REMOTE HEALTH ATLAS Section 16: PHARMACY

DRUG STORAGE ROOM STANDARDS

DRUG STORAGE ROOM STANDARDS

1. General Information
Most RHB health centres have a dedicated drug storage room where medicines can be safely stored. While there is considerable variation in the size and configuration of this room in the DHF health centres across the NT, various features must be incorporated in the way these rooms are managed and fitted out. This Atlas item describes the standards that must be applied.
Note: Although this is sometimes called the pharmacy, the Poisons and Dangerous Drugs Act (PADDA) stipulates that the term pharmacy is only to be used for the premises on which a pharmacist principally conducts business.

2.

Definitions

Standard Drug List: a list of medicines which includes items to be stocked in all DHF remote health centres in the NT in a mandatory capacity, as well as a number of optional items. See Standard Drug List. S100: a section of the National Health Act 1953 which allows for special supply arrangements to be made by the Minister for Health to ensure availability of a pharmaceutical service to all Australians where general provisions of the PBS scheme cannot be easily applied. See Section 100 Pharmacy Arrangements. Bulk supply: drugs supplied to health centres as general stock, i.e. not dispensed to an individual client. Dose Administration Aids (including Dosettes / Blister Packs / Sachets): devices that allow medicines to be contained in sequential dosing portions according to a prescribed regime. See Dose Administration Aids for details.

3.
3.1 3.2 3.3 3.4 3.5

Responsibilities
Primary Health Care Manager Ensure all staff are aware of their legislated responsibilities in the PADDA Coordinate the management of the drug storage room or nominate a staff member to do so Report any changes to the drug storage room keypad code to Nursing Coordinator All Health Centre Clinical Staff Abide by legislated responsibilities in the PADDA. See Practice Guidelines for Registered Nurses, Nurse Practitioners, Midwives, Enrolled Nurses and Aboriginal Health Workers. Ensure familiarity with the layout and management of the drug storage room Nursing Coordinator Ensure that issues arising from pharmacy audits conducted by contracted pharmacists are followed up Observe adherence to Drug Room Standards during visits to Health Centres Maintain Register of Pharmacy Access Key Codes on behalf of Management on Call Town-Based Line Manager Liaise with Health Centre Managers on issues such as security, repairs and maintenance or upgrading of existing drug storage room facilities and equipment S100 Contracted Pharmacist Conduct regular audits of drug storage facilities in health centres as per contract

Developed by: Professional Practice Group Endorsed by: Professional Practice Coordinator Release Date: November 2008

Page 1

Reviewed:

May 2009, Mar 2010,

Next Review: March 2013

REMOTE HEALTH ATLAS Section 16: PHARMACY

DRUG STORAGE ROOM STANDARDS

Provide education and advice to health centre staff on all aspects of management of drug storage rooms as per contract Provide audit report of visit to the Professional Practice Coordinator, Area Service Manager, regional Nursing Director and to relevant Primary Health Care Manager

4.

Procedure

RHB recognises that facilities at a number of health centres will not meet the Drug Storage Room Standards. However, staff are expected to both abide by the provisions of the PADDA and to manage storage of drugs and pharmaceutical products under conditions as closely as possible to those described in these standards. 4.1 Drug Storage Room Standards The following drug storage room standards are derived from the Facilities Pharmacy Brief, relevant Pharmaceutical Society of Australia (PSA) Professional Practice Standards. Drug storage rooms must feature: - keypad locks or, where keypad locks have not yet been installed, a lockable room - security screens on all windows - adequate lighting (240 lx illuminance or more) - a temperature of 25oC or below, with air conditioning units that operate 24 hours per day and are connected to an emergency power supply - a purpose built vaccine refrigerator for storage of vaccines, anti-venom and point-of-care equipment consumables. See Cold Chain, i-Stat 1 Analysers and DCA 2000+ Analysers - a nominated refrigerator for cold storage of pharmaceutical products requiring refrigeration, in addition to the vaccine refrigerator - a dangerous drugs cupboard as described in S8 Medicines - where Restricted S4 Medicines drugs cannot be accommodated in the dangerous drugs cupboard, a secure and separate area or a lockable cupboard for storage of these drugs - adequate shelving for appropriate storage of the different categories of drugs used at the health centre as well as for DAAs - a workbench with an impervious top - an adjustable swivel chair on castors, if the workbench is low - a stainless steel sink with impervious surrounds, preferably with elbow controlled taps - two RUM containers as per Return of Unwanted Medicines - a soap dispenser and paper towel holder - a portable, non-slip step or a sturdy two rung ladder, if shelving is above shoulder height Optional features that may be located in the drug storage room or elsewhere in the health centre or equipment that may not be required in all health centres include: - a networked computer with access to electronic client records (PCIS) - an iron and a heatproof pad for sealing heat sealed blister packs (only for health centres that prepare these packs). 4.2 Drug Storage Room Resources The following must be available in the drug storage room: - Dangerous Drugs of Addiction Register (DDA Register) - Restricted Schedule 4 Medicines Register - The Approval to Possess and Supply Scheduled Substances Nurses, and Approval of Possession and Supply of Scheduled Substances - Aboriginal Health Workers must be displayed (available on S29 Notices) - relevant pharmacy related reference manuals as per Standard Reference List - current Vaccine Cold Chain Graphs (displayed on vaccine refrigerator) - packaging requirements including DAAs, labels, paper bags, time of administration stickers (sun and moon stickers)
Developed by: Professional Practice Group Endorsed by: Professional Practice Coordinator Release Date: November 2008 Page 2 Reviewed: May 2009, Mar 2010,

Next Review: March 2013

REMOTE HEALTH ATLAS Section 16: PHARMACY

DRUG STORAGE ROOM STANDARDS

- appropriate dispensing aids such as purified water, measuring devices, medicine cups, paper cups, syringes, pill cutters and mortar and pestle. In some instances health centres have also been provided with devices for making medicine labels, and these must be located appropriately. 4.3 Drug Storage Room Security and Access To comply with the provisions of the PADDA, all drugs must be safely stored and not be accessible to the public. This means that drug storage rooms in health centres must be kept locked at all times unless an authorised person is present. Where keypads are not yet installed, the HCM or delegate must hold the key. Access to the room is restricted to Registered Nurses, Registered Aboriginal Health Workers, Medical Officers and Pharmacists. 4.3.1 Keypad Codes The keypad code: - must be made known only to those who have legitimate access to the drug storage room - must be changed immediately if there is any breach of security. To change the keypad code, follow the instructions on page 3 of Pharmacy Keypad Lock Instructions. If the access code is not known and emergency access is required, contact Management OnCall. To ensure that the Register of Pharmacy Access Key Codes is kept up to date, notify the Nursing Coordinator whenever codes are changed. 4.4 Drug Storage Layout A standard categorisation of pharmacy items has been determined and is to be used in all drug storage rooms. Items are grouped in the following categories:
Refrigerated Drug safe Oral Injectable Topical Infusion Inhalational Non Drug

The Standard Drug List indicates the category of each item in the location column of the List. See Best Practice Communiqu 10-02 Drug Storage Categories. 4.5 Drug Storage Room Stock Control Pharmacy supplies must be moved to the drug storage room as soon as they arrive and be unpacked as soon as possible. To uphold quality standards in health centre drug storage rooms: - rotate stock so that the stock closest to expiry date is kept in front - when new stock arrives circle the expiry date or write it clearly on the box or other container and place it behind stock with an earlier expiry date - where the expiry date is only printed on the external packaging, keep the unmarked stock inside the package until it is going to be used or, if the unmarked items have to be removed from the packaging, write the expiry date on each separate item - as far as possible, keep drugs and pharmaceutical products in the drug storage room until they are required. 4.6 Drug Storage Room Safety of Clients and Staff The responsibilities of staff to consider their safety and the safety of others under the provisions of the Workplace Health and Safety Act apply in this instance, as in all others. See OH&S Overview.

Developed by: Professional Practice Group Endorsed by: Professional Practice Coordinator Release Date: November 2008

Page 3

Reviewed:

May 2009, Mar 2010,

Next Review: March 2013

REMOTE HEALTH ATLAS Section 16: PHARMACY

DRUG STORAGE ROOM STANDARDS

Staff must ensure that: - the drug storage room is kept locked when not in use - all drugs and medicine containers are labelled with the name, strength, batch number and expiry date - there are no expired drugs or other pharmaceutical products on the shelves - refrigerators contain only pharmaceutical products - the drug storage room is reserved for pharmacy related functions only - floors, walls, sinks, benches, shelves, containers and dispensing bottles are clean and free of anything likely to contaminate drugs - benches and surrounds are free of items not required for preparation or packaging of medicines - floors are free of stock or other obstructions. See Performing Manual Tasks for relevant information.

Forms

Remote Health Hospital Pharmacy Order S8 & RS4 Medicines from Hospital Pharmacy Order Form S100 Pharmacy Order Forms available from contracted pharmacists Vaccine Cold Chain Graph (HM144 C), available from hospital Stores

References and Supporting Documents

Restricted Schedule 4 Medicines Return of Unwanted Medicines Schedule 8 Medicines Section 100 Pharmacy Arrangements Section 29 NT Poisons & Dangerous Drug Act Standard Drug List Standard Reference List

Related Atlas Items: Cold Chain DCA 2000+ Analysers Dose Administration Aids i-Stat 1 Analysers Management On-Call OH&S Overview Performing Manual Tasks Pharmacy Ordering

Best Practice Communiqus: 07 21 Water for Oral Antibiotic Suspensions Communiqu 10-02 Drug Storage Categories Communiqu Poisons and Dangerous Drugs Act Poisons and Dangerous Drugs Regulations DHF Environmental Health / Poisons Control website: Section 29 Notices Code of Practice for the Storage and Transport of S8 Substances Competency Standards for Pharmacists in Australia 2003 Quality Care Pharmacy Program Pharmacy Guild of Australia Society of Hospital Pharmacists Australia Facilities Pharmacy Brief Pharmacy Keypad Lock Instructions Practice Guidelines for Registered Nurses, Nurse Practitioners, Midwives, Enrolled Nurses and Aboriginal Health Workers

Developed by: Professional Practice Group Endorsed by: Professional Practice Coordinator Release Date: November 2008

Page 4

Reviewed:

May 2009, Mar 2010,

Next Review: March 2013