Dispensing refers to the process of preparing and supplying medicines to a named person together with clear instructions, advice, and counseling where necessary on the use of those medicines. It involves the correct interpretation of the order for prescribed medicines and accurate preparation and labeling of medicines for use by the patient.
Good Dispensing Practice ensures that the right
medicines of desired quality are delivered correctly to the right patient with
the right dose, strength, frequency, dosage form, and quantity, together with
clear instructions, both written and verbal, and with appropriate packaging
suitable for maintaining the quality and efficacy of the medicine.
Adherence to good dispensing procedures is vital in
ensuring that medicines are dispensed correctly and any potential/real errors
which may occur during the dispensing process are detected and rectified before
medicines reach the patient.
Processing the Prescription
Screening:
• On receiving a prescription, it should be screened
and validated to ensure that it is for the correct patient and it complies with
the requirements in the Poisons Act.
• The prescription should be written legibly or
printed.
Interpreting the Prescription Order:
The person receiving the prescription should check for:
• Dose, frequency, and duration.
• Drug interactions, medicine duplication,
polypharmacy, inappropriate drug therapy, contra-indications.
• Allergies.
• Unusual usage and suspected drug misuse or
abuse.
• For partial medicine supply, ensure that the second
or subsequent supply does not exceed the quantity for the duration
prescribed.
Handling Prescriptions which Require
Clarification:
• If an incomplete prescription or one which requires further
clarification is received, attempts must always be made to contact the
prescriber.
• If the prescriber can be contacted and is available
on site, arrange for the incomplete/missing details to be inserted on the
prescription by the prescriber.
• Remedial action for such prescriptions should be
discussed with the prescriber before sending the prescription back to
him/her.
• If the prescriber is not available to amend the
prescription himself/herself, authorization to make the change may be obtained
verbally through the phone.
• If the prescriber cannot be contacted, the patient
should be informed and the prescription must be sent back to the prescriber
with information on the clarification/action needed.
• Prescriber should document any changes made to the
patient’s medical record.
Preparing the Medicines
Selecting the Medicines:
• When selecting the medicine to be dispensed, prevent
any medication errors by establishing an appropriate system to ensure that the
correct medicine is selected, especially if there are medicines with similar
names and packaging.
• Pick the medicine by reading the label at least
twice and cross-checking the medicine name and strength against the
prescription.
• If a barcode system is available, it should be used
to enable the correct and accurate election of the medicine.
• Check the expiry date of dispensed medicines to
ensure that they remain unexpired for the duration of the supply course.
• Medicines should be dispensed in the original
packaging as far as possible.
• Tablets/capsules should not be removed from the
strip/blister when dispensing.
• Bulk loss packs for supply are not encouraged.
• Avoid direct contact with the hand if loose packs
are to be used.
• Medicines that need to be packed such as loose
capsules/tablets should be packed into a clean, dry container, such as; a
bottle or plastic envelope which will not compromise the quality of the product
after dispensing.
Counter-Checking
• Counter-checking should be done by a second person,
other than the staff who did the previous filling and labeling tasks.
• Check all the medicines prepared for dispensing
against the prescription.
• Once the counter-checking is done, the person performing this task should initial on the prescription.
Recording
• Proper record keeping is an essential part of
dispensing as it facilitates good management and monitoring of services
provided. Such records can be used to verify the stocks used in dispensing and
will be required if a need arises to trace patients dispensed with a particular
medicine.
Issuing Medicines to the Patient
• Issuing or supply of medicine should only be done by
a registered pharmacist.
• When dispensing the medicines, ensure the 5 R’s.:
- Right Patient
- Right Medicine
- Right Dose
- Right Route
- Right Time
• Ask about allergies or known adverse drug reactions
(ADR).
• Give clear instructions and proper advice on how to
take/ use the medicines dispensed.
• Ensure the patient is made aware if there are special
requirements during transportation, proper storage conditions, and usage
requirements for the medicines.
Medication Counseling
• Where necessary, provide medication counseling to
patients to ensure proper use of medicines dispensed.
• It is encouraged to counsel patients with chronic
diseases on multiple medications.
• Maintain records of the counseling done.