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AN OVERVIEW OF STANDARD OPERATING PROCEDURES (SOPs )DefinitionsA standard Operating procedure is a document which describes the regularlyrecurring operations relevant to the quality of service being rendered. Thepurpose of an SOP is to carry out the operations correctly and always in the samemanner. It should be available at the place where the work is done. An SOP is acompulsory instruction. All changes in the instructions must be documented andreported to the authorities who are the only ones to authenticate and approvesuch variations.OBJECTIVES OF DEVELOPMENT OF SOPsStandard Operating Procedures (SOPs) for pharmaceutical Care Delivery in allhealth facilities in Nigeria will be expected to: Enhance the quality of the services provided by the Pharmacist.Promote uniformity in the services providedEliminate operational errors in pharmaceutical care delivery services.Elevate the status of pharmacists and enhance their motivation for betterperformance.SOPs occupy the center stage in most organizations worldwide and the practice ofpharmacy cannot be an exception.Areas covered by this SOPs include:1.2.3.4.5.6.SOP for Drug ListsSOP for Procurement of MedicinesSOP for Receiving Drugs into PharmacySOP for Drug StorageSOP for Vaccine StorageSOP for Temperature Control1

7. SOP forIssue and Delivery of Drugs to Dispensary/SatellitePharmacies/Wards /Other Units8. SOP for Dispensing /UDDS9. SOP for Patients Counseling10. SOP for Counseling of Handicapped Patients11. SOP for Compounding of Medicines12. SOP for Procurement, Dispensing and Distribution of Narcotic Drugs andPoisons.13. SOP for Disposal of Expired Drugs14. SOP for Clinical Ward Round15. SOP for Training of Intern Pharmacists16. SOP for Continuing Education17. SOP for Drug Revolving Fund (DRF) Scheme18. SOP for Drug Information Service (DIS)/Drug Information Center (DIC).19. SOP for Dress Code20. SOP for Therapeutic Drug Monitoring(TDM)21. SOP for Screening Prescriptions22. SOP for Preparing a Drug Formulary.1. SOP FOR DRUG LISTSI. Prepare an advocacy plan for the SOPII. Write a proposal to management for setting up of drug and therapeuticcommittee in line with requirements prescribed by the National DrugPolicy.III. Identify different categories of drugs required by the health facility basedon the national essential drug list (EDL) / National Standard TreatmentGuideline (NSTGs).IV. Draw up list using generic and international non-proprietary name (INN) ofthe drug.V. Obtain approval for the management of the facilityVI. Circulate approved list to stake holders within the facility.VII. Ensure strict compliance to the use of the ELD.2

V.XVI.XVII.XVIII.XIX.SOP FOR PROCUREMENT MEDICINES/ CONSUMABLESPrepare an advocacy plan for the sopConfirm the availability of fundsMatch needs with available fundsIdentify and verify the suppliersQualify suppliersChoose method of procurementPrepare an order formContact suppliers to quote the returns and complete the formState the date of submission of the tender documentOrganize public bid openings and record proceedingsConduct evaluationsSubmit recommendations to tender committee for approval of awardsForward copies of award document to the store and finance departmentsFacilitate the signing of contract agreementsMonitor suppliers performance and sanction defaultersReceive and store drugsFacilitate prompt payment to suppliersCommence preparation for next procurement cycleProvide the names and strength of each drug in the following order:Name (generic), strength and form, e.g.Paracetamol 500mg tabletsParacetamol 125mg/5ml oral liquidAmpicillin 500mg injectionGlucose 5% injectionXX.XXI.XXII.XXIII.Provide the package size required e.g. 10’s, 500’s, sachet, vial.Provide a column for the quantity required e.g each, 10, 200, 1000, 5000Provide a column for the for name of manufacturerProvide a column for the NAFDAC number of the product3

XXIV.XXV.XXVI.Provide a column for the expiry date of drugProvide a column for the price of each item and a column for the total priceProvide a space for the name of the company, giving relevant details suchas address, telephone number, e-mail address, name of the contact person.EXAMPLE OF ORDER FORM DRUGSNoName and Pkgstrength of sizedrugQty.Nameof NAFDACrequired manufacture pany: . .Address: .Telephone .No.:E-mail: .Name of contact person: . Telephone No.: .Dateofsubmissionof .document:Signature: .date:4

3. SOP FOR RECEIVING DRUG ITEMS INTO A PHARMACY BULK V.XV.XVI.XVII.XVIII.XIX.Prepare an advocacy plan for the SOPidentify and prepare store spaceensure the presence of the stock verifier and auditor before receivingitemsverify award documentsmatch the documents with that from the supplierconduct physical check of every item supplied in the line with thespecificationreceive itemsnote the number of items suppliedverify NAFDAC certificate of analyses for each of the productssuppliedif the quality of the item is suspicious, remove and quarantinesubmit samples for quality assurance testRelease and accept into the store if quality assurance standards aremetSign all necessary supply documentsDocument all items receivedPrepare appropriate documents and forward for prompt paymentArrange all items appropriately according to the storage system inuseItems requiring cold storage should be put in cold store or in therefrigerator immediately.Ensure the store is locked and the key is returned to the appropriateplace for safe keepingThe store should be insured incase of fire out break or theft5

4. SOP FOR DRUG XIV.XV.XVI.XVII.XVIII.Prepare an advocacy plan for the sopEnsure the pharmaceutical store is centrally locatedEnsure the pharmaceutical store meets PCN guidelinesEnsure the a tile floor finishing and that pallets and shelves areprovidedEnsure that the store in the storage area are made of concretereinforcement and/or tiled/terrazzo finishing.Ensure the that the pharmaceutical store is solely used for storage ofpharmaceuticalsEnsure the that pellets and shelves, steel ladder, steel cabinets andother relevant furniture’s and fittings are providedEnsure that the pharmaceutical store has a good and functionalcooling system at all times in line with the recommended storageconditions. Thermometer should be in place and record temperaturein chart regularlyEnsure the pharmaceutical store has a good lightening systemThat at least two standby generating systems are providedEnsure regular servicing of cooing systemsEnsure the store is adequately secure through the use of burglaryproofEnsure the photosensitive drugs are protected from light by provisionof blinds or paintings of windows using dark colors.Ensure that availability of standard stores’ stationary such as bincards, ledgers, store receipt vouchers, stores issue voucher, dailyissue books, antibiotic record book, poison disposal book, etc.Ensure the record received stock into bin or tally card using red pen.Ensure the record issue stock into bi or tally card using blue penIssue stock using FIFO/FEFO system (first in first out/ first expiredfirst out)Enter the stock into appropriate ledgers6

XIX.XX.XXI.XXII.Update store records regularlyEnsure the fire extinguishers are installedStorage of items should be in dosage forms and arranged accordingto their pharmaceutical uses or in alphabetical orderShelves labeling should code for ease of ensuring into acomputerized system5. SOP FOR STORAGE OF VACCINESI.II.III.IV.V.VI.VII.VIII.Prepare advocacy plan for SOPEnsure direct control for vaccines’ stores by pharmacistsEnsure that the vaccine store complies with all conditions enlistedunder general drug storageEnsure strict adherence with unbroken chain systemEnsure proper documentation of receipt and issuesConduct regular quality assurance/revalidation by pharmacist inchargeEnsure that expired vaccines are completely separated from theusable vaccinesInitiate prompt action for destruction of expired vaccines.6. SOP FOR TEMPERATURE CONTROLI.II.III.Prepare advocacy plan for SOPEnsure availability of temperature controlMonitor and record temperatures at regular intervals taking note of thefollowing:Standard temperatures (temperature chart)Room temperature 15-300C7

iv.v.Cool placebelow 150CCold placebelow 80CRefrigerator2-80CFreezer-20 0CReport any deviations to management stating the implicationsDocument actions taken7. SOP FOR ISSUING AND DELIVERING OF DRUGS TO DISPENSARY/SATELITEPHARMACIIES/WARDS AND OTHER UNITSI.II.III.IV.V.Prepare advocacy plan for sopReceive read and validate the requisition (taking note of source , date,signature of requisition)Confirm availability of drugs in the store by reviewing the balances of itemsin the bin cardsApprove and issue accordinglyEnsure complete documentation of all transactions and delivery ifnecessary.8.I.II.III.IV.V.SOP FOR DISPENSINGPrepare advocacy planReceive read and validate the prescriptionIntroduce yourself to the patient by saying “I am a pharmacistIdentify the prescribers intention for the patientConfirm the ownership of the prescription in order to avoid dispensing toproxyVI. Find out if the medicine and/or other required items are available in thepharmacyVII. Cost the medicines prescribedVIII. Inform patient of the cost implication of their medication (conduct with thephysician for reviews if the need arises).8

IX.X.XI.XII.XIII.XIV.XV.XVI.XVII.XVIII.Direct the patient to make necessary payments and to present theappropriate receipt confirming payment of medicines/items dispensed.Select the correct medicines /items in the pharmacy and read the label onthe container (and/or package) before, during and after dispensing.Write the label on each medicine, giving precise direction for use.Put the medicine in the dispensing vial and place the label on the vialCheck the dispensed medicine and confirm that the medicine is what wasprescribedHand the dispensed medicine to the patient or care giver/patient’s relation.Counsel the patient giving details on how the medicine should be usedGive the patient a chance to ask questions and give the patient appropriateanswers.Say “thank you” to the patient before he leaves. This is to be done with asmile.Keep all patient medication record.Telephone number: .Name of patient: . . to be taken every hourbefore /with or after mealsName, strength and form of drug Quantity dispensed: .Expiry date: .Name of prescriber: .Signature and name of Pharm.: 9

9. SOP FOR UNIT DOSE DISPENSING SYSTEM IV.XV.Prepare advocacy plan for the SOPDesign the produce the patients medication profile (PMP) (seeprototype on pg. 22).Receive , read and validate prescriptionFind out the prescriber’s intention for the patientFind out whether the medicines (and / or other required items areavailable in the pharmacy)Open the patient medication profile.Cost the medicinesInform patient of the cost implication of their medication (conductwith the physician for reviews if the need arises).Direct the patient to make necessary payments and to present theappropriate receipt confirming payment of medicines/itemsdispensed.Select the correct medicines /items in the pharmacy and read thelabel on the container (and/or package) before, during and afterdispensing.Prepare the appropriate label which could contain the name, strengthand quantity of the medicine being dispensed. All necessary directionsshould comply with legal requirements (where applicable).Include the expiry date for any product with limited shelf-life (whereapplicable).Select the appropriate container and closure for dispensing medicines(where applicable). Plastic, amber dispensing vials for tablets andcapsules are preferred.Affix the written instructions (labels) on the container.Ensure that all dispensed are put in patients respective cassettes andarranged in a trolley10

XVI.XVII.XVIII.XIX.XX.Deliver the trolley to the ward and give any necessary information tothe nurses.Initiate therapeutic drug monitoring (TDM) where necessary.Document patients’ medication complaint(s) and discuss with theprescriber.Reference must be made to the doctor’s prescription for everyadministration.Pharmacist must be present at the ward to monitor the unit dosedispensing system (UDDS), improve in-patient dispensing and makethe necessary therapeutic interventions.Note: the technical aspects of dispensing (such as counting tablets,pouring liquid and labeling containers) can properly be conducted bytrained support staff under the supervision of a pharmacist. There isno alternative to the direct involvement of the pharmacist in theassessment of prescriptions and ensure that all necessaryinformation is given to the patient or care-giver (i.e. patients’relative) to achieve maximum therapeutic benefits.10.SOP FOR PATIENT COUNSELLINGPatient counseling should be carried out in a room or space dedicated forsuch purpose. Such a room should be adequately equipped.I.II.III.IV.V.Prepare advocacy plan for the SOPWelcome the patient with a warm smileEnsure the patient is comfortably seated before facing youIntroduce yourself to the patient by saying’ I am apharmacist . I am here to talk to u about your medication’’.Receive the prescription from the patient or the patients’ relative(care giver)11

.XIX.XX.XXI.XXII.XXIII.Ensure the pat