2. • The major criticism of small hospital was
the lack of pharmaceutical service on 24
hours.
• Two major reasons for that are:
1. Shortage of trained personnel
2. Prohibitive costs
3. Means of the hospitals to provide 24-
hour a day pharmacy coverage
A. Use of the Nursing Supervisor
B. Emergency Boxes and Night Drug Cabinets
C. Use of Physicians
D. Pharmacist-On-Call
E. Purchased Service
5. Use of the Nursing Supervisor
• It permit the evening and night nursing
supervisor to enter the pharmacy and
provide limited type of services
• The first and the most widely used
6. Use of the Nursing Supervisor
Disadvantage:
1. Dangerous
2. An illegal practice (in some areas)
7. Use of the Nursing Supervisor
• However; the advocator said:
There exists a correlation between the nurse
selecting a medicine from the drug cabinet
on the pavilion and selecting the same item
from the pharmacy.
8. Use of the Nursing Supervisor
• The fallacy of this view:
The medication in nursing station have
Already had the benefit of special packaging
Handling and labeling by professionally
competent.
• So, it should be practiced with caution(if it is
the only mean available to small hospital)
9. Use of the Nursing Supervisor
• Nursing personnel serving in this category
should be:
a. Specifically prohibited form compounding a
mixture
b. Restricted to dispensing from the selection
of pre-labeled and pre-packaged items
11. Emergency Boxes
• Is necessary to expedite treatment in situations
where time is of the essence.
• So, the emergency box must be:
i. Large enough
ii. Sufficiently compact(to facilitate handling items)
iii. Kept in a ready accessible place(known to all ward personnel)
iv. Ready for use at all times
12. Emergency Boxes
• In order to accomplish this goal;
The pharmacy should’ve reserve boxes
prepared so that the units may be handled on
an exchange basis reduce the period of
time without a ready to use emergency box
13. Emergency Boxes
• If the hospital policy charge for the supplies
used from emergency box
the nurse should prepare a charge ticket and
submit it to the pharmacy with the used box
14. Emergency Boxes
• “Emergency cart” or “resuscitation
cart”; Mobile units have on them the same
basic supplies contained in emergency box
plus :
i. Facilities for the administration of oxygen
ii. The application of suction
iii. A cardiac pacemaker
15. Emergency Boxes
• Emergency box must be checked on
regular basis(monthly) by hospital
pharmacist.
• In order to:
Remove outdated
Deteriorated medications
16. Emergency Boxes
• This system requires placing an inventory and
product control card in the box
17. Emergency Boxes
• The objectives of the card;
1. Serves as an inventory of the emergency box
2. Shows when the unit was last checked
3. Provides the nursing personnel with
adequate directions for replenishing any
item which may have been used.
18. The night drug supply cabinet
II. The night drug supply cabinet
An adjunct to the charge floor stock
medications already on the pavilion.
Range from simple cabinets with drawers to
large elaborate installations which include
narcotic vaults and refrigerate
compartments.
19. The night drug supply cabinet
• The large cabinets are usually
constructed in the wall of the pharmacy
→→ serviced from within the pharmacy
→→ yet is accessible from the corridor
side to authorized nursing personnel
20. The night drug supply cabinet
• It should be stocked with:
Pre-packaged
Labeled containers of the drugs
• Many hospitals also store certain medical
and surgical supplies.(oxidized cellulose)
21. The night drug supply cabinet
• The nursing supervisor leave identified charge
ticket Listing:
– the item removed
– To whom it was administered
The next morning the pharmacy personnel
restock the unit and forward the charged
ticket to accounting office.
23. Use of Physicians
• Require the physician enter the
pharmacy and obtain any special
medication not provided through:
• The floor stocks
• Night cabinets
• Emergency box
24. Use of Physicians
• drawbacks :
o A physician might waste a great deal of
time searching for a product
o An unfair burden to place upon their
already heavily taxed work hours.
25. Use of Physicians
• Advantage:
o The physician may be influenced to
use available drug which will
accomplish the same purpose
27. Pharmacist on call
• In order to encourage this type of coverage,
many administrators have developed:
Bonus
Extra pay plans
• A rotational plan of on-calls will not burden
single individual
29. Purchased Service
• Contracting with local community
pharmacy for:
• Night
• Holiday
• vacation
relief for the staff pharmacist
30. Purchased Service
Advantages
• Safe and legal
• protect the drug needs of the
hospital and patient
• safeguard the health needs of the
area on a round-the-clock basis.
31. Purchased Service
• Where there is more than one
pharmacy in the community, care
should be taken to avoid any
claims of favoritism or politics
32. Purchased Service
• This may be accomplished by:
• Develop a set of specifications and
requirement concerning the desired service
• Request the local establishments to submit
their bids.
• Only the retail pharmacies with adequate
staff, inventory, and delivery service can
qualify to bid.
