By
Department of Pharmaceutical Services
Ministry of Health
RIPAS Hospital Pharmacy Services Section is made up of the Outpatient Pharmacy and Inpatient Pharmacy.
Both pharmacies are located on the ground floor - the Outpatient at the Outpatient Block and the Inpatient at Block 4.
The mission of the Pharmacy Department is "to provide patients with medications that are efficacious, safe and of acceptable quality, with adequate information to ensure they would be used appropriately to optimise treatment".
Layout of the pharmacy
The Outpatient Pharmacy is enclosed by two waiting areas and has seven counters serving patients.
Counter 1: To receive non-paying prescriptions with more than one item. Two types of numbers are dispensed:
a) ticket starting with 1xxx for ordinary patients, and
b) ticket starting with 5xxx for 'Warga Emas' patients.
Counter 2 & 3 : Collection counter for ordinary patients with ticket starting with 1xxx.
Counter 4 : Collection counter for unclaimed prescription (1xxx).
Counter 5 : Dispensing for non-paying patients who collect only one item.
Counter 6 : Paying counter for patients with B$5 registration coupons.
Counter 7 : Collection counter for 'Warga Emas' with ticket number starting with 5xxx.
'Warga Emas' are patients who are 60 years and above.
The Inpatient Pharmacy has a waiting area with a counter for receiving prescriptions or orders from the wards.
Functions
The services provided by the Outpatient and Inpatient pharmacies are:
1. Dispensing of medicine to patients
The main role of the Outpatient Pharmacy is to dispense medicines to outpatients in RIPAS Hospital and also patients from other district hospitals and health centres. Supply of medicines is claimed using PHY cards or prescription chits.
The Inpatient Pharmacy dispenses medicines to warded and discharged patients in RIPAS Hospital. Medicines that are not kept in the ward as a stock item will be claimed through each inpatient's prescription chart.
Supply of medicines for discharged patients is claimed using either PHY cards or prescription chits, or the discharge section of the inpatient prescription chart.
These prescriptions are then brought down by the porter or the ward staff, and supply is done on a "first-come, first-served" basis.
There may be circumstances where certain medicines are needed urgently. For these prescriptions, they will be given priority.
Both pharmacies are opened during normal government working hours. On Fridays, Sundays and public holidays, the Inpatient Pharmacy is opened for a shorter time-frame, to cater only for discharges and other emergency, or urgent request, for medicines.
Registration coupons
All outpatient prescriptions must be attached with a registration coupon before dispensing, except for:
* Children below the age of 12
* Pregnant mothers attending the ante-natal clinic
* Personnel and immediate family members of the Royal Brunei Armed Forces, Navy and Prisons Department
Registration coupons are obtainable at the point of registration, before consultation with the doctor. The registration coupon is essential for identifying the paying status of the patients. There are three types of registration coupons available:
* B$1 coupon for citizens
* B$3 coupon for permanent residents and expatriates serving in the government sectors, and
* B$5 coupon for others who have to pay for their medication
Monthly supply of long term medications
Patients with chronic illnesses such as hypertension, diabetes or asthma are prescribed with medicines for long-term use.
Medicines for long-term use will be supplied for one month on each visit or upon discharge.
The prescription chit/ PHY card held by the patient must be brought back to the Outpatient Pharmacy the following month for refills. Other patients with once-off prescription will be dispensed with the full quantity, and the prescription will be kept by the pharmacy. Patients are encouraged to inform the pharmacy if they have excess medicines at home so that only the required ones are supplied.
Returning medicines
Any excess medicines that are not needed anymore can be returned to the pharmacy. This also applies to expired, damaged/spoilt medicines or medicines which have changed colour or appearance.
Waiting time
The waiting time at the Outpatient Pharmacy can range from 15 to 60 minutes - depending on the time of the day, number of staff on duty, the appointments of clinics and complications arising from the prescriptions.
You may choose to leave your prescription, get a number and return another time to collect the medicines at Counter 4 (or Counter 7 for Warga Emas) by presenting the ticket number.
Unclaimed medicines are cleared and put back to the stock after oneweek for once-off medicines and after two weeks for long-term medicines.
Carrier bags
In an effort to conserve the environment, you are advised to bring a reusable carrier bag each time when you come for your medication.
1. Supply of medicines to wards, specialist and dental clinics
Each individual ward, specialist clinic and dental clinic will keep a range of medicines, which they use frequently. These medicines are ordered from Inpatient Pharmacy on a daily basis, or whenever required.
Every ward has its own individual ward stock-order list. On every working day morning, assistant dispensers from the Inpatient Pharmacy will make a round to every ward to collect these ordering lists and send them down to the pharmacy for supply. Once the supply has been done, the stock medicines will be sent back up to the ward again.
2. Clinical services Counselling
The Outpatient Pharmacy provides one-to-one counselling services to patients on inhalers, warfarin and patients with multiple medications.
Patients are either identified upon dispensing or referred by doctors for counselling.
If you are in doubt about your medicine, do bring your medicines (and prescription if available) and speak to the pharmacist.
Group counselling by pharmacists is provided as part of the Cardiac Rehabilitation Programme. In this programme, targeted patients are counselled with regards to their cardiac (heart) medications in order to improve compliance.
At the Inpatient Pharmacy, bedside counselling service is provided at the wards.
Currently, patients on inhalers and warfarin are counselled. Patients are referred by doctors and nurses, or are identified for counselling during the pharmacist ward rounds.
Daily clinical pharmacy ward rounds
This service involves two pharmacists visiting four targeted wards every morning during government working hours.
Among the activities carried out by these pharmacists are to clinically assess every prescription on the targeted ward, identify patients on inhalers and warfarin for counselling.
With the implementation of daily ward rounds, any problems encountered with prescriptions can be solved then and there; thus ensuring safe and appropriate administration of medicines. This service also helps to establish and maintain a good rapport between pharmacists and other healthcare professionals towards ensuring patient safety and improving patient care.
Clinical pharmacy ward round service is currently implemented at RIPAS Hospital only.
Oncology aseptic dispensing
This specialised service is currently available in RIPAS Hospital only. The term "oncology" means the study of tumours and "aseptic" means free from contamination.
Oncology aseptic dispensing is the preparation of anti-cancer drugs prior to administration to the patients using techniques to ensure that the drugs are free from contamination. The preparation is done by trained pharmacy personnel.
Pharmacy is also involved in checking dosages of anti-cancer drugs being prescribed and counselling to patients where necessary.
3. Provision of drug information
On top of the daily dispensing duties, the Hospital Pharmacy Services Section also provides quick and brief drug information services to healthcare professionals and the public within the resources that are available. If more in-depth information is required, this would be referred to the pharmacist based at the Drug and Poisons Information Section in RIPAS Hospital.
The Hospital Pharmacy Services Section is not just involved in the dispensing of medications - emphasis is also placed on counselling to ensure that patients are aware of the different types of medications that they are on. This works towards improving the health, care and safety of the patient in support of the vision of the Department of Pharmaceutical Services "Excellence in Pharmaceutical Services and Care: Towards Building a Healthy Nation."
- Ministry of Health's public awareness programme
Source: Weekend, 28 June 2008
