Eye Hospital : Documented procedures address procurement and usage of implantable prostheses.

 

Documented procedures guide the organisation of pharmacy services and usage of medication.

a)     ...........................Hospital has following SOP for purchase, storage, prescription and dispensation of medication. All the relevant staff members are made aware of this and form a part of training topic.

b)     Hospital’s pharmacy store has stock adequate amount of all medicines as listed in hospital’s formulary.

c)      The stock is maintained in computer in Pharmacy Software.

 

SOP for Purchase, Storage, Prescription and Dispensation of medications.
Sr. No.	Process Flow	Responsibility
1	The list of medication is prepared.	Pharmacist
2	The list of suppliers is prepared.	Pharmacist
3	Medical director decides the items that need to be purchased and order is placed on the suitable suppliers.	Medical    Director
4	After the receipt of material, the same is verified for batch number, expiry date, breakage of item etc.	Pharmacist
5	In case the medications need to be stored in cold storage, the maintenance of cold chain (temperature) is verified.	Pharmacist
6	After the inspection, the same is stored as per labeled instructions.	Pharmacist
7	The temperature of Refrigerator is monitored.	Pharmacist.
8	MCI/UMC Registered doctors are authorised to prescribe medication.	Treating Doctor
9	Prescription includes the type of preparation, the name of the drug, dose, and route of administration, frequency and duration.	Treating Doctor
10	All the medication orders are written clearly, legibly and are dated, timed, stamped and signed.	Treating Doctor
11	A list of high risk medication used in hospital is maintained.	Pharmacist
12	After the medication is dispensed, the same is recorded in the patient file.	OT Tech Nurse Asst.

 

d)     Whenever there is a demand for any medication that is not listed in the formulary, the medication is provided on cash purchase from a retail outlet, by the Pharmacy or by approval of the drug & therapeutic committee.

e)      For purchase of drug existing in the pharmacy but reached safety stock, purchase order is raised by the pharmacist and stock is maintained.

f)      The hospital ensures that the medication purchased, stored, prescribed and dispensed is in line with applicable laws such as UMC and FDA.

g)     LASA drugs are stored separately and to the extent possible the hospital avoids to purchase of LASA drugs. List of LASA is as follows:

 

-      Look alike Medication

 

VIGAMOX                                  VOZOLE

VIGAMOX                                  KITMOX

KETOMAR                                 ZYMAR

KITMOX                                    KITMOX D

ZYFLACE                                  ZYLOPRED

 

-      Sound alike Medication

 

LUBREX                                   LUBRIFRESH

IOTIM                                       IOTIM PLUS

IOTIM                                       IOTIM B

OSMEGA                                  OSMEGASITE

ATROPINE                                ATRODEX-C

 

h)     Following SOP to handle LASA drugs is available in the hospital.

 

 

SOP for LASA drugs
Sr. No.	Process Flow	Responsibility
1	To the extent possible, LASA drugs are not prescribed. In the event it is unavoidable, the same are written in CAPITAL and stored separately.	Pharmacist Nurse Asst. OT Tech.
2	At the time of dispensation, a buddy system is used that means one staff announces the name and the other staff verifies the complete details and then dispenses the medicine.	Nurse Asst. OT Tech.
3	After dispensing the medications, the same is recorded in patient’s file.	Nurse Asst. OT Tech.

 

i)      All the medicines stored in the hospital are marked and each location a person is made responsible to ensure that the expired medicines are sorted out and disposed as per SOP detailed below. As a policy all the employees of the hospital are instructed to check the drug for expiry before dispensing.

SOP for Destruction of Expired Medicines
Sr. No.	Process Flow	Responsibility
1	Medicines which are expired can be of the following formations: a.    Eye Drops b.    Tablet c.    Ointment d.    Injectable e.    Liquids	Pharmacist Nurse Asst. OT Tech.
2	The tablets are crushed and emptied in yellow bag.	Pharmacist Nurse Asst. OT Tech.
3	Liquid, Ointment and Injectable are emptied in 2% sodium hypo-chloride solutions and disposed in yellow bag.	Pharmacist Nurse Asst. OT Tech.
4	All the containers whether that have filled liquid and injectable are crushed and disposed in black bag.	Pharmacist Nurse Asst. OT Tech.

j)       Intraocular Lens like EYE Intraocular Lens is procured as per the patient need.

k)     The selection of Intraocular Lens is based on scientific criteria and internationally recognized approvals.

l)       The batch and serial number of the Intraocular Lens used on the patient is recorded in the patient's medical record. The pouch and the stickers are preserved and it is sent to the finance dept while one sticker is put on the patient file.

m)    The usage of such Intraocular Lens is picked up after every 15 days or 1 month and the same is communicated to the vendor for obtaining the bill and simultaneously purchase order is raised.

n)     Following SOP is used for procurement and usage of implantable prosthesis

SOP for Purchase of Implantable Prosthesis  ( intra ocular lens)
Sr. No.	Process Flow	Responsibility
1	A list of implants that are used is maintained	Pharmacist Nurse Asst. OT Tech.
2	A list of suppliers for the above is maintained.	Pharmacist Nurse Asst. OT Tech.
3	The prosthesis is purchased against specific requirements of patients.	Administrator.
4	The patients are informed about the advantages and disadvantages of various options.	Ophthalmologist
5	Sr. No. of implants used is recorded in the OT register and patient record.	Nurse Asst. OT Tech.
6	All standard precautionary measures in terms of sterilization are adhered to.	Nurse Asst. OT Tech.