Pharmacy Premises and Equipment Guidelines

Pharmacy Premises

• Food/drinks can only be consumed/stored in a designated pantry area, away from drug preparation areas.
• Food/drinks cannot be stored in the refrigerators.
• Dispensing/retail counters are cleaned twice daily using liquid detergent and water.
• Floors are cleaned daily.
• Dispensing areas and medication storage shelves are cleaned at least weekly in pharmacy and monthly in the store.
• Pest control is carried out by a contracted pest control vendor at least monthly.
• The pharmacy is a restricted area, generally only accessible by pharmacy staff. Delivery personnel must be accompanied by staff.
• Counsellng rooms are available to give patients privacy.
• Pharmacy staff are authorized to hold the keys (limited to four sets).

Pharmacy Equipment

• A consolidated equipment list is maintained by the nurse manager. This list tracks locations, specifications, and maintenance/inspection dates/schedules.
• The pharmaceutical fridge, domestic fridge, electric water pot, hot air oven, and electronic weighing balance for weighing children require maintenance.
• Pharmaceutical fridge: 6-monthly preventive maintenance checks.
• Other equipment: Regular functional checks and annual electrical safety checks. Annual calibration and equipment safety checks by vendors.

Procurement of Drugs

• Optimal stock holding level for pharmacy stocks: 0.5 month for clinic pharmacy, 1 month for SHP overall.
• Stock levels are monitored based on consumption patterns, and drug usage patterns, providing continuity of stock supply to patients.
• Procurement is undertaken promptly to ensure availability.
• Patient profiles are considered in drug procurement to ensure supply meets the clinic's needs.
• Drug samples are not kept by SHP. (Refer to specific questions for how needed items are procured).

Vaccine Cold Chain

• "Break in Vaccine Cold Chain" definition: Fridge: min or max temperature readings outside the 2°C-8°C range, or freezer < -20°C range.
• Actions for cold chain break: Record temp readings, check fridge doors, power, quarantine & label affected vaccines "Do not use! Break in Cold Chain", inform Head of Supplies & Logistics, and complete report.
• Min-max thermometer reset: After each routine temp recording (twice daily), or in case of excursion immediately.

Pre-packing of Medications

• Pre-packing medications improves efficiency and reduces patient wait times.
• Medications from the same batch are packed together.
• Loose quantities from the packing are handled separately.
• Pre-packing area is cleaned before/after each use using a hot air oven for items needing haste.
• Each ziploc pack has correct quantity printed or indicated by senior staff verification.

Dispensing

• Two patient identifiers are used to verify the patient's identity.
• The 5 Rights are followed (Right Patient, Right Drug, Right Dose, Right Time, Right Route).
• Patient identity is checked using 2 identifiers, addressing any potential issues such as no appointment cards and lack of recollection of NRIC numbers (using a list of four other identifiers in order from most important to least important).
• Manual handwritten prescriptions from polyclinic doctors are accepted during system downtime.
• Patient understanding is ensured through verbal/ written instructions, and interpreters, as well as written medication instructions (with pictograms), are provided. Visual aids such as medication counselling are used as well.
• Patient understanding of administered medications are checked through patient/caregiver re-explanations and demonstrations of the instructions.

Hazardous Material/Waste Management

• Sharps (lancets, insulin needles) are discarded into a sharps container and not overfilled.
• Chemical spills are handled promptly, with consultations to relevant manuals. Mercury spills are no longer an issue.
• Chemical safety information is displayed (MSDS) and maintained for easy access.

Pharmacy Staff Qualifications & Education

• Pharmacy staff qualifications include a recognized pharmacy degree and registration with SPC, or MOH certificate / PSS Certificate / Diploma.
• Competency assessments are conducted for pharmacists and pharmacy technicians every two years, and for other staff annually.
• If performance doesn't meet expectations, a further competency assessment will be carried out.
• Training and orientation on work procedures, safety, and operational details are provided regularly.

Pharmacy Automation

• Electronic systems are used for dispensing and maintenance of inventory.
• Near misses/ errors are logged to prevent future issues.

Quality Improvement & Patient Safety

• Records of prescription interventions and dispensing errors are kept.
• Clinical quality indicators are tracked and monitored through staff meetings, emails, circulars, memos, notices, telephone communications, plus the SHP intranet.
• Patient fall risks are managed to prevent hospitalisation.
• Patient safety issues are reported at management, pharmacy and clinic levels by various means.

Others

• Information on policies and relevant legislation is readily available.
• Abusable medications are monitored in terms of quantities and durations of supply, and the staff involved in dispensing are trained.
• A consistent approach to drug dispensing is maintained.
• Patient confidentiality is preserved in terms of privacy during dispensing, and storage of patient records.
• Community outreach is regularly conducted.
• Standard handling procedures for various medication types are in place.
• The pharmacy has a system to deal with patient complaints.

Test your knowledge on the essential guidelines for pharmacy premises and equipment management. This quiz covers critical topics such as cleanliness, restricted access, equipment maintenance, and pest control measures. Ensure you are familiar with the best practices for maintaining a safe pharmacy environment.