When pharmacy services are not available 24 hours, then various strategies are being followed. PTC or equivalent committee existing at hospital makes policies and procedures. It allows and specifies the personnel having approach to pharmacy, list of drugs etc.
The following strategies are being used worldwide:
Use of Nursing supervisors:
It’s the most widely used strategy which allows the nursing supervisor to enter the pharmacy but their services are limited. Though this practice is very dangerous and illegal but a correlation exists between the nurse while making a selection of medicines from drug cabinet (at ward) and selection of the same item from pharmacy. Nurses serving in this category should be limited/restricted to dispensing, from selection of pre-labeled and pre-packed items and especially from compounding a mixture etc.
Emergency boxes and night drug cabinets:
They are installed to provide medications during off-hrs and should be large enough, ready for use, installed at easy accessible place known to all ward personnel and sufficient compact for facilitating handling items.
Use of physician:
In such case, a physician is allowed to enter the pharmacy and may obtain (any) special medication which is not provided through the floor stock, emergency boxes and night drug cabinets. The danger here, is less as compared to the first case, however a physician might waste sufficient time in searching for the desired product.
Pharmacist on-call basis:
In this case, pharmacist services could be available on on-call basis. Pharmacist can be reached whenever needed, however this type of service should be encouraged by extra pay plans or bonus. A rotational plan of on-call will reduce burden on a single individual.
Such service could be available if a contract is signed with a local community pharmacy for off-hrs and vacations. This is a safe method and is also legal and aims to safeguards health needs on round-the-clock basis. However, only the retail pharmacy with sufficient staff, inventory and delivery services should be contracted.
Automated dispensing devices/machines:
This is an innovative facility to dispense drugs during off-hrs.
A modern way is tele-pharmacy which provides all type of pharmacy services, even clinical services when pharmacist is not available at floor. In such case pharmacist or organization providing the service is contacted via online, internet, or videoconferencing.
Abid Ali @abidaliphm
Doctor of Pharmacy