Quality of pharmaceutical services

Standards are an important part of measuring the quality of service provided to the consumer. Why did the International Federation of Pharmacists adopt international guidelines for the practice of good pharmacy in its council meeting in Tokyo 5-9-1993 because it believes that the standards based on these guidelines should be used by pharmaceutical organizations, governments and international pharmaceutical organizations to reach acceptable national standards for the practice of good pharmacy.

This revised version of the declaration was adopted by the thirty-fifth meeting of the WHO Expert Committee on Standardization for Pharmaceutical Preparations in April 1997 and approved by the Congress of the International Pharmaceutical Federation in September 1997.

The Guidelines for Good Pharmacy Practice are based on the pharmaceutical care provided by pharmacists. The Guidelines recommend that national standards be developed with the aim of:

Promoting health, providing medicines and medical devices, patient self-care, and improving drug prescription and use, all through the activities of pharmacists.
The International Pharmaceutical Federation urges pharmaceutical organizations and governments to work jointly to produce standards or, if national standards exist, to revise them in light of the guidelines laid out in the Good Pharmacy Practice document.


1 Introduction
2 The philosophical basis of the topic
3 Requirements for good pharmacy practice
4 conditions for good pharmacy practice
5 Application of good pharmacy practice
6 additional things to do in good pharmacy practice
7 Establish standards for good pharmacy practice
7.1 Promote health and prevent ill health
7.2 Provision and Use of Prescription Medicines and Other Health Care Products.
8 self-care
9 Influencing drug prescribing and use
10 Documentation and research
11 Achieving good pharmacy practice
12 references

International accreditation for pharmaceutical services and how to apply quality standards (Dr. Mukhtar Abd al-Ghani Mukhtar Egypt, Mansoura Belgay) Bachelor of Pharmacy, Al-Azhar Al-Sharif, health quality specialist, Cambridge, Britain, member of the Federal Federation of Pharmacists……….. These are some of the broad lines that must be worked on To obtain international accreditation for hospital pharmacies

1- Policies and methods that clarify and describe the field of pharmaceutical services

2- Drug safety systems

3- Continuing pharmaceutical education program

4- Drug distribution system

5- Methods of storage, distribution, and how to deal with narcotic drugs and all drugs that need special control 6- Drug records management

7- Indicative measurements for the administration of medication for patients who visit the hospital and non-residents

8- Determine the individual responsibilities of each of the doctor, pharmacist and nurse and the role of each individual in administering antibiotics through intravenous solutions

9- Clarifying the policy of how to obtain medicines for inpatients in the hospital after Basic working hours

10- Measurements and recommended methods for the retrieval process

11- Policy for returning medicines that were requested in error – expired medicines – medicines with a manufacturing defect – damaged medicines

12- Discrimination policy for damaged medicines – stored – received

13- Monthly pharmacist inspection on each unit The hospital regarding medication

14- A review policy for preparing, taking and dealing with medications, methods of storing them, and methods of distributing them inside the hospital to ensure the highest health care for the patient

15- Providing a policy for how to deal with side effects of drugs so that they are excluded by discovering, evaluating, determining, and evaluating the size Its risks, treatment, classification, monitoring, and proving it in a report so that we can then exclude, reduce or prevent it as much as possible in new patients

16- A policy for recording medical and drug errors

17- The work of a pharmaceutical advisory board whose role is multiple visits to take samples and evaluate them

18- Policy To find out the conflict between drugs and the food provided to the patient

19- Standard care for drug administration for patients who take the drug through a tube and are unable to take it orally

20- Develop a policy for storing the drug under ideal conditions in order to maintain the highest efficiency of the drug such as controlling temperature – light – humidity – ventilation Isolation – Safety

21- A policy for receiving medication requests from departments in the hospital, whether verbally or by phone

22- A specific methodology for how to deal with emergency drugs

23- The role of pharmaceutical services in infection control in terms of methods, policies and responsibilities granted to the pharmaceutical department to monitor, control and prevent infection

24- The role of the pharmaceutical service to improve the general performance of the hospital as planned. These policies depend on their application to the pharmacist staff in the hospital and their full knowledge of the tools by which quality is measured, which amount to about thirty-four tools. God willing, I will tell you about them soon, and I will also tell you in detail about the previous points in the policies Public (Dr. Mokhtar Abdel Ghani Mokhtar Amer, Egypt, Mansoura Belgay)

All practicing pharmacists have an obligation to ensure that the service they provide to each patient is of an appropriate quality. Good pharmacy practice is a means of demonstrating and fulfilling this obligation.

The role of the International Pharmaceutical Federation is to provide leadership to national pharmaceutical organizations, which in turn provide the impetus for the development of national standards. A vital component is the commitment of the worldwide pharmacy profession to encourage perfection in practice for the benefit of those it serves.

For the general public and other professions, they will assess the profession by how its members translate this commitment into practice in community and hospital pharmacy settings.

This document aims to encourage national pharmaceutical organizations to focus attention on pharmacists working in community and hospital pharmacies to develop the elements of service they provide to suit different circumstances.

It is not appropriate for the World Health Organization and the International Pharmaceutical Federation to set standards or a list of minimum requirements that must be met in all Member States.

The practice conditions

It varies greatly from one country to another, and each national pharmaceutical organization is the best authority to decide what can be achieved and within any time scale.

National pharmaceutical organizations should also take action to ensure that pharmaceutical education, both pre- and post-graduate qualification, is designed to qualify pharmacists for the roles they must assume in practice, in the community and in hospitals.

Therefore, within the necessary foundation of pharmaceutical sciences, there must be sufficient emphasis on the effect and use of drugs; There should also be a reasonable introduction in the course of the pre-graduate qualification to the relevant elements of the social and behavioral sciences.

And yet, in all stages of pharmaceutical education, it should emphasize the appropriate development and improvement of communication skills with people.

In the context of developing these standards, important differences between countries must be considered. Rich countries often have effective systems that regulate medicine based on legislation.

These devices monitor (correspond) and ensure the quality of industrially produced pharmaceutical products through several means:

issue licenses for products or marketing permissions;
And by licensing and inspecting drug manufacturers, wholesalers and others who distribute medicines, as well as community pharmacies, hospital pharmacies and other drug dispensing outlets;
And through quality control from time to time in government laboratories.
As for many developing countries, they lack an effective drug regulatory system, and this places the main part of the responsibility for the quality of pharmaceutical products on the shoulders of pharmacists, who must rely on themselves or on their syndicates to assess the quality and must make sure that the sources of obtaining medicines are limited to reliable sources. The International Pharmaceutical Federation has developed special guidelines for drug procurement

There are a great deal of reports that substandard and counterfeit pharmaceutical products are common in international trade.

And developing countries are the most frequently exposed to the impact of such products, which may be ineffective and even toxic products, and this threatens the erosion of confidence in the health care system.

Because of the aforementioned, the 47th World Health Assembly adopted in May 1994 Resolution WHA47.12 on the role of the pharmacist in supporting the WHO revised drug strategy, which drew attention to the responsibilities of pharmacists in ensuring the quality of the products they dispense.


The philosophical basis of the topic

The mission of the practice of pharmacy is to provide medicines, health care devices and services to help people and society get the best use of them.

Comprehensive pharmaceutical service includes activities for both: ensuring good health and avoiding ill health in the population. When treating ill health, it is necessary to ensure quality in the context of the use of medicines in order to reach the highest therapeutic benefit and avoid the side effects that may follow.

This entails that pharmacists accept joint responsibility with other professionals and with patients for the outcome of treatment.

The term pharmaceutical care has established itself in previous years as a philosophy of practice, with patients and the community as the main beneficiaries of the pharmacist’s business.

This concept is particularly relevant to special groups such as the elderly, mothers, children, chronic patients and society as a whole as well, for example, considering: cost containment.

While the basic concepts of pharmaceutical care and good pharmacy practice are largely identical, we can say that good pharmacy practice is a way of applying pharmaceutical care.


Requirements for good pharmacy practice

• Good pharmacy practice requires that the pharmacist’s primary concern in all circumstances is the benefit of patients. And good pharmacy practice requires that the core of the activity in the pharmacy be the provision of medicine and other health care products with guaranteed quality, the provision of information and advice to the patient, and the monitoring (control) of the effects of their use. It is required by good pharmacy practice that an integral part of the pharmacist’s contribution is the promotion of prudent and economical prescription and appropriate use of medicines. Good pharmacy practice requires that the objective of each element of the pharmaceutical service be patient-related, clearly defined, and effectively communicated to all relevant stakeholders.


Conditions of good pharmacy practice
In order to achieve these requirements, the following conditions must be met:

Professionalism should be the main philosophy on which practice is based, although it is accepted that economic factors are also important.
Pharmacists should have a shared input into decisions related to the use of medicines. There should be a device that enables pharmacists to report adverse incidents, medical errors, product quality problems, and detection of counterfeit products. This reporting may include information on drug use provided by the patient or health professionals. Either directly or through pharmacists.
The ongoing relationship with other health professionals, especially physicians, should be seen as a therapeutic partnership that includes mutual trust and dependence in all matters related to pharmaceutical treatments.
Relationships between pharmacists should be collaborative and aim to improve pharmacy service rather than competitors.
Indeed, organizations, group practices and pharmacy managers must accept their share of responsibility for defining, assessing and improving quality.
The pharmacist must be aware of the basic medical and pharmaceutical information that pertains to each patient, and obtaining this information is easy if the patient chooses one pharmacy to deal with or if the patient’s medication file is available.
The pharmacist needs independent, comprehensive, objective and contemporary information on the treatments and drugs used.
Pharmacists, in all their workplaces, must accept their personal responsibility to maintain and value their self-efficacy throughout their professional career.
Education programs for entry into the profession should be appropriately oriented to both current and foreseeable changes

future in the practice of pharmacy.
The National Standards for Good Pharmacy Practice should be articulated and adhered to by practitioners.

Good pharmacy practice application
Good pharmacy practice includes four categories of activities:

First, activities related to promoting good health, avoiding ill health, and achieving health goals.
Second: Activities related to the provision and use of medicines and materials for taking medicines or for other aspects of treatment (and these activities may take place in places such as pharmacies, institutions, or homes).
Third: Activities related to individual self-care, including giving advice – when appropriate – and providing medicine and other treatments for symptoms of diseases whose nature allows for self-treatment.
Fourth – activities related to influencing the prescription and use of medicines.


Additional matters in good pharmacy practice
In addition to these categories of activities, good pharmacy practice includes:

Establish agreements with other medical professional groups for population-wide health promotion activities, including reducing drug abuse and misuse.
Professional evaluation of advertising materials for medicines and healthcare-related products.
dissemination of resident information on medicines and other aspects of health care;
Participation in all stages of clinical trials.

Establishing standards for good pharmacy practice
For each of the four key elements of good pharmacy practice, national standards relating to processes and facilities should be established. And these standards must be promoted among members of the profession.


Promote health and prevent ill health
We need national standards:

Facilities for private conversations where no one else can be heard.
Providing general advice on health matters.
Involve people in special campaign briefings to ensure coordination of efforts and consistency of advice.
Quality assurance of instruments used and advice given in laboratory tests.

Provide and use prescribed medications and other healthcare products.
Activity: Receiving the prescription and ensuring the integration of communication We need national standards for:

Activity: Evaluation of the prescription by the pharmacist. This activity includes the therapeutic aspects (pharmaceutical and pharmacological) and considering the appropriateness of the prescription for the individual, societal and economic aspects.

We need national standards for:

Information sources
People efficiency
For drug notifications
Activity: Collecting the described materials

We need national standards for:

Sources of provision of medicines and other materials, manufacturers of medicines
The circumstance is the case of saving for the patient
required person
Required facilities and workplaces
Compositions and guarantee the quality of immediate compositions
Disposing of unused pharmaceutical products and pharmaceutical waste
Activity: Advise to ensure that the patient or his caregiver receives and understands sufficient written and oral information so that he or she derives the optimal benefit from treatment.

We need national standards for:

Facilities for private (secret) talk that others cannot hear
Information sources
Proper tracking and documentation procedures
competence of the persons involved
Activity: Follow up the effect of the prescribed treatments

We need national standards for:

Procedures that must be followed routinely for the systemic (total) evaluation of the treatment process and its results on the individual and on groups of patients.
Access to monitoring (control) devices and affiliated facilities.
Quality assurance for monitoring facilities.
Activity: Documentation of professional activities.

We need national standards for:

Record professional activities and patient data in a manner that allows access to comprehensive information.
Procedures for self-evaluation of professional activities and for quality assurance.

Self care
We need national standards for:

Private talking facilities that cannot be heard by others
competencies of the people involved
Methods for the correct assessment of the necessary information (for example, finding out who has the problem, what are the symptoms, how long has the condition existed, what action was taken, and what medications were taken)
Efficacy and safety of recommended products
Timing of the specialist doctor’s review and means of follow-up.

Influencing drug prescribing and use
We need national standards for:

Quality of prescribing data provided to pharmacists.
Preparing a book of national formulas for medicines.
Contact doctors based on the description of the individual patient
Evaluation of data on drug use in pharmaceutical and medical practices
Evaluation of promotional materials
Dissemination of resident information via the official network
Educational programs for health professionals
Sources of reference information available to the pharmacist
Confidentiality of data relating to individual patients
Report harmful incidents, medical errors, product quality defects, counterfeit and expired products.

Documentation and research

Pharmacists have a professional responsibility to document practice experience and activities and to conduct and/or contribute to pharmacy practice and clinical research.

Achieving good pharmacy practice
Specific standards for good pharmacy practice can be developed within the framework of a national organization.

These guidelines are recommended as a set of professional goals in the interest of the patient or customer in the pharmacy.

The responsibility for moving the project forward rests with each national pharmaceutical organization. Achieving qualitative standards for good pharmacy practice in each country according to these guidelines may require significant time and effort.

Pharmacists, as health professionals, have a duty to start this process without delay.


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