January 11, 1990
VA HANDBOOK 7610 (268)
b. Inpatient Pharmacy
NOTE: Beds mean total beds including Nursing Home Care and Domiciliary beds,
unless otherwise stated.
For the purposes of these criteria, 10.2 represents the average doses dispensed per
patient per day. 10.2 multiplied by the number of operating beds will establish the
FCF (Facility Conversion Factor) which is equivalent to the total doses per day
dispensed by the facility.
For all space calculations round to the nearest increment of 5.
(1) Dispensing Station - Should the pharmacy Medication Preparation Areas be in the
approved program, a maximum of two dispensing stations in the main pharmacy will
be allowed. If automated dispensing machinery is utilized only one dispersing
station will be required. This will also result in an appropriate reduction in space
requirements that will be determined on a project by project basis.
(a) Unit Dose ....................................................................................................................................12.6 NSM (135 NSF)
(One station for each 2,300 doses per day.)
Unit dose is a drug distribution system in which drugs are provided by Pharmacy
Service in dose size (e.g., one package of two aspirin tablets). It allows constant
monitoring of the patient's medication regimen, as each dose is identified by
name, form, strength, control number and expiration date. The doses are taken
from the bins in the dispensing station and put into individualized, labeled,
patient drawers. The grouping of drawers, or cassettes, are delivered to the
nursing units via transfer carts. They are then placed in the medication carts and
dispensing to the patients on the unit. Use o f master mobile carts may obviate
the need for transfer units.
or
(b) Ward Stock or Automatic Replenishment ..........................................................................12.6 NSM (135 NSF)
One station for each 240 oral tablets and injectable line items of inpatient
inventory.
In Ward Stock Dispensing, drugs are sent to the ward in bulk for a seven day
supply. The distribution is determined by the drug requisition from Nursing
Service.
Automatic replenishing is similar to the ward stock method except no requisition
from Nursing Service is required. The established stock levels are automatically
replenished by Pharmacy Service.
(2) Medication Assignment Area ....................................................................................................NSM = FCF x 0.0017
(NSF = FCF x 0.018)
This area is for the reviewing and processing physicians' orders, patient profiles
and verification of dispensing records.
(3) Controlled Substances Vault And Secured Dispensing Area
(a) Vault ..............................................................................................................................................11.2 NSM (120 NSF)
268-3
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