DISPENSING TO
OUT-PATIENTS OR
AMBULATORY PATIENTS
HOSPITAL PHARMACY 610-T
SHUMAILA
RECALL OF THE PREVIOUS:
• Outpatient is also known as ambulatory patient.
• A patient who is not hospitalized overnight but who visits a hospital, clinic, or
associated facility for diagnosis or treatment.
• These patients are divided into three categories: emergency, tertiary and primary
care.
• Emergency patient means an individual who is acutely ill, injured, or otherwise
helpless and who requires emergency care.
• A patient in tertiary care need highly specialized medical care usually over an
extended period of time that involves advanced and complex procedures and
treatments performed by medical specialists.
• Primary care describes a range of services adequate for meeting the great majority of
daily personal health needs.
LEARNING OBJECTIVES:
• Growth of ambulatory care clinics.
• Provision of pharmaceutical services in ambulatory care.
• Minimum standards for ambulatory care pharmaceutical
services.
• Location of out-patient dispensing area.
• Layout of out-patient dispensing area.
GROWTH OF AMBULATORY CARE CLINICS:
• Supplements its in-patient teaching program.
• Demand by the community.
• The new philosophy of hospitals.
• To exercise greater control over patients receiving
investigational drugs.
• The lack of sufficient numbers of a physician in some areas.
• The emergency service of a hospital is always available.
PROVISION OF PHARMACEUTICAL SERVICES
IN AMBULATORY CARE:
• Patient medication histories.
• Safety and efficacy of drug therapy.
• Providing drug information.
• Assisting prescribers.
• Utilizing assessment skills.
• Detecting and reporting adverse drug reactions.
• Educating and counselling patients.
Continued…
• Participating in drug utilization reviews.
• Education to health care providers.
• Supervising the preparation, storage, dispensing and administration of
medications in the patient care area.
• Developing and utilizing systems.
MINIMUM STANDARDS FOR AMBULATORY
CARE PHARMACEUTICAL SERVICES:
• By a qualified pharmacist.
• Appropriateness of the choice of drug, its dosage, route of
administration and amount must be verified by a pharmacist.
• Maintenance of medication profiles for patients.
• All medications dispensed to patients will be completely and correctly
labelled and packaged.
• Proper controlled.
LOCATION OF OUT-PATIENT DISPENSING
AREA:
• There is no set rule as to the best area to locate an out-patient
dispensing pharmacy. This is evidenced by the fact that in today’s
practice three equally suitable provisions are made for this area.
a) A separate out-patient pharmacy is available.
b) A combined in-patient and out-patient unit with services provided
from the same “window”.
c) A combined in-patient and out-patient unit with services provided
from the separate “windows”.
Continued…
• It is always preferable to have a separate out-patient pharmacy.
• If it’s not possible then units may combined and services provided
either with the same window or separate.
• There is no general rule regarding location of out-patient pharmacy but
it should be so located that minimum disturbance is caused to the in-
patients and routine working of the hospital and it’s pharmacy.
LAYOUT:
• It is important because the out-patient can carry good or a bad
impression about the hospital depending on the services they get.
• Unit must have prescription receiving window and delivery window.
• Waiting area should be elegant, clean, ventilated and provided with
comfortable seats.
• Publications related to medicine and pharmacy as well as newspaper
and magazines can be provided to make the whole department
attractive.
SUMMARY:
• The basic need and growth of ambulatory care clinics.
• Provision of pharmaceutical services in ambulatory care.
• Minimum standards for ambulatory care pharmaceutical services.
• It is always preferable to have a separate out-patient pharmacy.
• If it’s not possible then units may combined and services provided
either with the same window or separate.
• Layout of out-patient dispensing area.
REFERENCES:
• Nadeem Bukhari for hospital pharmacy.
• William.E.Hassan for hospital pharmacy.
