Modern hospitals function as complex healthcare ecosystems where safe and effective medication use depends heavily on structured decision-making, accurate information flow, and professional collaboration. Pharmacists play a central role in this system by contributing to policy development, patient counseling, drug information services, and interdisciplinary communication. Unit 3 focuses on the operational and clinical responsibilities that define hospital pharmacy practice today.
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Pharmacy and Therapeutic Committee: Backbone of Rational Drug Use
Organization and Structure
The Pharmacy and Therapeutic Committee (PTC) is a multidisciplinary body comprising physicians, pharmacists, nurses, and hospital administrators. It functions as the principal policy-making authority for medication management within a hospital. The committee ensures that drug use is evidence-based, safe, cost-effective, and aligned with institutional goals.
Functions and Policies
One of the primary responsibilities of the PTC is selection of drugs for inclusion in the hospital formulary. Decisions are based on efficacy, safety, pharmacoeconomics, and availability. The committee also formulates policies governing inpatient and outpatient prescriptions, ensuring standardized prescribing practices.
Automatic stop orders are implemented to prevent unnecessary prolonged therapy, especially with antibiotics and controlled drugs. The PTC is also responsible for preparing and periodically updating the emergency drug list, ensuring immediate availability of life-saving medications across critical care units.
Drug Information Services: Supporting Clinical Decision-Making
Drug and Poison Information Center
A Drug and Poison Information Center (DPIC) acts as a reliable resource for healthcare professionals seeking unbiased, up-to-date information on drugs and toxic substances. These centers handle queries related to dosage, adverse effects, drug interactions, contraindications, and poisoning management.
Sources and Computerized Services
Drug information is derived from primary sources such as research articles, secondary sources like indexing databases, and tertiary sources including textbooks and formularies. With the rise of digital healthcare, computerized drug information systems enable rapid storage, retrieval, and dissemination of information, enhancing clinical efficiency and accuracy.
Patient Counseling: A Pillar of Clinical Pharmacy Practice
Definition and Importance
Patient counseling is a structured interaction between the pharmacist and the patient aimed at improving understanding of medications and enhancing therapeutic outcomes. It bridges the gap between prescription and proper medication use.
Steps in Patient Counseling
Effective counseling involves assessing patient knowledge, explaining drug purpose, dosage, administration method, duration of therapy, possible side effects, and storage conditions. The pharmacist also checks patient understanding and encourages questions to clarify doubts.
Special Counseling Situations
Special attention is required when counseling pediatric, geriatric, pregnant patients, and those with chronic diseases or polypharmacy. In such cases, the pharmacist’s role becomes critical in preventing medication errors and improving adherence.
Education and Training Programs in Hospitals
Role of the Pharmacist
Hospital pharmacists actively participate in education and training programs for healthcare professionals, including doctors, nurses, interns, and pharmacy students. These programs enhance medication safety awareness and promote evidence-based practice.
Internal and External Training
Internal training includes in-service education and continuing professional development, while external programs involve workshops, seminars, and conferences. Pharmacists also extend educational services to nursing homes and clinics, supporting uniform standards of care.
Ethics and Community Health Education
Pharmacists adhere to a professional code of ethics, emphasizing patient welfare, confidentiality, and integrity. They also contribute to community health education by promoting rational drug use, vaccination awareness, and disease prevention strategies.
Prescribed Medication Orders and Communication Skills
Medication Order Interpretation
A prescribed medication order must be interpreted carefully to ensure legal and therapeutic correctness. It should include patient details, drug name, dosage, route, frequency, duration, and prescriber’s signature. Pharmacists verify orders for errors, interactions, or contraindications before dispensing.
Legal Requirements
Compliance with legal standards protects both patients and healthcare professionals. Proper documentation and adherence to regulations prevent medication errors and medico-legal issues.
Communication with Prescribers and Patients
Effective communication is essential for resolving prescription ambiguities, suggesting therapeutic alternatives, and ensuring patient understanding. Pharmacists must communicate clearly, respectfully, and confidently with prescribers while maintaining empathy and clarity when interacting with patients.