BP 703T.

PHARMACY PRACTICE (THEORY)

OBJECTIVES:

1. Drug distribution methods in a hospital

2. Monitor drug therapy
3. Medication history and counsel the patients
4. Identify drug related problems
5. Detect and assess adverse drug reactions
6. Know pharmaceutical care services
7. Do patient counseling in community pharmacy;
UNIT I

a) Hospital and it’s organization

b) Hospital pharmacy and its organization
c) Adverse drug reaction
d) Community Pharmacy
HOSPITAL AND IT’S ORGANIZATION

 Definition, Classification of hospital.

 Primary, Secondary and Tertiary hospitals.
 Classification based on clinical and non- clinical basis.
 Organization Structure of a Hospital, and Medical staff s involved in the hospital and
their functions.
Definition of Hospital :
 Hospital, an institution that is built, staffed, and equipped for the diagnosis of disease;
for the treatment, both medical and surgical, of the sick and the injured; and for their
housing during this process.
 A place where people who are ill or injured are treated and taken care of
by doctors and nurses.
CLASSIFICATION OF HOSPITAL

1. Based on Length of Stay of Patient

2. Based on Clinical Basis
3. Based on Non-Clinical Basis
1. Based on Ownership/Control Basis
2. Based on the Objectives
3. Based on Size
4. Based on Management
5. Based on Cost and
6. Level of Care
1. CLASSIFICATION BASED ON LENGTH OF STAY OF PATIENT

 Short term for the treatment of acute diseases.

 Long term for the treatment of chronic diseases.
2 CLASSIFICATION BASED ON CLINICAL BASIS

 Based on their anatomical- physiological specialisation:

 Based on the client group they serve:
 Based on the system of medicine adopted for treatment:
3 CLASSIFICATION BASED ON NON-CLINICAL BASIS

1. Classification based on ownership/control basis:

▪ Public hospitals -Under the control of central or state governments or local bodies on
non -commercial lines
▪ Voluntary hospitals - Hospitals are recognised and combined under the societies
registration act 1860 or public trust act 1882
▪ Private nursing homes - Regulated by an individual doctor or a group of doctors on
a commercial basis.
▪ Corporate hospitals - These hospitals are public limited companies running on
commercial lines and formed under the companies
2. Classification based on the objectives
 Teaching-cum-research hospitals - These are the hospitals having a college for
education of medical, nursing, dental, or pharmacy.
 General hospitals: - These hospitals help for curing the common diseases.
 Specialised hospitals - They concentrate on a particular aspect or body organ and
give medical and nursing care in the particular field
 Isolation hospitals - These hospitals treat patients who are suffering from infections
and communicable diseases and need to be isolated.
3. Classification Based on Size (Bed Strength)
 Teaching Hospitals: These hospitals have 500 beds and can be increased depending
on the number of students.
 District Hospitals: These hospitals have 200 beds and can be increased up to 300
depending on the population.
 Taluk Hospitals: These hospitals have 50 beds and can be increased depending on
the population.
 Primary Health Centers: These hospitals have 6 beds and can be increased up to 10
depending on the needs.
4. Classification Based on Management
 Union Government/Government of India: These hospitals are controlled by the
Government of India
 State Governments: These hospitals are controlled by the state or union territory.
 Local Bodies: These hospitals are managed by the local bodies.
 Autonomous Bodies: These hospitals are formed under a special act of parliament or
state legislation. They are financially supported by the Central/State
Government/Union territory.
 Private: These hospitals are run by an individual or by private organisation.
 Voluntary Agencies: These hospitals are run by a voluntary body, a trust, or a
charitable society registered under a suitable authority under Central/State
Government laws.
5. Classification Based on Cost
 Elite Hospitals: These hospitals are a symbol of high -tech medical development. The
per day room rates vary between Rs 300-1200. The deluxe rooms have fridge,
television, and telephone. Excluding the medical care, they are similar to five -star
hotels, thus, are also called five-star hospitals .
 Budget Hospitals: These hospitals are for moderate budget and low budget users,
e.g., civil hospitals, corporation hospitals, etc.
6. Classification Based on the Level of Care
 Primary Hospitals: primary care is the day to day healthcare given by a health care
provider. e.g Treatment of common diseases or injuries, delivery of essential facilities,
health education, pro vision of food and nutrition.
 Secondary Hospitals: secondary care hospitals are preferred with a medium size city,
country or district. They are responsible for providing complete health services.
 Tertiary Hospitals: They provide a specialised consultative care to a patient referred
from primary and secondary medical care. Specialised intensive care units, advanced
diagnostic support services, and specialised medical personnel are the key features of
tertiary health care.
ORGANISATION STRUCTURE OF A HOSPITAL

The organisation of hospitals includes the following:

1) Administrative staff,
2) Medical staff,
3) Associated medical services, and
4) Supportive paramedical services and staff
ADMINISTRATIVE STAFF

 Chief executive officer or president.

 Chief operating officer
 Chief financial officer
 Corporate vice presidents
 Personnel or human resources department
 Chief nursing executive
MEDICAL STAFFS INVOLVED IN THE HOSPITAL AND THEIR
FUNCTIONS

1) Residential Medical Staff: These staff members remain available for 24 hours to
attend the patients. They are also responsible for t he organisational and administrative
duties.
2) Associate Medical Staff: These staff members include the physicians allotted to
different services similar to the members of the active medical staff. These can be
progressive as the residential medical staff.
3) Consulting Medical Staff: These staff members include medical physicians of
known professional ability.
4) Honorary Medical Staff: These staff members are like part-time consulting medical
staff. These members are retired physicians or physicians possessing a clinic and
providing nominal facilities to the hospital.
ASSOCIATED MEDICAL SERVICES

1) Medicine Division: Following are the 7. Infectious diseases,

departments of the medical division: 8. Allergy,
1. Internal medicine, 9. Skin and venereal diseases,
2. Cardiology, 10. Endocrinology,
3. Gastroenterology, 11. Geriatrics,
4. Nephrology, 12. Immunology, and
5. Pulmonary diseases, 13. Paediatrics.
6. Psychiatry and neurology,
2. Surgery Division: Following are the 7. Nephrology,
departments of surgery division: 8. Neurological surgery,
1. General surgery,
9. Cardiothoracic surgery,
2. Obstetrics and gynaecology,
10. Plastic surgery, and
3. Orthopaedic surgery,
11. Anaesthetics.
4. Ophthalmology,
5. Otolaryngology,
6. Dental and oral surgery,
3. Radiology: It is the branch of medicine that deals with the diagnostic and therapeutic
application of radiant energy in the form of X -rays and radium. Modern radiology
departments also have facilities of sonography, Computer-aided Tomography (CT)
scanning, MRI (Magnetic Resonance Image), etc.
4. Pathology and Clinical Biochemistry Services: These services provide the facility
of collecting samples of blood, urine, sputum, faeces, etc., in order to detect the presence
of pathogenic infection or abnormality in biochemical parameters such as sugar, urea,
etc.
5. Blood Bank: This service provides facility of collecting, processing, and supplying
blood and its products (blood plasma, etc.).
SUPPORTIVE PARAMEDICAL SERVICES AND STAFF

1. Nursing Services:
2. Dietary Services:
3. Medical-Social Service Department:
4. Central Sterile Services:
5. Medical or Patient Treatment Records:
6. Drug Information Services or Centre:
7. Drug Distribution System:
NURSING SERVICES:

 The nursing team comprises of workers with variable degrees of skill in nursing and
are directed by a professional nurse. This team replaces the single nurse who has done
everything for the patient.
 Nursing care includes health promotion, care and prevention of disease,
rehabilitation, teaching and counselling, emotional support, and treatment of
disease.
 It is an essential part of the healthcare system and is performed in combination with
related medical, educational, and welfare facilities.
 The nursing team should respect individuality, dignity, and rights of every person
irrespective of race, colour, origin, and social and economic status
DIETARY SERVICES: Prepared nutritious diet

Following are the functions:

i) Plans menu for general or special diet for patients and employees,
ii) Selects and purchases food,
iii) Maintains relationship with food vendors,
iv) Receives and stores food,
v) Prepares and distributes food,
vi) Maintains cleanliness and safety in the department,
vii) Trains and supervises the staff,
viii) Educates nations on dietary habits along with the medical or nursing staff, and
ix) Conducts research programs in teaching hospitals.
MEDICAL-SOCIAL SERVICE DEPARTMENT:

 Link between the hospital and the patient and his/her relatives.
 The qualified social worker is a discipline who focuses on the social aspects of the
patient and his/her family.
 Gives information regarding the medical and social study of suitable patients
CENTRAL STERILE SERVICES:

 The main function of the Central Sterile Services Department (CSSD) is to give
sterile items, linens, and equipment to wards and OT’s.
MEDICAL OR PATIENT TREATMENT RECORDS:

 These are the systematic documentation of a patient’s medical history and care.
DRUG INFORMATION SERVICES OR CENTRE:

 The aim of these services or centre is to document drugs by extracting information

about them.
DRUG DISTRIBUTION SYSTEM:

 Every hospital use drugs and therapeutic substances in in-patient and out -patient
departments.
 The following two types of drug distribution system
 Drugs are distributed to indoor patients,
 Drugs are distributed to outdoor patients
 Two more drug distribution types are:
 Dispensing of narcotics and other controlled substances, and
 Distribution and dispensing of ancillary substances and articles.