICES SUBMITTED BY: SANDEEP SINGH MHA (1ST SEM)DE
PARTMENT : SPORTS MEDICINE AND PHYSIOTHERAPY SUBMITTED TO: DR. B.R.NANDA
2. CONTENTS1) Layout and Physical Facilities For Medical Store Designing a Drug
Store Location and Layout of the Hospital Pharmacy Layout Flow charts for Materi
als and Members
General Flow Chart Out Patients
General Flow Chart In Patients G
eneral Flow Chart for Materials Selection of Site Space, Layout & Design For Com
munity Pharmacy Plan an Ideal Retail and Whole sale Store Legal Requirements Gen
eral Licenses
Restricted Licenses Physical Facility
Personal and Floor space Req
uirement including Equipments2) Staff Selection Of Staff Compensation3) Receipt
of drugs What is a Drug? Requisition, Supply and Receipt of Drugs
Drug request C
ompleting Stores Requisition/ Delivery (issue) Form Supply of Drugs from Medical
Stores
Store Requisition / Delivery (issue) Form
Receipt of drugs at Dispensary
4) Disposal of Expired Drugs5) Drug Safety6) Unit dose dispensing What is UDD AD
VANTAGES7) Guidelines To Minimize Pilerage of Drugs8) Hathi Committee Recommenda
tion For Hospital Pharmacy
3. Layout & Physical Facilities for Medicine StoreHospital pharmacy is one of th
e most important departments among the several departments of the hospital.Hospi
tal pharmacy may be defined as that department of the hospital which deals with
procurement, storage,compounding, dispensing, manufacturing, testing, packaging
and distribution of drugs.Designing a Drug StoreDesigning a drugstore needs to p
rovide both convenience for the people working there and those shopping there.Th
e layout must be welcoming, have inviting department colors, convenient navigati
on and easy-to-identifysignage. The pharmacy must provide a complete shopping ex
perience for customers needing health aids rangingfrom prescriptions to toiletri
es.Location and layout of the Hospital Pharmacy It should be located in hospital
premises so that patients and staff can easily approach it. In multi- storied b
uilding of the hospital, the pharmacy should be preferably located on the ground
floor especially the dispensing unit. Outpatient pharmacy should give pleasant
appearance and must have enough space for seating of patients who have to wait f
or medicines. It should have educative posters on the health and hygiene and lig
ht literature for reading. Space must be provided for routine manufacturing of s
tock solution, bulk powder, ointments etc. The manufacturing room should be adja
cent to the pharmacy. Medical stores of a pharmacy should be adjacent to the pha
rmacy itself or should be directly connected to pharmacy. Pharmacy receives mate
rials from two sources : 1. Medical stores 2. Manufacturing division of the hosp
ital Layout Typical layout of hospital pharmacy
4. Flow charts for materials and mena) General flow chart out patientsb) General
flow chart for In patients
5. c) General Flow chart for MaterialsSelection of Site Space, Layout and Design
for community pharmacy
6. Various factors should be considered during the selection of a site for a new
pharmacy. Such as population inthe trading area, distribution of the income amo
ng the population, type of industry and the competitive climate. During the sele
ction of a site for new pharmacy following factors should be considered: A needy
town or city should be selected. Site of pharmacy in a particular city should b
e most suitable among those available. Site of pharmacy should be convenient and
accessible to the majority of consumers. For this purpose site location should
be centre to population to be served. Pharmacy site should be equipped with adeq
uate free parking facility. If possible then site should be in neighborhood of a
community shopping centre for the convenience and accessibility of the consumer
s. An island type of location, where the pharmacy sites by itself in a main traf
fic artery and surrounded by adequate parking facility, should be preferred. Usu
ally, a bargain location in terms of rent proves to be a liability rather than a

n asset in the long run.Plan of an Ideal Retail and Whole Sale Drug Store One of
the main factors responsible for the success of a drug store its location and p
roper layout design. Anideal plan for proper layout design of a retail drug stor
e and whole sale drug store. Objective of layout design 1. To attract a large nu
mber of customer. 2. To increase the sale of a store. 3. To reduce the selling e
xpenses to a minimum. 4. To provide the customer satisfaction. 5. To have space
for reserve for stock, office and resting place for the employees. 6. To have a
proper entrance for coming goods. 7. To project a professional image and improve
general appearance. 8. To minimize the movement of customers within the premise
s of the drug store. A modern drug store should fulfill all the requirements in
schedule N of the drug and cosmetic rules, 1945.To start a retail drug store a min
imum of 150 sq. meter area is required similarly to whole sale drug store aminim
um of 200 sq. meter area is required.
7. The legal requirements for the establishment of retail drug store. For retail
sale two types of licenses are issued.1. General licenses2. Restricted licenses
General licenses: General licenses are granted to persons who have the premises
for the business and whoengage the services of a qualified person to supervise
the sale of drug store. Licenses for retail sale of drugs other than those speci
fied in schedule C,C1 and X are issued in form 20 fordrug specified in C, C1 exc
luding those specified in schedule X in form 21 and for schedule X drugs in form
20F. Condition for general licenses: 1. The licenses should be displayed in pro
minent place in a part of premises open to the public. 2. The licenses should co
mply with the provisions of drugs and cosmetics act and rules there under in for
ce. 3. Any change in the qualified staff should be reported to the licensing aut
hority within one month. 4. Precaution prescribed by the licensing authority for
the storage of schedule C and C1 drugs should be observed. 5. For the sale of a
dditional categories of drugs listed in schedule C, C1 excluding X the licensee
must take prior permission of the licensing authority. Restricted licenses: The
licenses for the restricted sale of drug other than those specified in schedule
C, C1and X and those specified in schedule C and C1 but not in schedule X are is
sued in form 20A and 21A respectively. Condition for restricted licenses: 1. The
licensee must have adequate premises equipped with facilities for the proper st
orage of drugs to which the licenses applies provided that this condition does a
pply to vendors. 2. Licensee should be complying with the provisions of the drug
s and cosmetics act and rules there under in force. 3. Drugs only purchased from
a duly licensed dealer or manufacturer. 4. The licenses can deal only in such d
rug as can be sold without the supervision of qualified person. 5. Drugs should
be sold in their original container.Physical facilityThe extent of pharmacys phys
ical facility is determined by the size and the services provided. A large pharm
acydepartment might have the following sections Administrative office Bulk stora
ge Narcotic or dangerous drug locker Manufacturing and repackaging Intravenous s
olution compounding Inpatient dispensing Outpatient dispensing In case of Hospit
al Pharmacy Medicine information resource centre Emergency medicine storage
8. Personnel and floor space requirements including equipments based on individu
al and basic needs There are variations in the size of floor space devoted to th
e pharmacy in hospitals of the same size and type. In smaller hospitals with one
pharmacist only one room is usually required for the pharmacy having a combinat
ion of dispensing, manufacturing, administrative and all other sections of compl
ete pharmaceutical services. When sterile products are to be prepared there shou
ld be separate room or area for such work. An area of this type is required for
reconstitution of lyophilized injections into syringes and for the preparation o
f intravenous admixture, all of which must be sterile. Hospitals with 200 or mor
e beds provide the opportunity for departmentalization of pharmacy activities. T
here should be a separate area for in-patient services and unit dose dispensing,
out-patient services, an office for the chief pharmacist, a compounding, pre pa
cking and labeling room, a store room, sterile product and IV admixture room. A
separate area for drug information services and space assigned on various nursin
g units for unit dose drug administration and clinical pharmacy service. Floor s
pace requirement The pharmacy requires a minimum of 250 sq. feet for any sized h
ospital. From that point onward, basicrequirements from 10 square feet per bed i

n 100 bedded hospital, 6 square feet in 200 bedded hospitals andan average of at
least 5 square feet per bed in large hospital. The floor of pharmacy should be
smooth, easily washable and acid resistant. In manufacturing sections,drains sho
uld be provided; walls should be smooth, painted in light colour. The wooden cab
inets areenameled or laminated. Fluorescent lamps are placed immediately above t
he prescription counter. Gasoutlets are required on the work table or counter fo
r the Bunsen burners.
9. EquipmentsThe usual equipments are:1) Prescription case2) Drug stock cabinets
with proper shelves and drawers.3) Sectional drawer cabinets with cupboard base
s.4) Work tables and counters for routine dispensing.5) Sink with drain board.6)
Cabinet to store mortars and pestles.7) Cabinet for glass utensils, flasks, fun
nels and beakers.8) Refrigerator of suitable capacity.9) Narcotics safe with ind
ividually locked drawers.10) Office desk with telephone connection and file cabi
net.11) Shelf space for pharmacy library.12) Dispensing window for nurses and ou
t- patient. The parenterals are prepared in separate room in large hospitals. Th
ey are equipped with water still, workbench, cabinets, resistant glass storage t
anks, burettes, sintered glass filters, bottle racks, adjustable metal shelves,
double sink with drain boards, pressure sterilizer etc. Depending upon the type
of manufacturing undertaken in hospital equipments such as ointment mills, mixin
g machines, collapsible machines, fibers, powder mixtures, granulators, tablet c
ompressing machines and filter presses may be considered for installation in a h
ospital. Personnel The organized hospital department has an integrated set up co
nsisting of dispensing section, manufacturing section, quality control section a
nd clinical pharmacy. 1) There are no standard rules regarding the requirement o
f personnel for in-patient pharmacy department and it is the nature and quantum
of services to be provided that governs the personnel requirement. 2) The number
of pharmacists required for a hospital is calculated on the basis of workload,
like the number of prescription received and dispensed number of beds available.
For a very small hospital minimum of 3 pharmacists are required. As the number
of beds increase, the number of pharmacists also increases.
10. 3) The pharmacist should possess adequate pharmacy qualification and experie
nce. The overall charge of the in-patient department should remain with the chie
f- pharmacist. 4) The following is suggested staff pattern of pharmacists. Pharm
acist requirement Bed strength No. of Pharmacists required Upto 50 beds 3 Upto 1
00 beds 5 Upto 200 beds 8 Upto 300 beds 10 Upto 500 beds 15 5) If the pharmacy i
s also involved in the manufacture of drugs an adequate number of pharmacy techn
icians, assistants, peons etc may be required. 6) Both measurable and non measur
able workload should be taken into consideration for determining the personnel r
equirements of pharmacy department. Staff Staff (Personnel): Personnel or staff
selection is one of the most important aspects of developing anefficient operati
ng community pharmacy. Success of a community/hospital pharmacy depends upon pro
perselection training, and maintenance of employees (staff). Selection of staff:
Following criteria should be followed during the selection of the staff for com
munitypharmacy: Minimum standards for qualification of employees should not be a
llowed to fall below the minimum standards under here for a given position will re
sult in fall in reputation of pharmacy.
11. Over hiring means superior people should not be hired for inferior jobs; this
type of selection may result in an adverse effect on staff moral and efficiency.
For the proper selection of staff for a specific job, the manager should develo
p a job description and a jobspecification for each position in pharmacy. This j
ob description should contain such detail as scope of job, itsrelation to other
jobs, working hours, and pay scale, etc. It prevents misunderstanding about the
nature of theduties of a particular job. Promotion within a pharmacy staff may b
e appropriate. But in most of the cases external source must beused such as empl
oyment agencies, placement offices of schools and universities or classified new
s paperadvertising. Coopwork study program may prove as a big source of part time
employees. An availability file (a record ofqualified peoples who applied for jo
b) should be maintained in pharmacy which serves when no opening existed. Owner
or manager of pharmacy should design an application form to assist in the select
ion process.Although an application form serves basically to provide information

about the applicant, it also serves in followingway: Helps in observing the app
licants ability to follow simple written instruction. Serves as a guide during in
terview. Serve as a permanent record of employee and a source of information of
social security and withholding tax reports. All the employment policies and pro
cedures must be consistent with applicable federal state laws governingequal emp
loyment opportunity. In general such laws prohibit discrimination in selection a
nd hiring process. Orientation and training of staff: After proper selection nee
ds to be followed by adequate orientation andtraining of the employee, which res
ults in increase productivity and reduced employee turnover. During theorientati
on process, discussion should be on the basis of give and take basis on the foll
owing points: Basic goal and philosophy of the pharmacy. Expected working hours
from the employee (evening, weekends & holidays). Duration of lunch hours. Overt
ime rules and compensation. Policy of coffee break. Rules about punctuality. Uni
form rules and paying schedule for uniform purchase and maintenance. Safety and
security regulations. Telephone usage and answering authority of telephonic ques
tions. Personal telephone usage. Vacation policy Policy regarding leave (sick or
personal business) Opportunities and procedures for advancement or promotions.
Policies on employees purchase and discount.
12. These points concern to both the employer and the employee so a clear discus
sion about them prevents,reduces problems between employers and the employee. Af
ter a general orientation to the pharmacy, the employee needs specific training
in the duties andresponsibilities of the job. Sinkor swim method of training is in
sufficient to pick up knowledge on the job, for thispurpose a community pharmacy
should arrange a sophisticated training program. There are effective simpletrai
ning methods that can be used. The sponsored system of training is most suitable
for a pharmacy. A newemployee is assigned to a capable experienced employee who
explains and demonstrates the job in questions.Conference method can also be us
ed, by itself of sponsored system. Compensation: Retaining good employees is one
of the most difficult problems faced by the communitypharmacy manger. Many fact
ors decides keeping of employees but most important factor is the compensationpl
an. Adequate compensation is necessary, not only to retain employee but also to
encourage them to worktoward the overall goals and objectives of the pharmacy. R
eceipt of DrugWhat is a drug?A drug can be given three possible operational defi
nitions: a chemical substance that affects the processes of the body or mind; an
y chemical compound used on or administered to humans or animals as an aid in th
e diagnosis, treatment or prevention of disease, or other abnormal condition, fo
r the relief of pain or suffering, or to control or improve any physiologic or p
athologic state; A substance used recreationally for its effects on the central
nervous system.Since the advent of the essential drug concept, essential drugs h
ave been defined by WHO as those that areindispensable and necessary to satisfy
the health care needs of the majority of the population. They shouldtherefore be
available and accessible at all times, in the appropriate dosage forms and at p
rices affordable to all.This definition does not in any way diminish the usefuln
ess of any drug that may not be on any given essential druglist. It is a conscio
us attempt to utilize available resources on the most important drugs of benefit
to the majorityof the population while recognizing the competition in the publi
c sector.Requisition, supply and receipt of drugsDrug requestDrugs that are orde
red for use in the health centre must be approved for use in the centre. Drugs i
n the healthcentre should be relevant to the pattern of endemic diseases as well
as the type of services being provided in thehealth centre.It is advisable to r
equest drugs on a regular basis to prevent shortages. If drugs are not always av
ailable, patientsmay lose confidence in the health centre and will be discourage
d from visiting it. It is important to make requestson a regular basis, as drugs
will only be delivered when requested. The delivery time should be taken intoco
nsideration in ensuring that drugs are not in short supply.
13. Importance of Requesting Regularly Completing stores requisition/delivery (i
ssue) form It is advisable to make a request on a standard stores requisition/de
livery (issue) form. The stores requisition/delivery (issue) form should be prod
uced in four copies. The original and two other copies of the form will be sent
to the central store when completed. The fourth copy is kept in the dispensary t

o remind the health worker in charge of drugs or items requested. Ensure that th
e following items are filled in correctlyo Name of drug and dosage form;o Unit o
f issue and quantity requested;o The requisition number (it is preferable to beg
in with a new number each year, e.g. 1/00);o The name of the dispensary and the
date the requisition was made;o The name and signature of the health worker maki
ng the requisition;o Where the stores requisition/delivery (issue) form is desig
ned to contain all the items listed, fill in only the quantities of those items
needed;o Write down the approximate unit price of each requested item and the ap
proximate total cost of each item;o Name and signature of the health worker maki
ng the requisition;