Pharmacy Practice and Hospital Pharmacy: distribution and inventory control
What hospital and practice pharmacy tests
This domain covers hospital drug distribution, inventory control, prescription screening, sterile and non-sterile compounding, medication safety, the pharmacy and therapeutics committee (PTC) and hospital formulary management. D.Pharm questions often test practical calculations and correct workflow.
Core rules
- Unit-dose distribution reduces medication errors compared with bulk floor stock; narcotics require separate locked storage, double signature and an accurate register.
- FEFO, first expiry first out, is used in stores; expired drugs are segregated and documented, not returned to active stock.
- Reorder level = average daily consumption x lead time + safety stock. Maximum stock level limits capital tied up and expiry.
- A hospital formulary is a continually revised list of selected medicines with prescribing information, approved by the PTC; it is not a price list.
- Prescription screening checks patient details, drug, dose, route, frequency, duration, interactions, allergies and legality. Clarify illegible or incomplete prescriptions with the prescriber.
Worked example
A ward uses 40 vials of ceftriaxone per day. The supplier lead time is 10 days and the hospital keeps 5 days' safety stock. Reorder level = (40 x 10) + (40 x 5) = 400 + 200 = 600 vials. If current stock is 650, no order is needed yet; at 600, order enough to reach the maximum, not just the reorder level.
Traps
Using average monthly instead of daily use; ignoring lead time variability; treating the formulary as a fixed national list; and failing to document returned or wasted controlled drugs.