Drug Storage Management Overview

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Medicines and medical supplies consume are the major portion of the hospital expenses. So that if the drug management is not managed in an effective and efficient manner especially on storage process will affect on the hospital entirely. The purpose of this research was to know the drug storage management overview in the pharmacy warehouse of Sentosa WCH

- Method

This research was using qualitative description with a draft as observational research. The respondents at this research were the head of pharmaceutical installation, the head of pharmaceutical installation storage room, staff of pharmaceutical installation storage room, and the head of maintenance unit. Data were collected by depth interviews and observation on drug storage including their recording and storing system. Data analysis was made in a way of qualitative description, and triangulation technique was done to guarantee data validity.

- Results and Discussion

- Factors of drug storage management system in the hospital pharmacy installation warehouse.

Drug storage system in the hospital pharmacy installation warehouse was using combination of FIFO system and FEFO system. FIFO (First in First Out) system is to describe a way of dealing with perishable drugs, or with a specified expiry date. The drugs with the deadline for the next intake will be the first to be served or removed from stock. Put newly received drugs at the back of existing stock. FEFO (First Expired First Out) system is to place drugs that will expire first in front. The principal to be followed is FEFO system first then FIFO system. Always put drugs that will expire in front even though the drugs received later on. (WHO,2012)

The storage system was classified based on different kinds and types of forms, such as:

- Dosage form: Medicines come in different forms, such as tablets, syrups, injections, and external use products such as ointments and creams.

- Raw Material

- Nutrition

- Medical Equipment

- Medical Gas

- Easily flammable

- Hazardous drugs

- Reagent

- X-ray Films

Drug arrangement in the hospital pharmacy installation warehouse at Sentosa WCH was using Alphabetical order by generic name from A-Z, but they had not used arrangement of therapeutic or pharmacologic category. Drug storage in the warehouse begin with receiving supplies and all the supporting documents, organizing supplies, checking supplies, input data to the computer, then keeping supplies in storage room. The suitability between drug storage management in hospital pharmacy installation warehouse at Sentosa WCH as follow:

Table 1. The suitability between drug storage management in hospital pharmacy installation warehouse at Sentosa WCH with Standards for quality of pharmacy services (based on observation)

Standard

Implementation in Pharmacy Warehouse

Yes

No

FIFO system

✓

FEFO system

✓

Classified based on different kinds and types of forms

✓

Classified based on alphabetical order

✓

Classified based on therapeutic or pharmacologic category

✓

Drug storage management in pharmacy warehouse of Sentosa WCH did not suitable with the standard, because in drug storage management used FIFO and FEFO system, classification based on different kinds and types of forms, and classification based on alphabetical order by generic names, but they had not used classification based on arrangement of therapeutic or pharmacologic category. The drug products shall be classified according to pharmacologic-therapeutic use.

Barriers related with drug storage in pharmacy warehouse among others were classification of drugs that had not been based on therapeutic or pharmacologic category yet, because patterns of drug prescriptions by doctors were still changing. This can cause the drug stay longer in the warehouse. Higher the stay of item in the warehouse, the slower would be the movement of the drugs; eventually the drugs would be expired. It can be overcome by:

- Hospital form a Clinical Leader, an association consists of doctors, led by the professional specialists to formulate a standard drug / formulary for a disease that is a trend today, then recommend to Pharmacy and Therapeutics Committee (P&T Committee).

- P&T Committee responsible for establishing and implementing medication-related policies and procedures as well as those committees responsible for the provision of patient care, including the P&T, infection prevention and control, patient care, medication-use evaluation, medication safety, nutrition, and pain management committees (or their equivalents), as well as the institutional review board, quality-improvement, and information technology committees (or their equivalents)

- P&T committee responsible for developing and maintaining written criteria for drug product selection, which shall address formulary requests for medications intended for use in special populations (e.g., pediatric or geriatric populations).

A doctor should have enough basic knowledge about the science of pharmacology is about pharmacodynamics, pharmacokinetics and physical properties of medicinal chemistry of a given drug may prescribe appropriately and rationally. Therefore, physicians play an important role in the process of health services, especially in carrying out treatment through delivery of drugs to patients. (Aditama,2003)

Hospital Pharmacy Installation (HPI) has various functions, which

can be classified into the function of non-clinical and clinical functions. Scope of clinical functions include the functions that performed in the hospital program, specifically: monitoring drug therapy; evaluation of the use of drugs; handling of hazardous drugs; services