Pharmacy Policy: Ambulatory Prescription Dispensing

What is the ambulatory prescription dispensing?

Ambulatory prescription dispensing is part of the pharmacy policy and procedures.

As usual, with most of the policies sample posted here, there is some default data that should be listed in the policy header and footer. Below are some of the info that you need to include in your ambulatory prescription dispensing policy header:

• Hospital name, obviously.
• Pharmacy department operational policy and procedure, this header just to notify the reader that the following policy belongs to which department.
• Policy code or Number, for filing/indexing purposes.
• Edition Number, same purpose as above.
• The title of the policy, in our case; would be ambulatory prescription dispensing.
• Important dates [date reviewed, approved date, effective date, and due for review date].
• Applies to [department] in this case, it should be pharmacy department
• And last but not least, you’ll mention the nature of the policy, whether it’s going to be multidisciplinary or department-specific. (Multidisciplinary policy)

Read moreHow to Write Pharmacy Mission and Vision Policy

Ambulatory prescription dispensing policy

Definitions

• Outpatient prescription is an authorized physician medication order, to supply medications related to the patient diagnosis for specific duration of treatment.

Types of Outpatient prescriptions used in a hospital are:

1. Control Drug Prescription (Pink).
2. Regular Manual Prescription.
3. Insurance Manual Prescription.
4. E-Prescription.

• Dispensing is the process of supplying the medications to patients according to an authorized outpatient Prescription received from an authorized licensed physician. All dispensed medications should be labeled in (Arabic or English) and dispensed by a licensed Pharmacist.

Purpose

1. To setup standards and procedures where by medications are dispensed efficiently and accurately with greatest consideration towards patient care.
2. To define the responsibilities of pharmacists while handling the outpatient prescriptions.

Policy

1. Pharmacist shall dispense standard and completed prescriptions authorized by licensed physician.
2. Updated sample signature list should be available in the pharmacy as a reference to all pharmacy staff.
3. Only formulary drugs should be prescribed by the physicians and dispensed by the pharmacists for patients. In case of prescribing non-formulary drug the physician shall complete the Non-Formulary drug request form along with the prescription.
4. Physicians are not allowed to prescribe medications for themselves or members of their families.
5. Discharged patient prescriptions will be dispensed from the Inpatient Pharmacy/Outpatient Pharmacy.
6. All medications will appear in the E-Prescription form in their Generic names (bolded) and brand names. Outpatient pharmacist are privileged to give Drug Substitution without counseling the prescriber unless the prescriber specifies dispense as written.
7. The E-Prescription form shall contain the following information’s:

• Date of prescription.
• Patient’s name, Age and medical record number.
• Name of drug and dosage form.
• Strength or concentration of the drug.
• Frequency, quantity and Duration of treatment.
• Medication Dose.
• Directions for use.
• Prescriber’s stamp.
• Prescriber’s signature.
• Diagnosis.
• Encounter number.
• Gender.
• Allergies.
• Weight.
• Pregnancy.
• Lactation.

8. All patient information are readily accessible to all Pharmacist and all health care professionals including but not limited to:

• Patient age & Sex.
• Current medication (Medication reconciliation).
• Diagnosis, Co-morbidities.
• Laboratory values.
• Allergies.
• Body weight and height.
• Pregnancy & Lactation status.

9. Pharmacist shall call the treating physician in case of any discrepancy noticed in the prescription and to record the necessary corrections in the prescription and complete the Pharmacy intervention report.
10. Medications will be dispensed and labeled in the proper containers; the label shall bear the following information’s:

• Patient name in Arabic or English.
• Medical records number.
• Prescription number.
• Directions for use in Arabic or English, including dose and frequency.
• Drug name, strength, dosage form and quantity.
• Date of dispensing.
• Physician’s name.
• Specialty.
• Expiry date.
• Batch number.
• Appropriate auxiliary and cautionary labels.

11. Medications should not be picked up by children under the age of Twelve (12) years unless accompanied by adult.
12. All outpatient prescriptions will be handled as confidential documents.
13. Physician can use manual prescription in case of system failure.

Procedures and responsibilities

1. Licensed pharmacist shall review/verify the Outpatient Prescriptions for the following:

• Patient Identification (Patient full name & M.R. number) and other related patient information’s.
• Appropriateness of the Prescribed Medications to the diagnosis.
• Patient allergies and ask the patient for the allergy card given by the physician if any allergy was identified.
• Drug-Drug interactions.
• Therapeutic Duplication.
• Patient medication history.
• Appropriateness of drug dose.
• Any restrictions related to the prescribed medication(s) or/and specialty.

2. Licensed pharmacist shall call the treating physician in case of any discrepancy noticed in the prescription and to record the necessary corrections in the prescription and complete the Pharmacy intervention report.
3. Licensed pharmacist or Pharmacy Technician shall prepare the prescribed medications and note the quantity prepared according to the dose calculation, the duration of treatment and the substituted medication if any (after calling the treating physician).
4. Pharmacist or Pharmacy Technician will carry out the computer entries of the prescriptions and generate Patient instruction labels in Arabic or English.
5. Licensed pharmacist shall ensure the Double-checking procedure for all dispensed medications and initial the prescription form.
6. Licensed pharmacist shall ensure the implementation of the International Patient Safety Goals in Patient Identification; in which the patient should have an active participation by mention his complete name; and patient understanding to the medication use while dispensing the prescription.
7. The Dispensing Pharmacist and Patient shall counter sign the prescription to assure patient understanding to the medication use.
8. Pharmacy Supervisor shall verify all prescriptions against the printout of Patient charge list and to be submitted to billing department for billing purposes.

Attachments

1. Attachment A- Control Drug Prescription Form (Outpatient Use).
2. Attachment B- Prescription form.
3. Attachment C- Insurance Prescription form.
4. Attachment D- Regular Manual prescription.
5. Attachment E- Patient charges list (Sample).
6. Attachment F- Pharmacy Intervention Report.

Read moreHow to Write Pharmacy Goals and Objectives Policy

You’re almost done and the pharmacy ambulatory prescription dispensing policy is almost ready, what’s remaining is just a few basic policy layout filling.

• References.
• Revisions: Revised as per timescale.
• Distribution: Here you should mention where this policy will be sent, and which departments will get a notification for it:
  • Medical/Hospital Director.
  • Pharmacy Department.
  • Signed original is maintained in Manual & Indexing Office.

The policy is now finished, and it’s time to get proper signatures, whether your hospital is implementing electronic signatures, or manual signs and stamps.

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