ORS stock control before the monthly order
At a district hospital pharmacy in Battambang, oral rehydration salts (ORS) are supplied in sachets and ordered monthly from the provincial store. Average ORS use is 3,000 sachets per month, with a seasonal maximum of 3,600. The procurement lead time is 8 weeks. The pharmacy policy sets safety stock at 4 weeks of average use. Current stock is 2,400 sachets, but 600 sachets expire in 6 weeks; there are no outstanding orders. The store budget can finance at most a 4-month supply at current prices, and ORS shelf life is 24 months. A new nursing supervisor wants to postpone ordering until the stock falls below 1,000 sachets to avoid overstock. The pharmacy technician asks you to review the situation before the monthly order is submitted. You have the consumption records, expiry dates, and lead-time data. No computer inventory system is available, so the calculation and documentation must be practical.
1. Calculate the reorder point and the quantity to order now. State your assumptions and explain how the 600 expiring sachets change the decision.
Read the worked answer
Using average use of 3,000 sachets/month:
- Lead time = 8 weeks = 2 months.
- Safety stock = 4 weeks = 1 month = 3,000 sachets.
- Reorder point = (average monthly use × lead time) + safety stock = (3,000 × 2) + 3,000 = 9,000 sachets.
- Using the seasonal maximum of 3,600, reorder point = (3,600 × 2) + 3,000 = 10,200 sachets.
Current stock is 2,400, so the pharmacy is already far below either trigger. The order must be placed now, not at 1,000.
A practical target is 4 months of supply: 2 months lead time + 1 month review period + 1 month safety stock = 12,000 sachets. Nominal order = 12,000 − 2,400 = 9,600 sachets, or 96 boxes of 100.
The 600 short-dated sachets expire before an 8-week delivery. If they cannot be used first, add 600 to replace them: 10,200 sachets. If ward staff can reliably issue them first, 9,600 is adequate. The safer operational choice is 10,200 unless expiry use is closely monitored. Record the formula and the expiry assumption in the order file.
2. The nursing supervisor proposes waiting until stock falls below 1,000. Explain why this is unsafe and outline an action plan for the expiring stock and stock-out communication.
Read the worked answer
Waiting for stock below 1,000 is unsafe because 2,400 sachets covers only about 0.8 month at average use, while replenishment takes 2 months. A stock-out would occur before delivery, and ORS is life-saving in diarrhoeal dehydration. A 1,000 threshold ignores lead time and safety stock.
Action plan:
- Place the order immediately using the calculated reorder point and order quantity.
- Segregate the 600 short-dated sachets, label them 'use first', distribute them to oral rehydration corners and diarrhoea wards, and check daily.
- Set a written reorder point of 9,000-10,200 sachets and review stock monthly.
- If the balance falls below 1,500 before delivery, request an emergency transfer from the provincial store or a nearby health centre.
- Inform clinical staff of the risk and use a simple stock card showing receipts, issues, balance, batch, and expiry.
Do not borrow stock informally without documentation. Show the supervisor the calculation. A 10,200-sachet order remains within the 4-month budget limit; confirm pack size and storage space before submission.
3. What monitoring and documentation should the pharmacy put in place after the order is submitted?
Read the worked answer
Use a simple bin card for each batch: date received, quantity, batch number, expiry, quantity issued, running balance, and signature. Review consumption weekly during the rainy season, when diarrhoea and dengue may rise. Compare actual use with the 3,000 average and update the reorder point if use changes substantially. Check expiry monthly and rotate stock so shorter-dated sachets are issued first. Keep a copy of the order, delivery note, and any emergency transfer. If a stock-out occurs, document the dates, the reason, and the action taken. Report expiry losses through the normal pharmaceutical management channel rather than hiding them. This record also allows the supervisor to see that the 1,000 threshold was not evidence-based.