- Medications are stored in the pharmacy to the manufacturer’s recommendation or as per government recommendations. All medications are stored in designated areas which are sufficient to ensure proper sanitation, temperature, light, ventilation, moisture control, segregation, and security.
- Proper consideration is also given to the safety of employees as well as patients.
- Drugs are stored in licensed premises or in designated areas of the hospital for patient care purpose.
- Medicines are stored alphabetically in the Pharmacy and according to FIFO method.
- All drugs storage container/racks are clearly & legibly labeled
- All drugs are stored above the floor level.
- Inventory levels are monitored and directed by the departmental head
- Drug storage area has a 24 hours uninterrupted power supply.
- Drugs requiring cold chain are stored in refrigerator within temperature range of 2 to 8 degree C and the rest of the drugs are stored at room temperature between 20 and 25 degree C.
- A list of drugs to be stored in the refrigerator (between 2 to 8ºC) is displayed outside the refrigerator.
- Monitoring of temperature of all refrigerators and recording is done twice a day. The Log is signed by the observing staff.
- Both the compartment temperatures are monitored independently using a digital display. (Thermo hygrometer)
- Drug storage refrigerators will be inspected daily by the nurse/pharmacy staff.
If temperature varies outside the normal range the Engineering Department will be notified to fix the refrigerator
- The non functioning refrigerator will be clearly marked as NOT IN WORKING CONDITION and are not to be used.
- Any major fluctuations / deviations are immediately self-rectified by adjusting the temperature OR is reported to the BME to respond. In such case, all drugs will be removed & stored in other refrigerator
- If any drug or item requires freezing temperature, such items are stored in the freezer and the list is displayed.
- The medicines are arranged alphabetically on the racks except for Chemotherapy and Cytotoxic drugs, these drugs are stored separately under the direct supervision of Chief Pharmacist.
- Open drug containers are stored separately with clean & clear label.
- Medications are protected from loss or theft.
- External Products disinfectants and drugs for external use are stored separately from internal and injectable medications.
- Storage policy & guidelines are followed at sub-store/ nursing stations also.
Storage Of Emergency Medication
- A list of emergency medication is prepared and made available in the Pharmacy and in the Wards.
- Emergency medicines are stored in the Crash Cart in the wards and they are checked for availability on a daily basis.
- Crash cart medicines are secured from theft and lifting by the visitors
- Emergency medications are available all the time
- Emergency medications are replenished in a timely manner when used.
- Emergency Medications are made available in all the Emergency Trolleys throughout the hospital. Based on the previous years of use of emergency medicines, reorder level is identified and followed. This mechanism ensures that emergency medications are available all the time. Whenever Stock Checking activity carried out, it is informed well in advance to all the Nursing Stations. However in case of any emergency, medicines are dispensed without causing any inconvenience.
- Emergency medicines are checked for inventory level on a daily basis and replenished on a timely basis. A checklist with quantity is made available for re-order level. The trolleys are sealed to avoid unnecessary usage. Ward In Charges along with Central Purchase Department ensures the emergency medications are replenished in a timely manner after use. This is examined by the concerned supervisor. During audits a check on availability of emergency medication is checked in the above area.
Storage Of Narcotic Drugs
- Narcotics & Controlled Drugs are stored under double lock and has limited access.
- These drugs are stored separately under the direct supervision of Chief pharmacist
Storage Of Cytotoxic and Hazardous Drugs
- To prevent accidental contamination resulting in exposure of personnel to cytotoxic and hazardous drugs are stored in segregated areas which are clearly labeled, with access limited to authorized personnel.
- All stocks of cytotoxic drugs will be kept in a secure area.
Storage Of Light Sensitive Medications (Photo Sensitive)
- Medications that are considered light-sensitive, as labeled by their respective manufacturers, will be stored and dispensed in a manner as to protect them from light.
- The list of medications that will be protected from light is to be maintained in the Pharmacy
- If a medication comes in a non-light protected package (i.e., clear ampoules, syringe, and unit-dose package) or removed from the original manufacturer’s container, the product will be stored in an amber bag.
- If the medication is commercially available in a light-resistant package, the medication may be stored on the shelf as is.
Storage Of Expired Drugs
- Drugs shall not be kept in stock after the expiration date on the label and no contaminated or deteriorated drugs shall be available for use.
- The pharmacy/nurse routinely checks drug storage areas for outdated or otherwise unusable drugs.
- Medicines removed from the stock 3 months prior to the expiry.
- Expired drugs found in the hospital are sent to the pharmacy for proper disposition.
- Drug stocks in HIS have a system for flagging the list of medications that are expired and nearing 3 months expiry. Report can be generated for the same.
- The mechanism for destruction and disposal will be as per laid down norms and regulations.
- In case of non-supervision, all drugs shall be stored under Lock & Key.
Storage Of Look Alike and Sound Alike Medicines
- Look Alike & Sound Alike and High Risk Medications are stored in clearly identified separate racks and stored apart for other medicines and apart from each other. The same principle is followed if this category of medicine is to be stored under refrigeration i.e. separate racks/ box for LASA.
- A list is prepared of LASA drugs essentially including all the drugs with Look Alike – Sound Alike risk from the Hospital Pharmacy Formulary.
- Display the LASA list next to areas where look or sound-alike products are stored
- Store products with look or sound-alike names in different locations in pharmacies, patient care units, and in other settings, including patient homes. (Example: instead of storing by generic name (e.g. vincristine and vinblastine) store drugs by brand name (e.g. Oncovin and Velban) while medication arrangement.
Pharmacy and related stores are well lit and ventilated. The area is kept clean. The recommendations of the manufacturer with respect to storing condition are strictly maintained and monitored. This also applies to the medications stored in wards. Pharmacy has access control. Only the staff who are concerned with the functioning of the pharmacy are allowed to enter the pharmacy. Medicines are always dispensed against prescription, which is again entered in the HIS under patient’s name. Stock checking is also carried out regularly to check the differences. Regular audits are conducted to identify the gaps to take corrective and preventive actions.
Pharmacy carries out inventory checks once a month. And ensures that there is no gap between the stock as per Soft Copy and the physical stock. All the areas of storage follow First in First Out inventory control mechanism. In addition, ABC Analysis is conducted once in a year to maintain a strict vigilance on important items and VED is conducted to make revisions in the formulary.