11
Hospital Pharmacy
Dispensing
Learning Objectives
1 Describe the functions of a hospital and its organizational framework. (Section 11.1)
2 Define the roles and functions of the Pharmacy and Therapeutics Committee (especially on the hospital formulary) and the Institutional Review Board (on investigational drug studies). (Section 11.1)
3 Explain the functions of the pharmacy department within the hospital structure and the roles and responsibilities of the director of pharmacy, the pharmacist, and the pharmacy technician. (Section 11.2)
4 Identify the training and certifications required for a technician to work in a hospital pharmacy. (Section 11.2)
5 Paraphrase the role of the interoperability of hospital management software, different types of electronic health records, medication orders, and automated technology. (Section 11.3)
6 Discuss the functions and benefits of CPOE, AMDS, BPOC, and eMARs. (Section 11.3)
7 Describe the different dispensing systems for medication orders, such as unit dose carts, robotic filling and dispensing equipment, automated dispensing cabinets, and specialty cleanroom services. (Section 11.4)
8 Explain the proper procedure for preparing, labeling, and repackaging unit dose medications. (Section 11.4)
9 Describe the ordering, receipt, and documentation of controlled medications, including the advantage of utilizing an automated dispensing storage unit. (Section 11.4)
10 Understand inventory management of pharmaceuticals, including drug bidding, ordering, receiving, and storage processes. (Section 11.5)
11 Describe other institutional pharmacy practice settings that serve the aging population. (Section 11.6)
12 Explain the major role of the Joint Commission in establishing accreditation standards for hospitals. (Section 11.7)
13 Identify the importance and types of various measurements of productivity in the pharmacy department. (Section 11.8)
ASHP/ACPE Accreditation Standards
To view the ASHP/ACPE Accreditation Standards addressed in this chapter, refer to Appendix B.
As compared to community pharmacy practice, hospital practice has different organizational structures and medication filling/distribution systems. In addition, the services and policies of a large urban hospital pharmacy will vary from an academic university hospital, a veterans hospital, or a 50-bed rural hospital. Yet they all share many important commonalities.
If you wish to work in hospital practice, you generally must be certified and often must have specialized education, experience, and/or training in areas such as medication reconciliation, unit dose medications, repackaging, floor stock, narcotic inventory, or intravenous (IV) and chemotherapy medication preparation. Even more than in the community pharmacy, hospitals rely on computer software, technology, and automation in medication ordering, filling, distribution, inventory control, and bedside drug administration. Therefore, pharmacy technicians must be familiar with all these advanced technologies that have made a significant impact on reducing medication errors.
Working in a hospital pharmacy environment presents unique challenges, compared to working in a community pharmacy.
This chapter provides an overview of hospital pharmacy practice, including regulatory controls and standards, and it outlines the roles and responsibilities of pharmacy technicians in providing safe, effective patient care. It also highlights the importance of hospital care teams and accreditation.