Pharmacy lpu where it should be located geographically. Medicines for inpatients. The main tasks and functions of hospital pharmacies. Clinical pharmacy - together with doctors, develops a list of drugs necessary for the operation of the hospital and takes part
Modern people have a clear understanding of pharmacies. But what are the types and functions of pharmacy organizations? Not everyone knows about it. Their activities are regulated and controlled by legislative acts and internal affairs bodies. We live in a state of law, where physical and legal entities obliged to abide by the laws. Pharmacy activity is also regulated by several laws, acts and other documents.
Pharmaceutical activity
The article will describe pharmacy organizations, their types, Comparative characteristics and others important points this area. This term refers to companies that carry out retail, manufacture and dispensing of medicines.
As for retail, this is a type of trade and provision of services to customers for personal, family, home purposes, which have nothing to do with entrepreneurial activity.
List of such companies:
- pharmacy points;
- pharmacy kiosks;
- pharmacies;
- pharmacy stores.
Based on external and functional characteristics, existing species pharmacy organizations have their own characteristics and differ from each other. As a rule, trading outside the premises of the pharmacy is prohibited. This suggests that the pharmacist does not have the right to sell medicines and other products outside of a specialized company.
Types of pharmacies
- Pharmacies that are created to serve the population. Such establishments sell both narrow and general medicines. They may have their own assortment, which is spelled out in their classification. For example, homeopathic pharmacies have a range of products of this direction and specialize in their sale. Profile activities are different. For example, an oncology pharmacy produces and sells drugs designed to fight cancer.
- Hospital pharmacies. Each medical institution has its own pharmacy organization. In any case, she should be there.
- Interhospital pharmacies - such organizations supply drugs to medical and preventive and other institutions.
This list classifies the types of pharmacy organizations by type of activity. There are other indicators according to which pharmacies have their own characteristics.
The nature of the production activities of pharmacies
- Production. These points carry out the manufacture of medicines according to the prescriptions of doctors and the requirements of medical institutions. Companies of this kind have the right to sell finished products.
- Institutions for the implementation of ready-made medicinal forms. Such types of pharmacy organizations and the functions they perform are reduced to the sale of medicines to the population and their sale to medical institutions.
- Night pharmacies. As the name implies, such points are designed to serve the population at night.
Order 553n "On approval of types of pharmacy organizations" contains the basic concepts and characteristics adopted in this area. According to the data of this document, all the activities of pharmacies are regulated based on the content of this paper.
In this area, as in any other, it is important to know the laws and apply them correctly. Some unscrupulous implementers, taking advantage of the legal illiteracy of people, do not provide proper services to the population, taking into account the law. Therefore, in addition to the book of complaints and suggestions, any type of pharmacy organizations must have the specified document in the consumer's corner. This is necessary so that the visitor to the pharmacy can easily study it. The order on the approval of the types of pharmacy organizations is also necessary for periodic acquaintance with it directly by pharmacy workers. This is understandable, since the norms prescribed in it will help to better cope with their duties.
Functions of pharmacies
As noted above, Order 553n “On approval of the types of pharmacy organizations” not only regulates the legality of the activities of pharmacies, but also contains a list of the functions of these institutions.
The functions of pharmacies depend not only on the type of activity, but also on its type. Scroll:
- Production. As a rule, this item includes the manufacture and production of medicines both by prescription of doctors and for healthcare organizations in the Russian Federation.
- Supply. Dispensing and dispensing of medicines/funds for healthcare organizations and their structural divisions.
- Informational. Employees of each pharmacy should be informed about the absence and availability of drugs in the institution, informed about new drugs and their correct use.
- Trading. Sale of medicines to the population both by prescription and without it.
- Financial. Pharmacies have the right to accept cash, payment by bank card, process these monetary transactions, keep records of them, transfer funds to the bank and make other calculations.
- Packing and packaging of medicines.
- Sale of medical goods and pharmacy assortment.
- Quality control, expiration date, compliance with the integrity of the package, proper storage location.
- Compliance with the established sanitary standards and hygiene rules.
- Consulting. The pharmacist must have sufficient knowledge about the drugs that he sells, always explain to the public if there are questions of an informative nature regarding medicines, medical equipment, and other pharmacy assortment.
- Development of instructions that affect the quality of public service and the work of staff.
- Reporting compliance.
- Carrying out self-inspection, in accordance with the norms of the legislation of the Russian Federation.
All types of pharmacy organizations Russian Federation are subject to a single rule: their employees are required to know the latest updates in the law on medicines.
Job responsibilities of employees
Employees must know:
- Rules for the sale of goods.
- The law under which pharmacy activities are carried out.
- Acts regulating the rules of conduct for pharmacy workers.
- Pharmacy's internal working hours.
- own rights and obligations.
- Rules for communicating with the public.
- The latest information about the medicines that a particular pharmacy sells.
- Terms of use cash register and computer programs.
- Approximate assortment.
- In what place, department and on which shelf the drugs are located.
- Competently answer questions, express your thoughts clearly and on medical topics.
Location of pharmacies
Each building in which a pharmacy is located should be located in the most populated area, be within walking distance of hospitals, clinics, schools and other crowded places. It does not matter what types of pharmacy organizations they are - their tasks and functions are to consistently serve the population and provide people with the opportunity to purchase the necessary medicines at a set time. Accordingly, the location of pharmacies on the map of the settlement is an important issue.
Nowadays, there are a lot of pharmacies that carry out their legal activities on the territory of the Russian Federation. It is worth noting that according to all civil norms, pharmacies should be in any locality, regardless of whether it is a metropolis or a remote village.
Today, not every city with a small number of inhabitants can boast of having a pharmacy in it. People are forced to wander in search of drugs, call an ambulance if the house does not have the necessary funds. The Ministry of Health of the Russian Federation is closely involved in this issue, but it may take years to implement it.
Existing types of pharmacy organizations are able to carry out their activities in the territory of location, if their geographical location allows customers to easily and quickly reach them. Some citizens note that pharmacies located in cities and villages are located too far from their places of residence. Therefore, to visit a pharmacy, you sometimes need to go through a thorny path.
Central District Pharmacy
The most important and large-scale institution in a district or city is the central pharmacy. In accordance with the document on the approval of the types of pharmacy organizations, it controls many processes related to medical devices.
Responsibilities:
- Provision of pharmacies with toxic substances and ethyl alcohol.
- Informing pharmacies and healthcare facilities about the receipt of drugs.
- Monitoring the receipt and delivery of drugs from the warehouse.
- Reception and correction of applications for the issuance of medicines.
- If there is a body managing pharmacies, deliver applications for obtaining drugs and medical equipment there.
- Control of supplies, availability and condition of drugs for rural pharmacies.
Pharmacy staff according to the regulations
All types of pharmacy organizations contain a minimum staffing which may include the following vacancies:
- Pharmacist.
- Nurse.
- Defector.
- Pharmacist-technologist.
- Head inspector.
Each of the employees performs separate functions, in accordance with the charter and regulations of the pharmacy organization. The staff is obliged to comply with the regime and rules of the institution.
Pharmacist
Appointment and dismissal from this position is carried out by the head of the pharmacy of the health facility. Execution control official duties the pharmacist is led by pharmacists: a technologist and an analyst. In order to work in this position, it is not necessary to have higher education- Enough of the average pharmaceutical.
The pharmacist must:
- Manufacture drugs for the purpose of medical institutions.
- Prepare products according to medical prescriptions.
- Prepare medicines before dispensing.
- Issue the drug before the holiday.
Nurse
Appointment and dismissal from this position is carried out by the head of the medical institution.
Responsibilities:
- cleaning of premises;
- dishwashing and handling.
defector
To enter this position, the employee must have a higher pharmacological education. Appoints and dismisses from this vacancy the head of the pharmacy institution or his deputy.
Responsibilities:
- control of medication records;
- accounting for medical supplies;
- intra-pharmaceutical blanks;
- checking the presence of the required inscriptions and information on the packages of drugs;
- control of the drug expiration date, information about the manufacturer;
- work with other information about medicines sold by the pharmacy.
Pharmacist-technologist
To be accepted for this position, the employee must have a higher pharmacological education. He is appointed and dismissed by the head of the pharmacy, and the employee reports exclusively to the head of the pharmacy and his deputy.
Responsibilities of a pharmacist-technologist:
- prescription control;
- acceptance of prescriptions and requirements;
- clarification of information about medicines to the population;
- registration of medicines and medical products that are in stock;
- control over the storage of drugs;
- accounting for the use of medicines in departments and offices;
- bringing information to the medical staff of hospitals, clinics and other institutions about the presence / absence of medicines in the pharmacy.
Head pharmacist
In order to get hired this position, the employee must have a higher pharmacological education and work experience of more than 5 years in the field of pharmacology. Appointed to this position chief physician medical institution by order. The head pharmacist has identical rights with the head of the department of health facilities.
Responsibilities:
- control over the work of the pharmacy as a whole;
- monitors the correctness of the manufacture of medicines;
- accounting for the release of medicines according to doctor's prescriptions;
- control over the supply of medical equipment to medical rooms and laboratories;
- ensuring proper storage of drugs, medical instruments;
- controls the consumption of medicines;
- keeps a special account of the consumption of narcotic and poisonous drugs;
- ensuring pharmaceutical order in the pharmacy;
- control over the implementation of sanitary and hygienic standards by employees;
- preparation of estimates for the receipt of medical property;
- monitors how the staff performs their duties;
- issuance of orders, instructions and other documents related to work in the pharmacy.
This list of pharmacy employees may be more extensive - it all depends on what types of pharmacy organizations are meant. Their characteristics and functions have been described above.
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Medicines for inpatients.
Completed by: 5th year student
14 groups Petrov V.V.
Scientific adviser:
Tyumen 2017
List of abbreviations
Introduction
Chapter 1 Literature Review
1.1 Drug supply for inpatients
1.2 Dispensing medicines according to the requirements of health facilities. Accounting for a stationary recipe
Chapter 2. Main tasks and functions of hospital pharmacies
Conclusion
Bibliography
List of abbreviations
LPU - medical and preventive institution;
LS - medicines;
PKU - subject-quantitative accounting;
FPP - finished medicinal products;
medical devices - products medical purpose;
MBA - interhospital pharmacy;
BA - hospital pharmacy.
INN - international non-proprietary name.
Introduction
providing the sick with medicine
The current trend in European and Russian health care is to strengthen the mechanisms for the regulation and rational use of medicines, and, accordingly, contain the costs of their consumption in hospital treatment.
The urgency of the problem is due to the dominant share of drug therapy (95%) in the structure of therapeutic measures, which explains its large share in minor budget funds ah for the maintenance of stationary medical institutions. In this regard, before economic service Health care facilities are faced with the task of optimal spending allocated by the state Money, since at present neither the federal nor the territorial health budgets, nor the CMI funds can fully meet the needs of hospitals in financing their costs in full.
The foregoing determines the choice of topic term paper, the purpose of which is to analyze the methods of drug provision of patients in a hospital. To achieve this goal, the following tasks were solved in the work:
1. The features of drug provision for inpatients are disclosed;
2. Analyzed the main tasks and functions of hospital pharmacies.
Chapter 1.Literature review
1.1 Drug provision of inpatients
The organization of effective supply of medical and preventive institutions with medicines and medical products makes it possible to ensure high quality drug care for inpatients (i.e. patients who are at the inpatient stage of treatment in medical institutions). Drug provision of inpatients can be carried out through pharmacies serving the population, and through pharmacies of medical institutions, incl. hospital and interhospital.
In the delivery system medical care an important role is played by the drug supply of health care institutions intended to provide medical care to inpatients. According to the current procedure, the provision of drug care to inpatients is paid for at the expense of budgets of all levels and compulsory medical insurance funds.
Drug provision of inpatients is carried out by:
Pharmacy - urban, rural (any pharmacy serving the population, if it has a license and an agreement with a medical institution, can supply this institution with medicines).
Interhospital pharmacy - MBA (provides medicines and medical products for several medical institutions with a total number of beds of at least 500, and in small settlements with a total number of beds in all health facilities of at least 100; as well as educational institutions, social security and etc.).
Hospital pharmacy - BA (independent - provides medicines and medical products to one medical institution with 500 or more hospital beds, as well as in small settlements if there are at least 100 beds in a medical institution).
Hospital pharmacy - a department of health care facilities (organized at a medical institution with a number of beds of 100 or more and is one
from its branches).
The purpose of the activities of pharmacies serving inpatients is to provide healthcare institutions with medicines and medical products.
Operating conditions:
1. State registration(charter, memorandum of association).
2. License for activities
Based on the main task, hospital and interhospital pharmacies perform following features.
Functions inherent in a pharmacy as a retail link in the system of promotion of pharmacy products: reception, storage, sale of goods, marketing, information; production (pharmaceutical) (preparation according to the requirements of medical institutions and quality control of prepared drugs).
Control over the correct storage and consumption of medicines in medical institutions.
To perform the assigned functions, the pharmacy has the right to:
* to request information about the volume of allocations allocated for the purchase of medicines, dressings, and patient care items to the healthcare facility;
*request data on the effectiveness of new drugs transferred for implementation in healthcare facilities;
*make proposals to improve the distribution, storage, accounting of medicines in hospital departments.
Depending on the profile of health facilities served, pharmacies can be classified:
1. By type:
1.1. Hospital pharmacies of general hospitals, specialized hospitals (including neuropsychiatric, tuberculosis, etc.), clinics of medical institutes, sanatoriums.
1.2. Inter-hospital pharmacies of a mixed type (serving medical institutions and other institutions), inter-sanatorium, small-scale wholesale (serving institutions of education, social security).
2. By groups depending on the amount of work:
1.1. The volume of work for hospital pharmacies is determined by the number of beds, taking into account their profile ( general type or psycho-neurological) and turnover.
1.2. The volume of work for interhospital pharmacies is determined by the value of turnover or the value of turnover and the number of beds served.
Depending on the volume of work performed, the staff of hospital and interhospital pharmacies is calculated.
The supply of hospital and interhospital pharmacies is carried out by a pharmacy warehouse based on the requirements of pharmacies. The procedure for drawing up requirements for a warehouse, organizing the receipt and storage of goods in a pharmacy is carried out as for pharmacies serving the population in accordance with regulatory documents.
The storage of inventory items in the pharmacies of HCIs and IBAs is carried out with the same approved regulations as for pharmacies serving the population. The stock of medicines in pharmacies is established for the purpose of uninterrupted supply of healthcare facilities and other institutions. The size of the stock of medicines is limited in order to avoid overstocking of pharmacies and control over their correct use.
In hospital pharmacies, the stock of medicines is established:
* for poisonous and narcotic drugs - 1 month;
* for other drugs - no more than 2 months.
In interhospital pharmacies, the stock of medicines is established:
For poisonous and narcotic medicines - 1 month, for remote pharmacies - no more than the standard of commodity stocks in days;
For other medicines - no more than the standard of commodity stocks in days.
Accounting for inventory items in the pharmacies of HCI and MBA is carried out, as in pharmacies serving the population:
1. In sum (monetary) terms, all inventory items are taken into account.
2. In physical terms (subject-quantitative accounting) for specific groups of medicines.
The release of inventory items from pharmacies to healthcare facilities is carried out on the basis of invoices-requirements.
The requirement to receive medicines from pharmacies (organizations) must have a stamp, a round seal of a medical institution, the signature of its head or his deputy in the medical department.
The request specifies the name medicinal product, dosage and form of manufacture (tablets, ampoules, ointments, suppositories, etc.) and the total number and type of packaging (boxes, vials, tubes, etc.).
The names of medicines are written in Latin. The requirement specifies the method of application of the medicinal product: for injections, for external use, oral administration, eye drops, etc.
Requirements for narcotic drugs, psychotropic, potent and toxic substances and other drugs containing these groups of drugs, as well as apomorphine hydrochloride, atropine sulfate, homatropine hydrobromide, dikain, silver nitrate, pachycarpine hydroiodide, ethyl alcohol, indicating the concentration are written out on separate requirement forms for each group of drugs with a stamp, a round seal of a medical institution, and the signature of the head of the institution or his deputy for the medical part.
Treatment-and-prophylactic institutions, when drawing up applications for narcotic drugs, must be guided by the calculation standards approved by the PKPN.
If the invoice-demand does not contain complete data on the prescribed medicines, then the head of the pharmacy is obliged to make the appropriate corrections. It is strictly forbidden to make corrections in the direction of increasing the number of medicines. All invoices received by the pharmacy are checked and taxed by the head of the pharmacy or his deputy.
Invoices-requirements for which goods are released are registered in the pharmacy in the "Book of accounting for taxed invoices". At the end of the month, the “Book” calculates the total amount for each group of released inventory items: medicines, dressings, containers, auxiliary materials. Numbers of consignment notes with medicines subject to subject-quantitative accounting are underlined.
Medicines are dispensed by the pharmacy to departments (offices) in the amount of the current need:
* narcotic medicines - 3 days (at the admission department - 5 days);
* poisonous drugs - 5 days;
* all the rest -10-day requirement for them.
Medicines are dispensed from pharmacies to financially responsible persons of the departments (by order of the chief physician, a responsible person is appointed).
When dispensing medicines from a hospital pharmacy, a power of attorney for receipt is not required.
Medicinal preparations from MBA are dispensed to senior medical staff. sisters of departments or outpatient clinics by proxy. The validity of the power of attorney is set for no more than the current quarter for drugs of the general list and medical devices (permanent). To receive poisonous medicines, as well as ethyl alcohol, separate powers of attorney are issued, valid for a month. The power of attorney is valid for 15 days to receive narcotic and psychotropic drugs. If necessary, the LPU can issue a one-time power of attorney, the validity of which is 15 days.
Financially responsible persons of departments (offices) sign on the invoice-requirement for receiving medicines from the pharmacy, and the head of the pharmacy - for dispensing them.
The first copies of invoices executed by the pharmacy are stored in the pharmacy for one year (calendar), not counting the current one. Invoices-requirements for the release of medicinal products subject to subject-quantitative accounting are stored for three years.
According to the Federal Law No. 44 of 04/05/2013. (as amended on July 29, 2017) “About contract system in the field of procurement of goods, works, services to meet state and municipal needs”, health care facilities and pharmacy institutions themselves do not conclude an agreement between suppliers. Part 2 of Art. 59 of the Federal Law No. 44, customers are required to make purchases in the form electronic auction. When describing the object of procurement, one should take into account the features provided for in paragraph 6 of part 1 of Art. 33 FZ No. 44. In the description:
Not the name of a particular drug is indicated, but its INN;
In the absence of such a name, the chemical or grouping names of the preparation shall be indicated.
1.1 Dispensing medicines according to the requirements of health care facilities. Accounting for a stationary recipe
Servicing of wholesale buyers is carried out on the basis of contracts concluded between them and the pharmacy. Available at the pharmacy structural divisions, this is handled by the inventory department.
Goods for healthcare facilities and other institutions are sold at retail prices for cashless payments based on the requirement of the invoice (A-2.20).
Requirements are issued in 3 copies, and for medicinal products subject to PKU, in 4 copies. The procedure for issuing requirements is regulated by the order of the Ministry of Health of the Russian Federation No. 110 of February 12, 2007 (as amended on February 26, 2013) “On the procedure for prescribing drugs, medical devices and specialized food products”
The names of medicines are written in Latin. The dosage, dosage form, packaging, type of packaging, quantity and method of application must be indicated. When prescribing a medicinal product for an individual patient, his surname, initials and case history number are additionally indicated. Requirements for narcotic drugs, psychotropic, poisonous, potent substances and other drugs containing these groups of drugs, as well as apomorphine hydrochloride, atropine sulfate, homotropine hydrobromide, dicaine, silver nitrate, pachycarpine hydrochloride, ethyl alcohol, indicating the concentration, are written out on tear-off forms for each drug group. Separately, requirements for newborns are also written out. Invoice requirements for other goods other than medicines are issued in Russian.
The requirement indicates the name of the department or office of the health facility and the signature of the head of the inpatient unit, respectively. The requirements are signed by the head of the health facility or his deputy for the medical unit, as well as the chief accountant and are certified by the stamp and round seal of the health facility.
Narcotic drugs and psychotropic substances are prescribed in the volumes of a 3-day requirement. Toxic substances and medicines of list A in the amount of a 5-day requirement, and the rest of the drugs in the amount of a 10-day requirement.
Private practitioners licensed to medical activity and those who have concluded an appropriate agreement with a pharmacy can also write out requirements for the release of drugs and other pharmacy products, certifying them with a personal stamp, signature and seal. At the same time, private practitioners do not have the right to prescribe narcotic drugs, psychotropic substances and their precursors subject to CSP in pharmacy organizations.
Requirements are accepted and checked by a pharmacist-defector technologist. When checking, attention is drawn to the correctness of the requirements, the writing of medicines, their compatibility, the correctness of writing dosage forms and packaging. (FZ No. 751n dated October 26, 2015).
The medicines prescribed in the request must correspond to the profile of the beds.
After checking the requirements, they are adjusted by the deputy director for procurement, i.e., the number allowed for vacation is affixed. It is strictly forbidden to correct the quantity of goods upwards. When changing the packaging or dosage, the total amount of the dispensed drug should not exceed the prescribed amount.
If the drug is not available, put "no" or "-". After adjustment, the requirements are numbered from the beginning of the year and taxed by the pharmacist-technologist at retail prices. An order is formed, and if necessary, individual dosage forms are made.
On the labels of extemporaneous drugs containing narcotic drugs, psychotropic, toxic substances and drugs of list A, there should be a black letter A and a stamp in black ink "Poison". On the labels of drugs containing potent substances and drugs of list B, respectively, the red letter B. When dispensing drugs that are on the PKU, the fourth copy of the invoice requirement remains with the financially responsible person as a supporting document. Medicines issued according to the requirements of waybills and other goods can only receive medical worker(head nurse in the name of whom the request is issued). Vacation is made by power of attorney signed by the chief physician and chief accountant of the health facility. The power of attorney is issued for a period of up to 1 month for obtaining narcotic drugs, psychotropic, poisonous substances, drugs of list A and ethyl alcohol. And for a period of up to three years to receive the remaining drugs and other pharmacy products.
At the first issue of the goods, the power of attorney is withdrawn and subsequently stored in the pharmacy. The buyer's representative signs on all copies of the invoice request for the goods received from the pharmacy, and the pharmacist technologist signs for the issuance of the goods and the correctness of taxation. Together with the order, the employee of the medical facility is given the third copy of the invoice requirement. All invoice requirements for which the goods are released to medical facilities and other buyers are deciphered:
I. By type of vacation
1) Medicines, including:
a) extemporaneous (individual).
b) ready.
2) Others.
II. By product groups.
After decryption, they are recorded in the register of wholesale supply and settlement with the buyer (A-2.19). In this journal, a personal account is opened for each customer, in which, in chronological order, the sale of goods from the pharmacy by groups is reflected.
The procedure for payment for the dispensed pharmacy goods is indicated in the contract concluded with the buyer. If the calculations are systematic, then the goods can be released without advance payment, and the received medicines are paid on the basis of advance payments or upon the fact of release. Other institutions receive goods only after advance payment and only within the limits of the transferred amounts. To pay for the goods, the pharmacy issues an invoice to the buyer, to which the 2nd copy of the invoice requirement is attached. The 1st copy of the bill of lading at the end of the month is attached to the report of the financially responsible person and transferred to the accounting department of the pharmacy.
If the goods are released without advance payment, then the invoice can be drawn up for a certain period on the basis of several invoices attached to it. The invoice is drawn up in 2 copies. The first copy is sent to the buyer, and the second remains in the pharmacy. All invoices issued during the month in chronological order are recorded in the sales ledger and in the register of invoices (invoices) issued by the buyer (form A-2.22).
The register shows the amount wholesale trade per month, broken down by type:
1) The cost of extemporaneous and ready-made drugs.
2) Dispensing medicines (angro).
3) Other leave.
In the same register, invoices are also entered for paying for preferential and free dispensing of drugs to outpatients under the prescription of medical facilities.
Determination of the number of stationary prescriptions for drugs.
Based on the results of the month, the number of inpatient prescriptions for ILS and OTC drugs is determined by calculation. To do this, the cost of ILS, dispensed according to the requirements of health facilities, is divided by the average cost of 1 outpatient prescription for ILS. And the cost of OTC drugs dispensed by health facilities is divided by the average cost of 1 outpatient prescription for OTC drugs. At the same time, the average cost of 1 outpatient ILS is conditionally equated to the average cost of 1 inpatient ILS, and the average cost of 1 outpatient FPP is conditionally equated to the average cost of 1 inpatient OTC.
Chapter 2Main tasks and functions of hospital pharmacies
The main goal of hospital and interhospital pharmacies is the timely and high-quality provision of inpatients with medicines and medical products.
Pharmacies perform the following functions:
Determining the needs of health facilities for drugs, patient care items and other medical supplies;
Purchase and release of medicines, dressings, patient care items to the department of health care facilities;
Preparation of extemporaneous medicines according to the requirements - orders of health care facilities;
Quality control of prepared medicines;
Control over the correct storage and rational use of medicines in the departments and offices of healthcare facilities;
Control over the rational use of funds allocated for the purchase of honey. goods;
Information work.
Depending on the profile and structure of health facilities, hospital pharmacies can be:
1. General hospital pharmacies;
2. Pharmacies of specialized hospitals (tuberculosis, infectious diseases, neuropsychiatric);
3. Clinic pharmacies;
4. Pharmacies of sanatoriums.
Pharmacies that serve health care facilities can be budgetary (funding of these pharmacies is carried out at the expense of budgetary funds) and self-supporting. Self-supporting pharmacies - operate as a legal entity, carry out wholesale and retail sales of medicines and medical devices, and also manufacture extemporaneous drugs.
Pharmacies are opened to serve one health facility (hospital pharmacy) or several health facilities (interhospital pharmacy). Such pharmacies should be located in a separate room or in a medical facility with a separate entrance.
The purchase of drugs and medical devices is carried out from distributors, pharmacy warehouses on the basis of contracts with a license by participating in tenders (if there are at least 3 suppliers, with a purchase of at least 30 thousand UAH). The range of purchased drugs is regulated by the state.
Input control is carried out by an authorized person (head nurse, pharmacist or pharmacist of the pharmacy of the health facility, approved by order of the head of the health facility, their data is reported to the territorial state inspections).
Boundary standards for the storage of narcotic, psychotropic drugs and precursors in the structural divisions of healthcare facilities.
- Pharmacy of health care facilities - a two-week need;
- Department of health care facilities - a three-day requirement;
- Posts (offices) of healthcare facilities - a two-day requirement;
- Reception department of a hospital for the provision of emergency medical care for vital signs in the evening and at night - a five-day reserve;
- Outpatient clinics, FAPs - a weekly need.
- The procedure for prescribing drugs and medical devices and PKU in the structural divisions of health facilities.
- Medicines for the needs of health care facilities are prescribed separately for each department. The requirement-order is made out with a stamp, a round seal of the medical facility, the signature of the head or his deputy from the medical unit. The requirement-order indicates the names, dosage, forms of release and the total number of drugs (in 3 copies).
- Requirements-orders for drugs that are subject to PKU, drugs for anesthesia are issued on separate forms for each group of drugs (4 copies). They must indicate the name of the department or offices, the appointment of drugs (for injection, internal, etc.). Narcotic, psychotropic drugs, precursors of list No. 1 are prescribed in Latin and the amount is indicated in words.
- For narcotic drugs, in addition to the above, there should be: the number of the medical history, the full name of the patient, the name and dosage of these drugs, as well as their purpose. To receive drugs, a power of attorney is issued (valid for 10 calendar days).
PKU in health care facilities are subject to:
- Narcotic drugs.
- Psychotropic drugs.
- Precursors of list No. 1.
- Poisonous drugs (atropine and its salts - powder, tetracaine, trihexyphenidyl, peripheral muscle relaxants).
- Potent drugs (butorphanol, diphenhydramine (solid forms), clonidine (substance and liquid forms), methandienone, retabolil, promethazine).
- Combined drugs (solid forms), which contain tramadol, ephedrine, pseudoephedrine.
Budget pharmacies purchase medicines within the limits allocated from the state budget for the treatment of inpatients. Self-supporting pharmacies have the ability to form stocks in significant volumes, which allows the pharmacy to quickly respond to requests from healthcare facilities.
Pharmacies should have a number of additional premises to serve health care facilities, namely:
- service room for medical personnel (information room);
- order picking room;
- billet concentrates and semi-finished products;
- room for storing clean dishes;
- material for poisonous and narcotic preparations;
- material for storage of thermolabile substances;
- material for storage of medical products and others;
- unpacking.
Interhospital pharmacy staff:
- Administrative staff (pharmacy manager, pharmacist, chief accountant, safety engineer, economist);
- Pharmaceutical staff (pharmacists, pharmacists);
- Support staff (packers, nurses);
- Service personnel (repair worker, driver).
Responsibilities of a pharmacist
To perform functions regarding the organization of drug supply for inpatients in health facilities that are attached to pharmacies, the position of a pharmacist (but not more than two persons) is introduced, which is directly subordinate to the head physician or his deputy.
Responsibilities of the pharmacist:
- acceptance and verification of orders from the departments of healthcare facilities;
- acceptance of completed orders from the pharmacy and timely transfer of drugs and medical devices to the appropriate departments;
- constant communication with doctors, informing them about medicines;
- control over compliance with the established rules for the storage of medicines in the departments and offices of healthcare facilities.
Conclusion
Pharmacy regulation aims to ensure the quality of drug care, which includes the quality of the product itself, the quality of the facility, equipment and the quality of the implementation process. It is also necessary to regulate the pharmaceutical procedure (this is a set of requirements for the premises, staff, sanitary regime, storage conditions, forms of service, dispensing rules, incoming control of medicines, and other indicators that ensure the quality of drug care provided in a particular pharmacy, regulated by legal and regulatory acts of the Russian Federation).
In connection with the commercialization of the activities of pharmacies and the appearance on the shelves of pharmacies of falsified and counterfeit products, the development of a system for regulating pharmacy activities is of particular relevance.
Bibliography
1. Bagirova V.L. Management and Economics of Pharmacy: Textbook / Ed. V.L. Bagirova. - M.: JSC "Publishing house" Medicine ", 2004. - 720 p.;
2. Dremova N.B., Solomka S.V. Computer techologies marketing research in medical and pharmaceutical organizations. - Kursk: KSMU, 1999. - 147 p.
3. Order of the Ministry of Health of the Russian Federation of February 12, 2007 No. (as amended on February 26, 2013) No. 110 “On the procedure for prescribing drugs, medical devices and specialized food products”
4. Order of the Ministry of Health of the Russian Federation of 26.10. 2015 No. 751n "On approval of the rules for the manufacture and dispensing of medicinal products for medical use by pharmacy organizations, individual entrepreneurs who have a license for pharmaceutical activity.
5. Federal Law of 05.04.2013 (as amended on July 29, 2017) No. 44 “On the contract system in the field of procurement of goods, works, services to meet state and municipal needs”
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The population of Russia is currently 145 million people, of which 11 million are pensioners, that is, each working person currently supports 3 pensioners. The Russian population is aging. About 25% of the Russian population is annually treated in hospitals. The total number of beds in hospitals in the Russian Federation is more than 1 million, MOs are the main consumers of drugs. In the public sector, drugs are paid for at the expense of budgets and the Compulsory Health Insurance Fund (MHIF). Drug provision of patients undergoing inpatient treatment in hospitals, clinics, dispensaries, maternity hospitals and other medical organizations is carried out through pharmacies serving the population, as well as hospital and interhospital pharmacies.
In the city of Chelyabinsk, hospital pharmacies are available in the following municipal institutions health care: City Clinical Hospital No. 1, 3, 6, 4, 7, 8, 9, as well as regional Hospital, federal cardiology center. An interhospital pharmacy is a pharmacy of the regional pharmacy warehouse near the cardiology center.
A hospital pharmacy established as a department with at least 100 beds is financed from the local budget.
Interhospital and hospital pharmacies, established as independent legal entities, are organized to provide medicines to 2 or more medical units with a total number of beds of at least 500.
In a hospital pharmacy there is a staffing table, which depends on the number and profile of beds served, as well as on the volume of pharmacy sales.
A hospital pharmacy is organized in order to supply the structural units of the Ministry of Defense with ready-made and extemporaneous drugs, medical devices (dressing material, syringes, medical instruments, consumables, as well as patient care items).
The main tasks of hospital pharmacies are:
Provision of departments according to the requirements of medicines and pharmacy products.
Identification of the need for drugs and medical devices in accordance with the profile and specifics of the MO.
Organization of systematic information of doctors about the pharmacy range of the attached medical organization.
To carry out the assigned tasks, the pharmacy performs the following functions:
Provision of departments according to the requirements - medicines and commodity pharmacy assortment.
Produces the manufacture of medicines at the request of medical facilities and controls their quality.
Carries out systematic control over the correct storage and consumption of drugs and medical devices in the departments.
Ensures compliance with all requirements of the pharmaceutical order and sanitary regime.
Hospital and interhospital pharmacies perform all the functions inherent in a pharmacy organization:
Logistic.
Marketing (realization).
Production (manufacturing).
Marketing (product promotion.
Informational.
The hospital pharmacy should be provided with:
Premises (mainly 2 departments: OGLF and RPO), there used to be a department of reserves.
In the department of finished drugs there are material rooms for storing finished drugs (thermolabile - cold rooms or refrigerators), dressings, medical devices (syringes, blood transfusion systems, patient care items), consumable(X-ray film, reagents).
In RPO, all the same premises that exist in pharmacies serving the population:
Washing.
Sterilization.
Distillation.
Autoclave.
Marking.
Assistant.
aseptic block.
Analyst's office.
material rooms.
Drug room.
Alcohol room.
acid room.
Defectorskaya.
Control and marking.
Dry heat.
The hospital pharmacy also has administrative and amenity premises:
Manager's office.
Accounting.
Staff room.
Wardrobe.
Bathroom.
There is also a room for receiving requests from the departments of the Moscow Region and dispensing medicines to the senior sisters of the department.
The hospital pharmacy should be provided with pharmacy furniture, equipment, inventory, instruments and apparatus, drugs, dressings, patient care items, an irreducible supply of sera and vaccines, reagents and devices for quality control of drugs manufactured in the pharmacy, reference literature and the Global Fund.
Sanitary requirements for premises and equipment of pharmacies
Premises of pharmacies are equipped, finished and kept clean. Before entering the pharmacy there should be devices for cleaning shoes from dirt. Cleaning is done at least once a day. The workplaces of pharmacists in the hall should be equipped with glasses that protect against direct droplet infection. There should be vents or transoms for ventilation, as well as plastic insect nets. In summer, windows should be provided with sun protection devices. Currently, in accordance with order No. 706n, blinds must be installed on the windows to protect the drugs from direct sunlight.
When building pharmacies, they must be protected from rodents and animals. The surfaces of the walls and ceilings of industrial premises must be smooth, not allowing damage to the integrity of the coating, but allowing wet cleaning with the use of disinfectants. All coatings (paints, enamels, tiles) must have hygienic certificates. The coverings of the premises must be antistatic, the floors are covered with ceramic tiles, linoleum or relin with mandatory welding of seams. Pharmacy premises should have both natural and artificial lighting. Artificial lighting in pharmacies is carried out with fluorescent lamps and incandescent lamps. Pharmacies should have central heating and central plumbing. In the premises of the pharmacy, microclimate parameters (temperature, humidity) are monitored. All equipment used in pharmacies must be approved for use and have a certificate of conformity. AT industrial premises pharmacies (assistant, aseptic unit, autoclave, distillation, material rooms) it is not allowed to hang curtains, plant flowers, hang wall newspapers, lay carpets, corridors, staff rest rooms and offices can be used for this. Decorative design of non-industrial premises: landscaping is allowed provided that they are looked after at least once a week.
In the washing room where the dishes are processed, sinks for washing dishes should be allocated and marked: for injection solutions and eye drops, internal LF, external LF. Do not use these sinks for handwashing. To wash the hands of personnel in the locks of the aseptic unit, assistant (where non-sterile LF are made), washing, toilet, sinks with pedal taps or with elbow drives should be installed. Containers with disinfectants (chlorhexidine solution 0.1% or chloramine solution 0.5%), as well as electric air dryers, are installed near the sinks.
pharmacy staff
The pharmacy is headed by a pharmacist with at least 3 years of work experience.
The hospital pharmacy has the following staff positions:
Head of pharmacy pharmacist.
1 or 2 deputy heads (one is responsible for the work of the RPO, the second for the work of the OGLF).
Pharmacists (pharmacist-analyst, pharmacist-technologist).
Pharmacists who work in the RPO, that is, are engaged in the manufacture and distribution of extemporaneous dosage forms, in the OGLF - the distribution of finished drugs.
Accountant.
Packers.
Washers and cleaners.
Ancillary workers.
A pharmacy organization is an organization, a structural subdivision of a medical organization that retails medicines, stores, manufactures and dispenses medicinal products for medical use.
Any pharmacy organization must have a license, only specialists should work in a pharmacy organization. Management can be carried out by a pharmacist who has a certificate in the specialty of a pharmacist-organizer and work experience of 3 years.
By the nature of their activities, pharmacies are divided into 2 groups:
1 Carrying out the sale of finished medicinal products by prescription, without a prescription to health care institutions - pharmacy, pharmacy kiosk
2 Carrying out all functions, as well as manufacturing and selling, pharmacies with a production department and with the right to manufacture
Classification.
By form of ownership:
State
Municipal
By organizational and legal form:
AO-open and closed
ALC (additional liability company)
Unitary enterprises
By organizational type:
Types of pharmacies:
Pharmacy of finished dosage forms
Manufacturing pharmacy
Production facility with the right to manufacture aseptic molds
sick leave
Interhospital
Pharmacy healthcare institutions
homeopathic
Central, district, city
Pharmacy
pharmacy kiosk
pharmacy store
Served contingent:
Serving the population and healthcare facilities
hospital pharmacy
Interhospital
Health facility pharmacy
Central District Pharmacy
Departmental pharmacies
By the nature of the product range:
Universal
Specialized
Profile
By the presence of a production function:
Production
non-production
By mode of operation:
normal mode
On duty pharmacies
24/7
Pharmacy Functions
1 Production-manufacturing, packaging, water production, quality control
2 Logistics - inventory management
3 Marketing - sale to the population, health care facilities, vacation free of charge or preferential
4 Information and consulting
5 Financial function
6 Marketing research of the pharmaceutical market in order to determine the assortment and pricing policy of the enterprise
7 Control
8 Medical
9 Training
4. Organizational structure of pharmacies. Premises and equipment of pharmaceutical organizations. Qualification groups of positions of pharmacy workers.
They take into account the service area, functions, scope of work, composition of consumers, number of staff, pharmacy area, etc.
Large pharmacies have five departments:
Inventory department: applications, storage, vacation
Prescription and production: receipt of recipes, harvesting, packaging, quality control
OTC Department
Department of finished dosage forms
Department of free preferential leave
Pharmacy premises and equipment.
All rooms must be located in the building and combined into one block. Entrance and exit through the premises of other organizations is allowed. Ramps are required. On the premises of pharmacy organizations there should not be institutions that are not listed in the license. A pharmacy organization must have central water supply, heating, ventilation and fire alarm systems. The pharmacy must have a sign (type of organization, legal form, form of ownership, company name, location, working hours, addresses and telephone numbers of nearby pharmacies)
The premises of the pharmacy are divided into:
Production: premises for acceptance and unpacking of goods; shopping room; premises for the preparation of non-sterile medicines; premises for the preparation of medicines in aseptic conditions; control and marking
Administrative and economic: workplace manager, accountant, dressing room, staff room, archive
Sanitary and amenity premises: a lavatory with a lock, storage space for inventory, showers
Qualification groups of positions.
Established by Order No. 526
MEDICAL PHARMACEUTICAL STAFF OF THE 1ST LEVEL (nurse)
Special medical pharmaceutical staff (junior pharmacist, senior pharmacist, head of the pharmacy)
Doctors and pharmacists (pharmacist-intern, pharmacist trainee, pharmacist-technologist, pharmacist-analyst, senior pharmacist)
Heads of structural divisions (head of structural division, head)
5. STRUCTURAL UNITS OF THE PHARMACY ORGANIZATION FOR RECEIVING RECIPES, MANUFACTURING MEDICINES, CONTROL OF THEIR QUALITY AND DISPENSING. TECHNOLOGY OF RELEASE OF PRECISION MEDICINES. PHARMACEUTICAL EXAMINATION OF THE RECIPE.
In a pharmacy organization, two types of distribution of goods are possible - prescription and over-the-counter. To receive prescriptions for finished and extemporaneous dosage forms, manufacture medicines, control their quality, dispense prescription and non-prescription goods in pharmacies, the following structural units are distinguished:
Department of finished dosage forms, the main functions of which are the receipt of prescriptions and the release of finished drugs according to them
Prescription and production department, whose functions include taking prescriptions for extemporaneous forms, manufacturing, dispensing drugs and controlling their quality, and dispensing.
OTC department, organized for the sale of drugs without a doctor's prescription, as well as other pharmacy products
The technology for dispensing prescription drugs includes the following procedures:
Pharmaceutical prescription expertise
Taxation of prescriptions, placing an order for manufacturing, registration and control of manufactured medicines
Dispensing medication after payment
A prescription (FZ No. 61) is a written prescription of a medicinal product in the prescribed form, issued by a medical or veterinary worker who has the right to do so for the purpose of dispensing a medicinal product or its manufacture and dispensing.
Pharmaceutical examination of the prescription - assessment of the compliance of the prescriptions received by the pharmacy with the current regulations on the rules for prescribing and dispensing drugs for them. It is carried out in the following stages:
1 Definition of legal capacity
2 Compliance with the form of the form
3 Availability of basic details: stamp of the medical institution, date of discharge, last name and age of the patient, last name of the doctor, name of the drug, quantity, method of administration, signature and personal seal of the doctor
4 Additional details: the seal of the health facility for prescriptions, the round seal of the health facility, the series and number of the prescription, the number of the patient's medical record, the patient's address, the signature of the head doctor of the health facility
5 Expiry date of the prescription
6 Compliance with the order of dispensing: maximum permissible dispensing rates, compatibility of ingredients, compliance of doses with the age of the patient, dispensing according to a foreign prescription, dispensing according to a veterinary prescription
Taxation of a prescription is the determination of the cost of a medicinal product, which consists of the cost of ingredients, water, dishes and the tariff for manufacturing. The tariff includes electricity, rent of the premises in which they cook, utilities, wages of workers.
Prescription registration:
1 Receipt method
2 Journal method
3 Token form
4 Check form
They take a prescription, check the last name, receipt or token number, visually check the appearance of the medicine
