A Report on

Hospital Pharmacy Training

Submitted by

Bharti Waghile

Contact No:9097671111

Bachelor of Pharmacy
 Certificate of Completion

This certifies that

Bharti Waghile , has successfully completed the pharmacy training program at Ruby Hall Hospital.

Training Period:

From 06 June 2024 to 07th July 2024.

The comprehensive training program covered the following key areas:

- Prescription Handling: Best practices for managing and dispensing prescriptions.

- Patient Counseling: Techniques for e ective communication with patients regarding their medications.

- Medication Management: Strategies for ensuring proper medication use and adherence.

- Pharmaceutical Calculations: Precise calculations for dosage and compounding.

- Clinical Pharmacy Practice: Application of pharmacy knowledge in clinical settings.

- Hospital Pharmacy Operations: Understanding of hospital pharmacy workflow and protocols.

Signature:

_________________________

Pharmacy Department

Ruby Hall Hospital Pune

Index

Sr. No Content
1. Aim & Objective

2. Introduction

3. OPD Prescription

4. IPD Prescription

5. Store 1 [Direct cash sale ]

6. Store 2 [Day & Night Store]

7. Store 3 [Indent Store]

8. Store 4 [ Cental Store]

9. Cancer drug store

10. Cardiac Ot Pharmacy

11. Robotic Ot Pharmacy

12. Result and Conclusion

Aim & Objective

Aim: The aim of pharmacy training at Ruby Hall Hospital was to attain a comprehensive understanding
and practical proficiency in various facets of hospital pharmacy practice. This training was designed to
enhance my professional capabilities and equip me with the necessary skills to deliver exemplary
pharmaceutical care.

Objective:

To Master Prescription Management: Develop proficiency in prescription verification, preparation, and

dispensing processes to ensure accuracy and safety in medication delivery.
 To Enhance Patient Consultation Skills: Learn e ective communication techniques for patient education,
ensuring medication adherence and addressing patient concerns and queries.

To Understand Hospital Pharmacy Operations: Gain insights into the operational and administrative
functions of a hospital pharmacy, including inventory management, workflow optimization, and
interdepartmental coordination.

To Adhere to Regulatory and Compliance Standards: Learn and apply legal and ethical standards in
pharmacy practice to ensure compliance with regulatory requirements and uphold professional integrity.

To Strengthen Patient Interaction and Education: To improve my ability to e ectively communicate with
patients, providing clear and concise medication guidance and fostering better patient compliance and
health outcomes.

To Deepen Pharmacological Knowledge: To gain a comprehensive understanding of drug mechanisms,

therapeutic uses, and side e ects, thereby enhancing my ability to make informed clinical decisions.

Introduction
The field of pharmacy plays a critical role in the healthcare system, acting as a bridge between medical
practitioners and patients. During my training at Ruby Hall Hospital, I had the unique opportunity to immerse
myself in the dynamic and multifaceted environment of the hospital's pharmacy. Ruby Hall Hospital, renowned
for its commitment to excellence in healthcare, provided an ideal setting for gaining hands-on experience and
developing a deep understanding of various pharmacy processes.

Ruby Hall Hospital is a premier healthcare institution known for its state-of-the-art facilities, expert
medical sta , and comprehensive patient care services. The hospital's pharmacy department is integral to
its operations, ensuring that patients receive accurate, timely, and safe medication therapy. Throughout
my training, I was stationed at di erent pharmacy units within the hospital, each o ering distinct
perspectives and challenges that contributed to my professional growth.
 Figure : Ruby Hall Clinic Pune

Ruby Hall Hospital's pharmacy practices are characterized by a commitment to excellence, patient safety, and e
cient service delivery. The pharmacy department operates with a multifaceted approach, integrating
various practices to ensure optimal patient outcomes and streamline pharmacy operations.

Here are some key aspects of the pharmacy practices at Ruby Hall Hospital:

1. Patient-Centered Care:

Medication Counseling: Pharmacists at Ruby Hall Hospital engage in thorough medication counseling
sessions, providing patients with essential information about their medications, including usage
instructions, potential side effects and interactions with other drugs.
Medication Therapy Management (MTM): This involves reviewing patients' medication regimens to
ensure they are receiving the most e ective and safe treatments. MTM services are designed to
optimize therapeutic outcomes and enhance patient adherence to prescribed therapies.

2. Prescription Handling:

Verification and Dispensing: The pharmacy team meticulously verifies prescriptions for accuracy and
appropriateness before dispensing. This process involves checking for potential drug interactions,
duplications, and contraindications.

Electronic Prescribing: Ruby Hall Hospital utilizes advanced electronic prescribing systems to enhance
the accuracy and e ciency of prescription processing. This technology reduces errors and ensures
timely medication delivery.
3. Inventory Management:

Automated Inventory Systems: The pharmacy employs automated systems to manage inventory levels
e ectively. This ensures that medications are adequately stocked, reducing the risk of shortages and
overstocking.
Medicine Indenting: A systematic approach to indenting medicines involves forecasting demand,
coordinating with suppliers, and maintaining an optimal inventory to meet patient needs without
wastage.

4. Regulatory Compliance and Safety:

Adherence to Standards: The pharmacy adheres to stringent regulatory standards and best practices
to ensure the safe dispensing of medications. This includes compliance with local, state, and national
regulations.
Quality Assurance: Regular audits and quality checks are conducted to maintain high standards of
pharmacy practice. This includes monitoring for medication errors, maintaining proper storage
conditions, and ensuring the integrity of pharmaceuticals.

5. Technological Integration:

Pharmacy Information Systems (PIS): Ruby Hall Hospital integrates advanced PIS to manage patient
data, medication orders, and inventory. This technology streamlines workflow, enhances accuracy, and
facilitates e cient communication within the healthcare team.
Electronic Health Records (EHR): The use of EHR systems allows pharmacists to access comprehensive
patient information, enabling better-informed clinical decisions and coordinated care.

6. Financial Management:

Cash Sales Process: The pharmacy manages financial transactions with precision, ensuring accurate
billing and adherence to the hospital's financial policies. This includes handling insurance claims and
processing payments e ciently.

7. Sta Training and Development:

Continuous Education: Pharmacists and pharmacy technicians at Ruby Hall Hospital undergo
continuous professional development to stay updated with the latest advancements in pharmacy
practice.
Skill Enhancement: Training programs focus on enhancing clinical skills, patient communication, and
the use of technology in pharmacy operations.

One of the critical aspects of my training involved understanding and participating in the cash sales
process. This process is essential for managing the financial transactions related to the dispensing of
medications. I learned the importance of maintaining accurate records, processing payments e ciently,
and ensuring that all transactions comply with the hospital's financial policies and regulations. This
experience underscored the need for precision and integrity in handling monetary transactions within a
healthcare setting.
Indent Medicines:

Another vital component of my training was the indenting of medicines. This process involves the
requisition and procurement of pharmaceuticals to maintain an adequate inventory within the hospital
pharmacy. I was introduced to the meticulous planning and coordination required to ensure that the
pharmacy is well-stocked with essential medications without overstocking, which could lead to wastage.
Through this, I gained insights into inventory management, supplier relationships, and the logistics of
pharmaceutical supply chains.

Prescription Handling:

Prescription handling is at the core of pharmacy practice, and my training at Ruby Hall Hospital provided
extensive exposure to this critical function. I learned to interpret and verify prescriptions accurately,
ensuring that they are clear, complete, and appropriate for the patient's condition. This experience was
invaluable in understanding the importance of attention to detail, clinical judgment, and e ective
communication with healthcare providers to resolve any ambiguities or discrepancies in prescriptions.

Pneumatic Shoot System:

The hospital employs a pneumatic shoot system for the rapid transfer of emergency medications. This
system ensures that critical drugs reach their destination quickly, enhancing the responsiveness of
emergency care.

Furthermore, my training encompassed various management techniques that are essential for the e
cient operation of a hospital pharmacy. These techniques included workflow optimization, sta
coordination, quality assurance, and adherence to regulatory standards. I observed and participated in
the implementation of standard operating procedures (SOPs) that streamline pharmacy operations and
enhance patient safety. Additionally, I gained exposure to the use of technology in pharmacy
management, including electronic health records (EHRs) and pharmacy information systems (PIS), which
facilitate accurate and e cient pharmacy services.

OPD Prescriptions:
An OPD (Outpatient Department) prescription is a medical document provided by a healthcare
practitioner, detailing the medications and treatments prescribed for a patient who is not admitted to the
hospital but visits for consultation, diagnosis, or treatment. The prescription includes critical information
such as the patient's name, date, medication names, dosages, administration routes, duration of
treatment, and any special instructions.

OPD Prescription Handling at Ruby Hall Hospital

At Ruby Hall Hospital, the handling of OPD prescriptions is a meticulous and patientcentered process that
ensures safety, accuracy, and e ciency. The hospital’s pharmacy department plays a crucial role in
managing OPD prescriptions, integrating advanced technologies and stringent protocols to provide high-
quality care.

Process of Handling OPD Prescriptions:

a. Prescription Reception:
Upon receiving an OPD prescription, the pharmacy sta verifies the patient's details and consults
the hospital's electronic health records (EHR) system to ensure the accuracy of the prescription and
the patient's medication history. Verification includes checking for potential drug interactions,
allergies, and ensuring the prescribed medications are suitable for the patient’s current health status.

b. Prescription Verification:
The pharmacist reviews the prescription for clarity and completeness. This includes verifying the
medication names, dosages, routes of administration, and treatment duration.
Any ambiguities or discrepancies are promptly communicated with the prescribing doctor for
clarification.
c. Medication Dispensing:
Once verified, the prescription is processed, and the required medications are dispensed. Ruby
Hall Hospital’s pharmacy utilizes automated dispensing systems to enhance accuracy and e ciency.
The pharmacy sta ensures that each medication is correctly labeled with the patient’s name,
dosage instructions, and any special precautions or storage instructions.
d. Patient Counseling:
A critical aspect of the OPD prescription process is patient counseling.
Pharmacists at Ruby Hall Hospital provide comprehensive counseling sessions to educate patients
about their medications.
Counseling includes explaining the purpose of each medication, how and when to take them,
potential side e ects, and what to do in case of missed doses or adverse reactions.
e. Documentation and Record-Keeping:
All dispensed medications and corresponding prescriptions are documented in the hospital’s
pharmacy information system (PIS). This ensures accurate recordkeeping and facilitates future
reference if needed.
The documentation process also includes noting any specific instructions given to the patient and
any follow-up consultations scheduled.

6.Follow-Up and Monitoring:

Ruby Hall Hospital emphasizes the importance of follow-up and continuous monitoring of patients.
Patients are advised to return for follow-up visits to assess the e ectiveness of the treatment and
make any necessary adjustments. The pharmacy team collaborates with other healthcare
providers to monitor patient progress and address any issues related to medication adherence or
side e ects.

In conclusion, the handling of OPD prescriptions at Ruby Hall Hospital is a well-organized and
comprehensive process designed to ensure patient safety, medication accuracy, and optimal therapeutic
outcomes. The integration of advanced technologies, strict adherence to protocols, and emphasis on
 patient education and follow-up care exemplify the hospital’s commitment to delivering high-quality
pharmaceutical services. This structured approach not only enhances patient satisfaction but also
contributes to better health outcomes.

OPD Prescription:

IPD Prescription
An IPD (Inpatient Department) prescription is a medical order written by a healthcare practitioner for a
patient who has been admitted to the hospital. This prescription includes detailed information about the
medications, treatments, and care instructions necessary for the patient during their hospital stay. The
IPD prescription often includes dosage schedules, routes of administration, special instructions, and any
necessary monitoring parameters.
IPD Prescription Handling at Ruby Hall Hospital

At Ruby Hall Hospital, the handling of IPD prescriptions is a comprehensive and coordinated process that
ensures patient safety, accurate medication administration, and e ective communication among
healthcare providers. The hospital’s pharmacy department plays a crucial role in managing IPD
prescriptions, utilizing advanced systems and protocols to deliver high-quality inpatient care.

Process of Handling IPD Prescriptions:

a. Prescription Initiation:
When a patient is admitted, the attending physician initiates the IPD prescription based on the
patient’s diagnosis, medical history, and current condition. This prescription is entered into the
hospital’s electronic health records (EHR) system, ensuring immediate access for all relevant
healthcare providers.
The prescription includes detailed instructions on medication names, dosages, routes of
administration, frequency, and duration of treatment.
b. Verification and Review:
The pharmacy team receives the IPD prescription electronically and conducts a thorough review.
This includes checking for potential drug interactions, contraindications, allergies, and verifying
the appropriateness of prescribed medications.

Any discrepancies or concerns are promptly communicated to the prescribing physician for
clarification and modification if necessary.
c. Medication Dispensing:
Once verified, the pharmacy prepares the medications as per the prescription. This includes unit
dose packaging, compounding (if required), and labeling each medication with the patient’s details and
administration instructions. Ruby Hall Hospital utilizes automated dispensing cabinets (ADCs) and
other advanced technologies to ensure accurate and ecient medication dispensing. d. Delivery to the
Ward:
Medications are delivered to the respective wards in a timely manner. The hospital employs a
pneumatic shoot system for the rapid transfer of emergency medications, ensuring critical drugs
reach the patient quickly.
For routine medications, dedicated pharmacy sta ensure timely delivery to the nursing stations,
where nurses administer the medications according to the prescribed schedules.
e. Administration and Monitoring:
Nurses administer the medications to patients as per the IPD prescription. They follow strict
protocols to ensure the correct medication is given at the right time and in the proper manner.
Continuous monitoring of the patient’s response to the treatment is conducted. This includes
observing for any adverse drug reactions, e ectiveness of the medication, and making necessary
adjustments as advised by the physician.
f. Documentation and Record-Keeping:
All administered medications and relevant patient information are meticulously documented in
the EHR system. This ensures an accurate and up-to-date record of the patient’s treatment plan
and medication history.
Documentation also includes noting any changes to the prescription, patient progress, and any
adverse reactions or side e ects observed.
 g. Interdisciplinary Collaboration:
The pharmacy team collaborates closely with physicians, nurses, and other healthcare
professionals to ensure comprehensive patient care. Regular interdisciplinary meetings and rounds
are conducted to discuss patient progress and treatment plans.
Pharmacists participate in clinical rounds, providing their expertise in medication management
and assisting in optimizing therapeutic regimens.
h. Discharge Planning:
As the patient’s discharge approaches, the pharmacy team plays a critical role in planning for the
transition from inpatient to outpatient care. This includes preparing discharge medications,
providing medication counseling, and ensuring the patient understands their home medication
regimen.
A detailed medication list is provided to the patient and their caregivers, along with instructions
on follow-up appointments and any necessary monitoring.
Store 1 [Direct Cash Sale]
Introduction:

Pharmacy Store 1, which is a pivotal unit within the hospital's pharmacy department. This store is
renowned for its comprehensive range of services and stringent adherence to protocols, making it a
cornerstone of the hospital's medication management system. My experience there provided me with
invaluable insights into various aspects of pharmacy practice, from handling direct cash sales and
managing narcotic drugs to understanding inventory management and the importance of proper storage
conditions for di erent types of medications.

Services and Functions of Pharmacy Store 1:

1. Direct Cash Sales:

- Inpatient (IPD) Prescriptions: One of the primary functions of Pharmacy Store 1 is processing direct
cash sales for inpatient medications. When patients are admitted to the hospital, their treatment often
involves a variety of medications. The store is responsible for preparing and dispensing these medications
accurately and e ciently. This includes verifying prescriptions, ensuring the correct dosages are dispensed,
and providing necessary patient counseling.

- Outpatient (OPD) Prescriptions: Pharmacy Store 1 also caters to outpatients who need to purchase
medications directly. This service is crucial for patients who visit the hospital for consultations and require
immediate access to prescribed drugs. The store ensures that these patients receive their medications
promptly and provides detailed instructions on their use.

2. Narcotic Drugs Management:

Definition:

Narcotic drugs, also known as opioids, are a class of medications that are primarily used for pain relief but
can also be used for other medical conditions such as cough suppression and diarrhea. These drugs act on
 the central nervous system to produce pain relief, sedation, and, in some cases, euphoria. Due to their
potential for abuse and addiction, narcotic drugs are strictly regulated under various national and
international laws.

The process of handling narcotic drugs at Ruby Hall Hospital's Pharmacy Store 1 is a highly regulated and
meticulously documented operation. Through stringent protocols, secure storage, accurate
documentation, and continuous monitoring, the pharmacy ensures the safe and e ective management of
narcotic drugs. This comprehensive approach not only ensures compliance with legal requirements but
also safeguards patient safety and upholds the hospital’s commitment to high-quality healthcare. My
training in this environment has provided me with a deep understanding of the complexities involved in
handling controlled substances and the importance of maintaining rigorous standards in pharmaceutical
practice.

Pharmacy Store 1 has following Narcotic Drugs present and supplied according the need and authorized
prescription which is further maintained in order:

Narcotic Drugs:

Sr No: Content

1. Injection Fentanyl 2ml

2. Injection Fentanyl 10ml

3. Fentanyl Patch 4.2 MG/25MCG

4. Fentanyl Patch 8.4 MG/MCG

5. Tab Morphine 10 MG

Receiving Narcotic Drugs:

Verification: Upon receipt of narcotic drugs from suppliers, the pharmacy sta verifies the shipment
against the order details. This includes checking the quantities, batch numbers, and expiry dates of the
drugs.

Documentation: All received narcotic drugs are documented in the narcotic drugs register. This
includes recording the date of receipt, the quantities received, and any discrepancies noted during the
verification process.
 Figure: Narcotic Drug Issue Record

Storage:

Secure Storage: Narcotic drugs are stored in a designated, secure area within
Pharmacy Store 1. This area is equipped with high-security locks and is accessible only to authorized
personnel.
Temperature Control: If required, narcotic drugs are stored under specific temperature conditions as
indicated by the manufacturer. Regular monitoring ensures that these conditions are consistently
maintained.

Dispensing Narcotic Drugs:

Prescription Verification: When a prescription for a narcotic drug is received, it is thoroughly verified
by the pharmacist. This includes checking the patient’s details, the prescriber’s credentials, and the
appropriateness of the prescribed medication and dosage.
Documentation: Before dispensing, the prescription details are recorded in the narcotic drugs register,
including the patient’s name, the prescribing doctor, the quantity dispensed, and the date of
dispensing.

Separate Noting and Receipt System:

Logbook Entries: Each transaction involving narcotic drugs is meticulously documented in a dedicated
logbook. This includes entries for receiving, dispensing, and transferring narcotic drugs within the
hospital.

Receipt Issuance: For every supply of narcotic drugs, a receipt is issued. This receipt includes details
such as the quantity supplied, the recipient’s details, the date, and the purpose of the supply. Copies of
these receipts are maintained for record-keeping and audit purposes.

Administration and Monitoring:

 Administration Records: When narcotic drugs are administered to patients, detailed records are
maintained. This includes the patient’s name, the medication administered, the dosage, the time of
administration, and the name of the administering healthcare professional.
Adverse Event Monitoring: Any adverse reactions or incidents involving narcotic drugs are
documented and reported as per hospital protocols. This helps in monitoring patient safety and
improving medication practices.

- Exclusive Handling: As the only unit within Ruby Hall Hospital that manages narcotic drugs, Pharmacy
Store 1 operates under strict protocols to ensure the safe storage, handling, and dispensing of these
controlled substances. This responsibility requires meticulous attention to detail and adherence to
regulatory standards to prevent misuse and ensure patient safety.

- Documentation and Records: Before supplying narcotic drugs to other pharmacy stores or
departments, Pharmacy Store 1 maintains a dedicated logbook and receipt system. Each transaction is
meticulously documented, detailing the quantities supplied, the recipient, and the purpose. This ensures full
traceability and compliance with regulatory requirements.

3. Protocols for High Risk Medicines

- High-Risk Medications: The store follows rigorous protocols for handling high-risk medications. These
protocols include double-checking orders, using special labels, and ensuring secure storage to prevent
errors and misuse. High-risk medications are clearly identified and stored separately from other drugs.

Storage:

Segregated Storage: High-risk medications are stored separately from other drugs in clearly labeled,
secure areas. This segregation reduces the risk of mix-ups and ensures that these medications are
handled with the necessary precautions.
Controlled Access: Access to high-risk medication storage areas is restricted to authorized personnel
only. This includes locked cabinets or rooms with access controlled by key cards or combination locks.
Environmental Controls: Specific storage conditions, such as temperature and humidity, are
strictly maintained and monitored. For example, certain high-risk medications that require
refrigeration are stored in temperature-controlled refrigerators with continuous monitoring
systems.

3. Dispensing:

Barcode Scanning: To ensure accuracy, all high-risk medications are scanned using barcode technology
before dispensing. This system cross-checks the medication against the prescription and patient
records.
Labeling: High-risk medications are clearly labeled with prominent warnings and usage instructions.
The labels include information such as the patient’s name, medication name, dosage, route of
administration, and any special instructions.

4. Drug Arrangement and Inventory Management:

- Alphabetical Order: Medications, particularly tablets, are organized in alphabetical order. This
systematic arrangement facilitates easy retrieval and reduces the risk of dispensing errors. It also helps in
quick stocktaking and ensures that pharmacists can locate medications promptly.

- High-Risk Medications and Injections: These are stored separately in clearly labeled sections to ensure
they are handled with the necessary precautions. The segregation of high-risk drugs and injections
minimizes the chances of accidental misuse. High-risk medications are often kept in secure, locked
cabinets accessible only to authorized personnel.

5. Handling Cash Sales and Refunds:

- Transaction Processing: Pharmacy Store 1 handles direct cash sales with precision. This includes issuing
receipts, maintaining transaction records, and ensuring that cash handling procedures are followed
meticulously. The store uses advanced point-of-sale systems to streamline the process and ensure
accuracy.

- Refund Process: In cases where medications need to be returned, the store has a clear refund policy.
Medications eligible for refund are assessed, and the refund is processed in accordance with hospital
policies. This ensures patient satisfaction and financial accuracy, and also involves checking the condition
of returned medications to ensure they have not been tampered with or stored improperly.

Storage Conditions:

Proper storage conditions are crucial for maintaining the e cacy and safety of medications, especially
for injections and other temperature-sensitive drugs.

1. Injections and Temperature-Sensitive Medications:

- Refrigerated Storage: Many injections and biologics require refrigeration to maintain their stability and
e cacy. Pharmacy Store 1 is equipped with high-quality refrigerators that maintain a consistent
temperature range, typically between 2°C and 8°C (36°F and 46°F). These refrigerators are regularly
monitored and calibrated to ensure that the medications are stored under optimal conditions.

- Temperature Monitoring: The refrigerators are fitted with temperature monitoring systems that
provide real-time data and alerts if the temperature deviates from the set range. This ensures immediate
corrective action can be taken to prevent any compromise in the quality of the medications.

- Storage Protocols: Medications requiring refrigeration are stored in clearly labeled compartments, and
inventory is rotated regularly to ensure that older stock is used first
(First In, First Out - FIFO method). This minimizes the risk of using expired or compromised medications.

Quality Assurance and Safety:

 - Regular Audits and Protocols: Pharmacy Store 1 undergoes regular internal and external audits to
ensure compliance with regulatory standards and hospital policies. These audits help identify areas for
improvement and reinforce adherence to best practices.

- Continuous Monitoring: Ongoing monitoring of patients and feedback from healthcare providers help
identify and address any issues promptly, ensuring continuous improvement in the IPD prescription
process.

Integration of Technology:

- Electronic Health Records (EHR): The EHR system at Ruby Hall Hospital ensures seamless
communication and coordination among healthcare providers. It provides realtime access to patient data,
medication orders, and treatment plans.

- Pneumatic Shoot System: For emergency situations, the pneumatic shoot system ensures that critical
medications are delivered rapidly to the appropriate wards, enhancing the hospital’s responsiveness to
urgent patient needs.

Pharmacy Store 1 at Ruby Hall Hospital is a critical component of the hospital’s pharmacy services, known
for its comprehensive management of medications, including direct cash sales and narcotic drugs. The
store’s adherence to stringent protocols, systematic organization, and emphasis on safety and compliance
ensures that it provides high-quality, reliable pharmaceutical care to both inpatients and outpatients.
Through its dedicated team and robust procedures, Pharmacy Store 1 exemplifies excellence in hospital
pharmacy operations.

STORE 2 [Day & Night Store]

Introduction:

Pharmacy Store 2 at Ruby Hall Hospital is a vital unit within the hospital's pharmacy services, operating 24
hours a day to ensure the continuous availability of medications. This round-the-clock service supports
the hospital’s dynamic needs, providing direct cash sales, discharge medicines, and supplies for hospital
sta . The store is wellequipped with a diverse range of medications, including powders, ointments, and
injections like Rabivax, all maintained under optimal storage conditions.

Services and Functions:

1. 24-Hour Operation:
- Continuous Availability: Pharmacy Store 2 is open 24/7, ensuring that medications are available at all
times, including nights, weekends, and holidays. This service is crucial for emergencies and the continuous
care of inpatients and outpatients.

- Emergency Support: The store supports the hospital’s emergency services by providing immediate
access to essential and life-saving medications, ensuring that patient care is never compromised due to a
lack of availability.

2. Direct Cash Sales:

- Inpatient and Outpatient Services: Pharmacy Store 2 handles direct cash sales for both inpatients and
outpatients. Patients can purchase their prescribed medications directly from the store, ensuring they
receive the necessary treatments without delay.

- Transaction Management: The store uses advanced point-of-sale systems to manage transactions e
ciently, ensuring accuracy in billing and record-keeping. This system also helps in managing inventory by
automatically updating stock levels after each sale.

3. Discharge Medicines:

- Timely Provision: When patients are discharged from the hospital, Pharmacy Store 2 provides them
with the medications they need for their continued care at home. This includes verifying prescriptions,
preparing medications, and o ering patient counseling on the proper use of their medications.

- Coordination with Departments: The pharmacy coordinates closely with the hospital’s discharge
planning team to ensure that medications are ready for patients upon discharge, reducing wait times and
ensuring a smooth transition from hospital to home care.

4. Medicines for Hospital Sta :

- Sta Health Programs: The store supplies medications to hospital sta as part of the institution's health
programs. This includes routine prescriptions, vaccinations, and any required treatments, ensuring that
the sta remains healthy and can provide the best care to patients.

- Confidentiality and Convenience: Pharmacy Store 2 ensures confidentiality and convenience for
hospital sta by maintaining separate records and o ering flexible service hours that accommodate sta
shifts.

Range of Medications:
1. Powders and Ointments:

- Variety and Quality: The store stocks a wide range of pharmaceutical powders and ointments for
various medical conditions, including dermatological issues, wound care, and other topical treatments.

- Proper Storage: These medications are stored under appropriate conditions to maintain their e cacy.
Powders are kept in dry, cool environments, while ointments are stored at room temperature unless
otherwise specified by the manufacturer.

2. Injections:

- Rabivax and Other Vaccines: Pharmacy Store 2 includes important vaccines like
Rabivax (rabies vaccine), which are stored under stringent conditions to ensure their potency. These
injections are kept in temperature-controlled refrigerators, monitored regularly to maintain the required
2°C to 8°C range.

- Emergency Injections: The store also stocks a range of emergency injections and other injectable
medications, which are crucial for treating acute conditions and emergencies.
These are stored in designated areas to ensure quick access.

Storage Conditions:

1. Refrigeration:

- Temperature Control: Medications requiring refrigeration are stored in dedicated refrigerators that
maintain a constant temperature between 2°C and 8°C. These refrigerators are equipped with alarms to
alert sta if the temperature deviates from the set range.

- Monitoring: Continuous temperature monitoring systems ensure that any fluctuations are immediately
addressed. Sta members regularly check and record temperatures to comply with storage guidelines.

2. Ambient Storage:

- Room Temperature: Medications that need to be stored at room temperature are kept in well-
ventilated areas, away from direct sunlight and moisture. This includes most tablets, capsules, ointments,
and powders.

- Humidity Control: To prevent degradation, humidity levels in storage areas are carefully controlled,
especially for medications sensitive to moisture.

Patient-Centric Approach:
1. Tailored Medication Supply:

- Patient Needs: Pharmacy Store 2 stocks medications based on the specific needs of the patient
population served by Ruby Hall Hospital. This includes common prescriptions, specialized treatments, and
emergency medications.

- Inventory Management: The store employs advanced inventory management systems to ensure that
medications are always available when needed. Regular stock reviews and supplier coordination help
maintain optimal inventory levels.

2. Patient Counseling:

- Education and Guidance: Pharmacists at Pharmacy Store 2 provide detailed counseling to patients on
how to use their medications correctly. This includes instructions on dosage, potential side e ects, and the
importance of adherence to prescribed treatment regimens.

- Follow-Up Support: The store also o ers follow-up support to patients, addressing any questions or
concerns they may have about their medications after discharge.

Quality Assurance and Safety:

1. Regular Audits:

- Compliance: Pharmacy Store 2 undergoes regular internal and external audits to ensure compliance
with regulatory standards and hospital policies. These audits help identify areas for improvement and
reinforce adherence to best practices.

- Inventory Accuracy: Regular inventory checks and audits help maintain the accuracy of stock records,
preventing discrepancies and ensuring that medications are available when needed.

2. Training and Development:

- Sta Training: Continuous education and training programs for pharmacy sta ensure that they are up-to-
date with the latest pharmaceutical practices, safety protocols, and customer service skills.

- Competency Assessments: Periodic assessments of sta competencies help maintain high standards of
service and ensure that all procedures are followed correctly.

Surgical Items:

Wide Range of Supplies: Pharmacy Store 2 provides a comprehensive range of surgical items, including
surgical gloves, syringes, needles, bandages, sutures, and other essential supplies needed for various
medical procedures.
 Sterilization and Storage: Surgical items are stored in sterile conditions to prevent contamination.
Regular checks and adherence to sterilization protocols ensure that these items remain safe for use.

Store 3 [Indent Store]

Pharmacy Store 3 at Ruby Hall Hospital serves as the central indent store, integral to the hospital's
medication distribution system. This store is dedicated to managing medication indents, including a wide
range of injections, stock medicines, tablets, and surgical items. Equipped with advanced technology like
an indent machine and comprehensive scanning systems, Pharmacy Store 3 ensures accurate and e
cient handling of prescriptions and medication distribution. Indent Prescription

Definition:

An indent prescription is a formal, written order issued by a healthcare provider or a medical department
within a hospital, specifying the medications and medical supplies required for patient care. This type of
prescription is often used in larger healthcare facilities to streamline the process of requesting and
dispensing medications, particularly for inpatients. The indent system is designed to ensure that the right
medications are delivered to the right patients in a timely and e cient manner.

Services and Functions:

a. Indent Management:
Indent Machine: Pharmacy Store 3 utilizes an advanced indent machine that directly processes
prescriptions from various hospital departments. The machine facilitates the accurate selection
and preparation of medications based on electronic prescriptions.
Prescription Handling: Once the indent is received, the prescribed medications are removed from
storage, verified, and prepared for dispensing. This process involves meticulous attention to detail
to ensure that each prescription is accurately filled.
 Figure :Indent Machine

2.Medication Verification and Scanning:

Double-Check System: After medications are selected, they undergo a doublecheck system where
pharmacists verify the accuracy of the prescription against the patient’s electronic medical record
(EMR).
Computer Scanning: Each medication is scanned into the computer system, which updates the
patient’s history and ensures accurate billing. This step minimizes errors and ensures that the right
medication is charged to the correct patient.
 Documentation: The detailed documentation process includes recording each transaction in the
patient’s history and the hospital’s inventory management system, ensuring traceability and
accountability.

Figure: Computer Scanning of Indent Medicine’s

3.Storage and Organization:

Injections and Stock Medicines: The store maintains a comprehensive inventory of various injections
and stock medicines. These are stored under appropriate conditions, with injections requiring
refrigeration kept in temperature-controlled units.
 Tablets and Alphabetical Organization: Tablets are stored in alphabetical order to facilitate quick
retrieval. This systematic arrangement helps in e ciently managing large volumes of medications and
reduces the time taken to fulfill prescriptions. Surgical Items: Pharmacy Store 3 also stocks a
variety of surgical items necessary for patient care. These items are stored in sterile conditions to prevent
contamination and ensure their readiness for use.

4.Medication Distribution:

Ward Boys and Transfer: Once medications are verified and scanned, they are handed over to ward
boys who are responsible for transferring them to the patient’s bedside.
This ensures that medications reach patients promptly and securely.
Transfer Protocols: Ward boys follow strict protocols during the transfer process to maintain the
integrity and safety of medications. This includes using designated carts and ensuring that medications
are delivered to the correct wards and patients.

5.Storage Conditions:

a. Refrigeration:
Temperature Control: Medications requiring refrigeration, such as certain injections, are stored in
refrigerators that maintain a constant temperature between 2°C and 8°C. These units are
equipped with alarms and continuous monitoring systems to ensure compliance with storage
guidelines.
Regular Monitoring: Sta regularly check and record refrigerator temperatures to ensure that
medications are stored within the prescribed temperature range, preventing degradation and
ensuring e cacy.
 Figure: Storage Condition’s [ Temperature between 2°C and 8°C.]

Ambient Storage:

Room Temperature: Medications that do not require refrigeration are stored at room temperature
in well-ventilated areas. This includes most tablets, capsules, and some stock medicines.
 Humidity Control: Humidity levels in storage areas are carefully controlled to prevent
moisture-related degradation, ensuring the stability and e ectiveness of medications. Patient-Centric
Approach:

a. E cient Medication Delivery:

Timely Indent Fulfillment: The e cient handling of indents ensures that patients receive
their medications promptly. This is particularly important for critical and time-sensitive treatments,
where delays can adversely a ect patient outcomes. Coordination with Healthcare Teams:
Pharmacy Store 3 works closely with healthcare teams to prioritize and expedite the delivery of
urgent medications, enhancing the overall quality of patient care.

High-Risk Medications:

a. Handling and Storage:

Special Protocols: High-risk medications are handled and stored with special protocols to ensure
patient safety. This includes additional verification steps, secure storage areas, and stringent
documentation requirements.
Monitoring and Reporting: Patients receiving high-risk medications are closely monitored for
adverse reactions. Any incidents are promptly reported and investigated to prevent recurrence.

The handling of indent medicines at Ruby Hall Hospital is a meticulous and structured process, crucial for
ensuring that patients receive their prescribed medications accurately and promptly. This process is
particularly managed through Pharmacy Store 3, which specializes in indent prescriptions. The following
sections elaborate on each step involved in the handling of indent medicines, highlighting the protocols,
technologies, and best practices employed to maintain high standards of patient care.

Electronic Medical Records (EMR):

Healthcare providers enter medication orders into the hospital's EMR system. These orders are
detailed prescriptions tailored to each patient's specific needs.
The EMR system automatically generates an electronic indent prescription, which is transmitted to
Pharmacy Store 3. This automation minimizes manual errors and ensures clarity.
Medication Selection and Preparation:

Pharmacist Review:
A pharmacist reviews the indent prescription to ensure its accuracy and completeness. Any
discrepancies or unclear orders are promptly clarified with the prescribing doctor.
The pharmacist also checks for potential drug interactions or contraindications, ensuring patient
safety.

Selection Process:

Pharmacy sta use the consolidated list from the indent machine to locate and select the prescribed
medications from storage.
Each item is verified against the prescription to ensure the correct medication and dosage are selected.

Barcode Scanning:

Each medication is scanned using a barcode scanner, which records the medication in the hospital’s
pharmacy management system.
The scanning process updates the patient’s history, ensuring that the medication is accurately
documented and billed.

Surgical Items and Sutures:

 Pharmacy Store 3 also maintains a stock of surgical items and sutures, which are crucial for various
medical procedures. These items are stored in dedicated surgical racks.
Surgical items are organized based on type and size, ensuring quick and accurate retrieval. The
inventory includes a wide range of sutures, surgical instruments, and disposable items required for
surgeries and other medical procedures.

Store 4 [ Cental Store]

Introduction:

Ruby Hall Hospital’s Pharmacy Store 4, known as the Central Store, plays a pivotal role in the hospital’s
pharmaceutical supply chain. It acts as the central hub or godown, responsible for storing medicines in bulk
and ensuring that other pharmacy stores within the hospital are well-stocked. This store's operations include
the procurement, storage, and distribution of medicines to various hospital units, ensuring seamless supply
and availability of medications at all times. The following sections detail the processes and protocols followed
in Pharmacy Store 4, highlighting its critical role in the hospital’s overall pharmacy management.

1. Bulk Procurement and Storage:

- Procurement Process:

- Pharmacy Store 4 is responsible for procuring medicines in bulk quantities from various suppliers. This
includes negotiating with vendors, placing orders, and ensuring timely delivery of stock.

- The procurement team ensures that all medications are sourced from reputable suppliers, maintaining
high standards of quality and compliance with regulatory requirements.

- Storage Conditions:

- Bulk medicines are stored under stringent conditions to preserve their e cacy and safety. This includes
temperature-controlled environments for temperature-sensitive drugs and ambient storage for other
medications.

- Temperature-sensitive medicines, such as certain vaccines and biologics, are stored in specialized
refrigerators or cold storage units, with temperatures continuously monitored to ensure compliance.

- Stock Organization:

- Medicines are organized systematically within the central store. This includes categorizing them based
on their type, usage, and storage requirements.

- High-risk and controlled substances are stored in secure, locked areas with restricted access to
authorized personnel only.
2. Barcoding and Inventory Management:

- Barcoding System:

- A sophisticated barcoding system is employed to manage the inventory. Each item received in the
central store is tagged with a unique barcode, which is recorded in the hospital’s pharmacy management
system.

- The barcoding system facilitates accurate tracking of medications, ensuring that stock levels are
monitored in real-time and minimizing the risk of errors.

- Inventory Management:

- The central store maintains a comprehensive inventory management system that tracks stock levels,
expiration dates, and usage patterns. This system generates alerts for low stock levels and upcoming
expirations, enabling proactive management of the inventory.

- Regular inventory audits are conducted to ensure accuracy and compliance with hospital policies and
regulatory standards.

3. Distribution to Other Stores:

- Supply Chain Coordination:

- Pharmacy Store 4 coordinates with other pharmacy units within Ruby Hall Hospital to ensure a steady
supply of medications. This includes responding to requisitions from these units and dispatching the
required stock promptly.

- The central store acts as a bu er, ensuring that medications are always available when needed, even
during high-demand periods or supply chain disruptions.

- Order Fulfillment:

- When a requisition is received from another pharmacy store, the central store sta prepare the order by
selecting the required medications from the inventory.

- Each item is scanned using the barcode system, updating the inventory records and ensuring accurate
documentation of the transaction.

- Distribution Process:

- Medications are packed securely for transport, with temperature-sensitive items packed in insulated
containers to maintain their integrity during transit.

- The central store employs a reliable transport system to deliver medications to various units within the
hospital, ensuring timely and safe delivery.
4. Quality Assurance and Compliance:

- Quality Control Measures:

- The central store implements rigorous quality control measures to ensure the safety and e cacy of
stored medications. This includes regular inspection of stock for signs of damage or contamination.

- Medications are rotated based on their expiration dates.

- Regulatory Compliance:

- The central store adheres to all relevant regulatory standards and guidelines for pharmaceutical storage
and distribution. This includes compliance with Good Distribution Practices (GDP) and Good Storage
Practices (GSP).

- Sta are trained on regulatory requirements and best practices to ensure that all processes are conducted
in accordance with established standards.

5. Technology and Innovation:

- Advanced Systems:

- The central store leverages advanced technology to streamline its operations. This includes the use of
automated inventory management systems, barcoding technology, and electronic documentation.

- The integration of these systems enhances e ciency, reduces the risk of errors, and ensures accurate
tracking of stock levels and transactions.

- Continuous Improvement:

- The central store is committed to continuous improvement, regularly reviewing its processes and seeking
feedback from sta and other units. This helps identify areas for enhancement and implement innovative
solutions to improve e ciency and service quality.

- Ongoing training and development programs for sta ensure that they are up-to-date with the latest
advancements in pharmacy management and distribution practices.

6. Coordination with Other Units:

- Seamless Communication:

- E ective communication and coordination with other pharmacy stores and hospital units are essential for
the central store’s operations. This ensures that all units are aware of stock availability and can place
requisitions as needed.
 - Regular meetings and updates between the central store and other units help maintain a smooth flow of
information and address any supply chain issues promptly.

- Emergency Preparedness:

- The central store plays a crucial role in emergency preparedness, maintaining adequate stock levels of
essential medications and supplies to respond to unexpected situations.

- Contingency plans are in place to ensure that the hospital can continue to provide critical medications
and supplies during emergencies or supply chain disruptions.

Cancer drug store

Pharmacy Store 6: Cancer Drug Store at Ruby Hall Hospital

Introduction:

Ruby Hall Hospital's Pharmacy Store 6, located within the Cancer Building, is a specialized unit dedicated to the
storage and dispensing of cancer drugs, primarily used in chemotherapy. This store caters to the specific needs
of cancer patients by providing a range of oncological medications through both cash sales and indent
prescriptions. The importance of this dedicated cancer drug store lies in its ability to provide specialized
medications promptly and accurately, ensuring that patients undergoing chemotherapy receive their
treatments without delay. The following sections detail the processes and protocols followed in Pharmacy
Store 6, highlighting its critical role in cancer care at Ruby Hall Hospital.

1. Specialized Cancer Drugs:

- Chemotherapy Medications:

- Pharmacy Store 6 stocks a wide array of chemotherapy drugs, which are essential for treating various
types of cancer. These medications include, but are not limited to:

-Paclitaxel: Used in the treatment of breast cancer, ovarian cancer, and lung cancer.

- Cisplatin: E ective in treating bladder cancer, ovarian cancer, and testicular cancer.

- Targeted Therapy Drugs:

- The store also supplies targeted therapy drugs that specifically target cancer cells without a ecting
normal cells. Examples include:
 - Imatinib: Used for chronic myeloid leukemia (CML) and gastrointestinal stromal tumors (GISTs).

- Supportive Care Medications:

- In addition to chemotherapy drugs, the store provides medications for managing side e ects and
supporting patients during their treatment. These include antiemetics for nausea, growth factors for
boosting blood cell counts, and pain management drugs.

2. Cash Sales and Indent Medicines:

- Cash Sales:

- Pharmacy Store 6 has a dedicated counter for cash sales, where patients or their caregivers can
purchase prescribed cancer medications directly. This system ensures that patients can access their
medications without delay, facilitating timely treatment.

- The store follows a streamlined process for cash transactions, including billing, payment collection, and
issuing receipts.

- Indent Medicines:

- For inpatient treatments and specific outpatient cases, the store manages indent prescriptions. These
are generated by oncologists and entered into the hospital’s electronic medical record (EMR) system.

- Indent prescriptions are processed similarly to those in other pharmacy stores, with the added focus on
the unique handling requirements of cancer medications.
 Figure: Indent Medicine’s

3. Scanning and Tracking of Drugs:

- Barcode Scanning:

- Each medication in Pharmacy Store 6 is barcoded upon receipt. This barcode system ensures precise
tracking of drug inventory and minimizes errors in dispensing.

- When a medication is dispensed, it is scanned using a barcode scanner, updating the inventory in real-
time and recording the transaction in the patient’s medical record.

- Inventory Management:

- The barcode system also aids in inventory management, allowing sta to monitor stock levels, expiration
dates, and reorder points e ectively.
 - Regular audits are conducted to verify inventory accuracy and ensure that the store is well-stocked with
essential medications.

4. Importance of Pharmacy Store 6:

- Timely Access to Critical Medications:

- The specialized focus of Pharmacy Store 6 ensures that cancer patients have timely access to the critical
medications they need for their treatment. Delays in chemotherapy can significantly impact treatment
outcomes, making the prompt availability of these drugs essential.

- Specialized Handling and Storage:

- Cancer drugs often require special handling and storage conditions. Pharmacy Store 6 is equipped with
the necessary facilities, such as temperature-controlled storage units, to preserve the e cacy and
safety of these medications.

- Sta are trained in the specific protocols for handling chemotherapy drugs, including safe handling
practices to protect both the sta and the patients.

- Patient Support:

- The store provides support to patients through counseling and education on their medications.
Pharmacists explain the correct usage, potential side e ects, and management strategies to help patients
adhere to their treatment plans.

- Supportive care medications are also made available to help manage the side e ects of chemotherapy,
improving the overall patient experience.

6. Process of Handling Cancer Drugs:

- Receiving and Storage:

- Cancer drugs are received from suppliers and stored under optimal conditions.
Temperature-sensitive drugs are placed in refrigerators that maintain a constant temperature, while other
medications are stored in designated areas with appropriate ventilation.

- Dispensing:

- Upon receiving a prescription, either through cash sale or indent, the pharmacist retrieves the required
medication. Each drug is scanned to ensure accurate dispensing and updated in the inventory system.
 - Medications are double-checked for accuracy before being handed over to the patient or delivered to
the relevant department.

- Documentation:

- Detailed records are maintained for each transaction, including the patient’s details, the medication
dispensed, dosage instructions, and any special handling requirements.

- This documentation is crucial for tracking patient treatment histories and ensuring compliance with
regulatory standards.

Conclusion:

Pharmacy Store 6 at Ruby Hall Hospital is a specialized facility dedicated to the storage and dispensing of
cancer drugs. Its operations are critical in providing timely and accurate access to chemotherapy and
other oncological medications. The store’s emphasis on specialized handling, precise tracking, and patient
support ensures that cancer patients receive the highest standard of pharmaceutical care.

Cardiac OT Pharmacy at Ruby Hall Hospital

Introduction:

Working in the Cardiac OT (Operating Theatre) Pharmacy at Ruby Hall Hospital involves a unique set of
responsibilities and protocols that are essential to support cardiac surgeries and related procedures. This
specialized pharmacy unit is dedicated to ensuring the availability and proper handling of critical medications
used during cardiac surgeries. The following sections provide a detailed description of the processes,
protocols, and medications involved in the Cardiac OT Pharmacy, highlighting its crucial role in cardiac care at
Ruby Hall Hospital.

1. Prescription Indenting Process:

- Window for Prescription Indenting:

- The Cardiac OT Pharmacy features a dedicated window where prescriptions are indented. Surgeons,
anesthesiologists, or their assistants submit the prescription requests for the medications needed during
surgeries.
 - The prescriptions are typically entered into the hospital’s electronic medical record (EMR) system,
ensuring accurate and traceable documentation.

- Medication Preparation:

- Once a prescription is received, the pharmacy sta promptly retrieves the required medications. Each
medication is carefully checked against the prescription to ensure accuracy.

- Medications are then prepared for immediate use in the OT, with special attention to dosage and
administration instructions.

2. Medications Used in Cardiac OT:

- Anesthesia Drugs:

- Anesthesia drugs are crucial in cardiac surgeries to ensure that patients remain unconscious and pain-
free. Commonly used anesthesia drugs include:

- Propofol: Used for induction and maintenance of anesthesia.

- Fentanyl: A potent opioid used for pain management during surgery.

- Secretion Control Medications:

- These medications help control bodily secretions during surgery, which is essential for maintaining a
clear surgical field. Examples include:

- Atropine: Used to reduce saliva production and other secretions.

- Other Essential Medications:

- Various other medications are used during cardiac surgeries to manage di erent aspects of the
procedure, such as:

- Heparin: An anticoagulant used to prevent blood clotting during surgery.

3. Proper Care and Handling Protocols:

- Strict Adherence to Protocols:

 - Handling medications in the Cardiac OT Pharmacy requires strict adherence to established protocols to
ensure patient safety and the e cacy of the drugs.

- Sta members are trained in sterile techniques and proper handling procedures to prevent contamination
and ensure the integrity of the medications.

- Double-Checking Medications:

- Before any medication is supplied to the OT, it undergoes a double-check process where two
pharmacists verify the prescription details, the medication selected, and the dosage.

- This reduces the risk of errors and ensures that the correct medications are administered to patients.

- Temperature Control and Storage:

- Certain medications, especially anesthesia drugs, require specific storage conditions. These drugs are
kept in temperature-controlled environments to maintain their potency.

- Regular monitoring of storage conditions ensures compliance with safety standards.

4. Supplying Medications to Doctors:

- Immediate Supply to OT:

- Medications prepared in the Cardiac OT Pharmacy are delivered directly to the operating room. This
ensures that the surgical team has immediate access to the required drugs during the procedure.

- In urgent situations, additional medications can be requested directly from the pharmacy window and
supplied without delay.

- Patient-Specific Documentation:

- Each medication supplied is documented in the patient’s medical record, including details such as the
drug name, dosage, and administration time.

- This documentation is crucial for maintaining an accurate record of the patient’s treatment and for
future reference.

5. Handling Refunded and Extra Medications:

- Refund Process:
- Medications that are not required by the patient are carefully accounted for and returned to the
pharmacy. These medications are inspected for any signs of tampering or contamination before being
restocked.

- A refund receipt is issued, and the returned medications are recorded in the inventory system to ensure
accurate tracking.

- Additional Medication Requests:

- During surgery, if additional medications are needed, the surgical team can request them from the
pharmacy window. These requests are handled promptly to avoid any delay in the procedure.

- The additional medications supplied are added to the patient’s list in the EMR system, ensuring that all
administered drugs are accurately documented.

6. Importance of the Cardiac OT Pharmacy:

- Ensuring Surgical Success:

- The Cardiac OT Pharmacy plays a critical role in ensuring the success of cardiac surgeries by providing
timely and accurate access to essential medications.

- The availability of specialized drugs and the adherence to strict handling protocols contribute to the
overall safety and e ectiveness of the surgical procedures.

- Supporting the Surgical Team:

- By e ciently managing medication requests and maintaining a well-organized inventory, the

pharmacy supports the surgical team’s ability to focus on the patient’s care without concerns about
medication availability.

- The pharmacy’s role in managing anesthesia and other critical drugs directly impacts the quality of care
provided to cardiac patients.

Surgical Items in Cardiac OT Pharmacy:

Suture Materials:
A variety of suture materials are available to cater to di erent surgical needs.
These include absorbable and non-absorbable sutures in various sizes and lengths.

Surgical Blades:
 The pharmacy stocks a range of surgical blades necessary for di erent types of incisions. These blades
are sterilized and packed to ensure safety and e cacy. Examples include Scalpel Blades in sizes 10,
11, 15, and others based on the surgical requirement.

Surgical Drapes and Consumables:

Sterile surgical drapes are provided to create a sterile field during operations. These drapes are critical
in preventing infections and maintaining a clean surgical environment.
Other consumables include gauze sponges, sterile gloves, and surgical gowns.

Suture Removal Kits

IV Cannulas

Anesthesia Circuits

Breathing Masks

Wound Closure Strips

Sterile adhesive strips for wound closure.

List of surgical items commonly used in cardiac operations:

1. Scalpel - for making precise incisions.

2. Surgical Scissors - for cutting tissues and sutures.

3. Hemostats - for clamping blood vessels to stop bleeding.

4.Forceps- for grasping and holding tissues.

5. Retractors - for holding back tissues and organs to provide access to the surgical area.

6. Suction Tubes - for removing fluids from the surgical site.

7. Suture Needles and Threads- for stitching tissues together.8. Surgical Drapes and Gowns - for

maintaining a sterile field.

9. Surgical Sponges- for absorbing blood and fluids.

10. Electrocautery Device - for cutting tissue and sealing blood vessels.

11. Cardiopulmonary Bypass Machine - for temporarily taking over the function of the heart and lungs
during surgery.

12. Cannulas - for diverting blood during cardiopulmonary bypass.

13. Heart Stabilizer - for keeping the heart still during surgery.

14. Perfusion Tubing- for managing blood flow during surgery.

15. Pacemaker- for regulating heart rhythm post-surgery.

16.Defibrillator - for restoring normal heart rhythm if needed.

17.Anesthesia Machine- for administering anesthesia to the patient.

18. Coronary Artery Bypass Grafts (CABG) - for bypassing blocked coronary arteries.

19.ECG Electrodes - for monitoring the heart's electrical activity.

20.Three-Lumen Catheter - for intravenous access and administration of medications.

21.Syringes and Needles - for administering medications and drawing blood.

22.IV Drip Sets - for administering fluids.

23.Face Masks - for protecting against infection.

24.Gauze Pads - for absorbing blood and fluids.

25.Adhesive Tapes - for securing dressings and tubes.

26.Surgical Caps and Shoe Covers - for maintaining a sterile environment.

27.Disinfectant Solutions - for sterilizing the surgical area.

28. Alcohol Swabs - for disinfecting the skin.

29. Arm Boards - for supporting the patient's arms during surgery.

30. IV Fluids - for hydration and medication administration.

Robotic Ot Pharmacy

It involved the meticulous management of a wide array of materials and medicines essential for various
surgical procedures.It encompassed the handling and distribution of supplies for endoscopy, urology, and
other specialized surgeries, as well as the critical task of ensuring the proper storage and administration
 of high-risk medicines. This report provides a comprehensive overview of my experiences and the
systematic processes employed in the management of the Robotic OT Pharmacy.

Materials Used in the OT

Endoscopy

1. Endoscopes: Flexible and rigid scopes for visualizing internal organs.

2. Endoscopic Instruments: Forceps, scissors, and graspers for performing procedures.

3.Suction and Irrigation Tubes: For fluid management during procedures. Urology

1. Catheters: Foley, intermittent, and suprapubic catheters.

2. Guidewires: For navigating urinary tract obstructions.
3. Stents: Ureteral stents for maintaining urine flow.

Staplers and Sutures

1. Surgical Staplers: For closing incisions and anastomoses.

2. Absorbable Sutures: For internal tissue repair that dissolves over time.
3. Ophthalmic Sutures: Fine, delicate sutures used in eye surgeries.

Ophthalmic Sutures
Ophthalmic sutures are specialized for eye surgeries, requiring precision and minimal tissue reaction.

Medicines in the OT
Anesthesia Medicines

1. Propofol: For induction and maintenance of anesthesia.

2. Sevoflurane: Inhalational anesthetic for maintaining anesthesia.
3. Lidocaine: Local anesthetic for numbing specific areas.
4. Fentanyl: Opioid analgesic for pain management

Diuretics

1. Furosemide: For managing fluid retention and blood pressure.

2. Mannitol: For reducing intracranial pressure and treating cerebral edema.

Process of Window Medicines

When doctors request medicines during surgery, the process involves:

1. Receiving Requests: Doctors or nurses submit a request for specific medicines.

2. Verifying Orders: Ensuring the accuracy and appropriateness of the request.
 3. Preparing Medicines: Accurately measuring and preparing the required dosage.
4. Delivering to OT: Promptly delivering the medicines to the operating room.

Indented Medicines
Indented medicines are those specially requested for specific surgeries or patients. The process includes:

1. Receiving Indent Requests: Collecting specific medicine requests from the OT.
2. Checking Stock: Verifying availability in the pharmacy.
3. Removing from Inventory: Accurately removing the required quantity.
4. Supplying to OT: Ensuring timely delivery to the operating room.

Storage of High-Risk Medicines

High-risk medicines, such as certain anesthetics and controlled substances, require special storage conditions:

1. Refrigeration: Maintaining appropriate temperatures to ensure e cacy and safety.

2. Secure Storage: Keeping these medicines in locked and monitored refrigerators to prevent unauthorized
access.

Managing Drugs in the Robotic OT Pharmacy

Managing drugs in the Robotic OT Pharmacy involves a meticulous and systematic approach to ensure that all
medications are properly handled and available when needed:

1. Inventory Management: Regularly monitoring stock levels and ensuring that there is a su cient supply of
all essential medicines.
2. Expiry Date Checks: Routinely checking the expiration dates of medicines to ensure that expired drugs are
promptly removed from stock.
3. Order Processing: Placing orders for medicines based on usage trends and upcoming surgical schedules.
4. Documentation: Keeping detailed records of all medicines received, stored, and dispensed, ensuring
traceability and accountability.
5. Regulatory Compliance: Adhering to all hospital policies and regulatory guidelines for the storage and
handling of medicines.

Process of Administering Medicines

Administering medicines in the OT follows a strict protocol to ensure patient safety and e ective
treatment:

1. Prescription Review: Reviewing the doctor's prescription to ensure the correct medication and dosage.
2. Preparation: Preparing the medication, including measuring doses and ensuring the correct form (e.g.,
injectable, oral).
 3. Labeling: Clearly labeling prepared medicines with the patient's name, medication name, dosage, and
administration time.
4. Double-Check: Verifying the medication and dosage with another healthcare professional to prevent
errors.
5. Administration: Administering the medicine to the patient as per the prescribed route (e.g., intravenous,
oral).
6. Monitoring: Observing the patient for any adverse reactions or side e ects postadministration.
7. Documentation: Recording the administration details in the patient's medical records.

Conclusion
Working in the Robotic OT Pharmacy at Ruby Hall Hospital has provided me with extensive knowledge and
hands-on experience in handling a wide range of materials and medicines essential for successful surgical
operations. This role has enhanced my understanding of the critical processes involved in managing and
supplying medical resources in a high-stakes environment.

Result and Conclusion

Result:

The experience at Ruby Hall Pharmacy stores has provided me with a comprehensive understanding of
pharmacy operations and the critical role of technology in enhancing these processes. The integration of
advanced technologies such as electronic recording, barcode system scanning, and computerized receipt
generation has significantly improved the accuracy, e ciency, and transparency of pharmacy operations.
Additionally, the detailed handling of OPD and IPD prescriptions has highlighted the importance of meticulous
documentation and patient-centered care in pharmacy practice.

Improved Accuracy

The implementation of electronic recording and barcode systems has drastically reduced the risk of errors in
prescription processing and medication dispensing. This technological advancement ensures that prescriptions
are accurately transcribed and medications are correctly identified and dispensed. As a result, patient safety
has been significantly enhanced, leading to better therapeutic outcomes and increased trust in the pharmacy
services.

Enhanced E ciency

Advanced technologies have streamlined various pharmacy processes, reducing the time required for tasks
such as documentation, receipt generation, and inventory management. Electronic recording systems allow for
quick and accurate data entry, while barcode systems facilitate faster medication retrieval and dispensing. This
increased e ciency has allowed pharmacy sta to allocate more time to patient care and counseling, thereby
improving the overall quality of service provided.

Better Inventory Management

The implementation of barcode systems and computerized inventory tracking has enabled real-time
monitoring of stock levels, ensuring that medications are always available when needed. This system
minimizes the risk of stockouts and reduces wastage due to expired medications. Accurate inventory
management also ensures that the pharmacy can respond promptly to indent requests and maintain a steady
supply of essential medications.

Patient Satisfaction

E ective patient medicine handling, coupled with comprehensive counseling services, has improved patient
understanding and adherence to their medication regimens. By providing clear instructions and addressing
patient concerns, pharmacy sta have fostered better health outcomes and higher patient satisfaction. Patients
feel more confident in their treatment plans and are more likely to follow their prescribed therapies correctly.

Regulatory Compliance

Accurate recording and documentation have ensured compliance with regulatory requirements, facilitating
smooth audits and inspections. This compliance is crucial for maintaining the credibility and reliability of the
pharmacy services at Ruby Hall Hospital. The detailed records also serve as a valuable resource for monitoring
and improving pharmacy practices.

Seamless Communication

E cient communication management has enabled smooth coordination between di erent departments
and stakeholders, ensuring timely and accurate delivery of pharmacy services. E ective internal communication
ensures that all team members are well-informed and can collaborate e ciently. External communication
with suppliers and regulatory bodies ensures the timely procurement of medications and adherence to legal
standards.

Conclusion

In conclusion, my tenure at Ruby Hall Pharmacy stores has been immensely rewarding, providing me with
valuable insights into the complexities and challenges of pharmacy operations. The integration of advanced
technologies has played a pivotal role in enhancing the accuracy, e ciency, and transparency of these
operations, ultimately leading to better patient care and satisfaction. The detailed handling of OPD and IPD
prescriptions has underscored the importance of meticulous documentation and patient-centered care in
pharmacy practice.

The knowledge and skills I have gained from this experience will undoubtedly be invaluable in my future
career. The ability to leverage technology to streamline pharmacy operations, coupled with a strong focus on
patient safety and satisfaction, will be essential in ensuring the delivery of high-quality pharmacy services.
Moreover, the importance of e ective communication and collaboration in a healthcare setting cannot be
overstated, as it is crucial for the seamless functioning of pharmacy services.

Overall, my experience at Ruby Hall Pharmacy stores has equipped me with a solid foundation in pharmacy
practice, enabling me to contribute e ectively to the healthcare sector and make a positive impact on patient
outcomes. The practical application of advanced technologies, combined with a commitment to patient-
centered care, will guide my future endeavors in the field of pharmacy. I am confident that the skills and
knowledge I have acquired will allow me to excel in various pharmacy settings and contribute to the
advancement of pharmacy practices. This experience has not only enhanced my professional competencies
but has also instilled in me a deeper appreciation for the critical role that pharmacies play in healthcare
delivery.