Pharmacists work closely with other health practitioners to meet the needs of the public. The various societal needs for pharmaceutical care require that 24 hours pharmacies ( Geoallo pharmacie de garde ) in France provide a wide array of organized services. The primary purpose of this document is to serve as a guide for the provision of pharmaceutical services in hospitals. However, certain elements may be applicable to other health care settings. These Guidelines should also be useful in evaluating the scope and quality of these services.
As providers of pharmaceutical care, pharmacists are concerned with the outcomes of their services and not just the provision of these services. The following accreditation standards and elements of a pharmacy program are critical for overall successful performance in pharmacy practice.
Leadership and Practice Management
Effective leadership and practice management skills are necessary for the delivery of pharmaceutical services in a manner consistent with the hospitals’ and patients’ needs as well as continuous improvement in patient care outcomes. Pharmaceutical service management must focus on the pharmacist’s responsibility to provide pharmaceutical care and to develop an organizational structure to support that mission. The director of the pharmacy shall be responsible for setting the short- and long-term goals of the pharmacy based on the needs of the patients served. In addition he is also required to develop plans and schedules for achieving these goals as well as directing the implementation of the plans and the day-to-day activities associated with them.
Drug information and Education
The pharmacists working in 24 hours pharmacies in France shall provide patient-specific drug information and accurate and comprehensive information about drugs to other pharmacists, other health professionals, and patients as appropriate. Up-to-date drug information shall be available, including current periodicals and recent editions of textbooks in appropriate pharmaceutical and biomedical subject areas. Electronic information is desirable. This information may be provided in conjunction with medical libraries and other available resources. Appropriate drug information resources shall be readily accessible to pharmacists located in patient care areas. No medication should be administered to a patient unless medical and nursing personnel have received adequate information about, and are familiar with, its therapeutic use, potential adverse effects, and dosage.
Pharmacists should be available for and actively participate in patient education. Pharmacists must help to ensure that all patients are given adequate information about the medications they receive. Patient education activities shall be coordinated with the nursing, medical, and other clinical staff as needed. Pharmacists should keep the hospital’s staff informed about the use of medications on an ongoing basis through appropriate publications, presentations, and programs. Pharmacists should ensure timely dissemination of drug product information.
Optimizing Medication Therapy
An important aspect of pharmaceutical care is optimizing medication use in all 24 hours pharmacies in France. This includes processes designed to ensure the safe and effective use of medications and increase the probability of desired patient outcomes. The pharmacist, in concert with the medical and nursing staff, must develop policies and procedures for ensuring the quality of medication therapy. Medical record documentation is one way to enhance an optimized medication therapy. Clinical actions and recommendations by pharmacists that are designed to ensure safe and effective use of medications and that have a potential effect on patient outcomes should be documented in patients’ medical records.
Medications shall be prescribed by individuals who have been granted appropriate clinical privileges in the hospital and are legally permitted to order medications. The pharmacy shall advocate and foster practitioners’ conformance with standardized, approved terminology and abbreviations to be used throughout the hospital when prescribing medications. The only personnel who are authorized by the hospital and appropriately trained shall be permitted to administer medications to a patient. This may include pharmacists and other pharmacy personnel.
Medication Distribution and Control
The pharmacy shall be responsible for the procurement, distribution, and control of all drug products used in the hospital, including medication-related devices and pharmaceutical diagnostics, for inpatient and ambulatory patients. Policies and procedures governing these functions shall be developed by the 24 hours pharmacies in France with input from other appropriate hospital staff and committees. All patient medication orders shall be contained in the patient’s medical record. A direct copy of the prescriber’s order, either hard copy or prescriber-entered electronic transmission shall be received by the pharmacist. Order transmittal safeguards should be used to ensure the security of the prescriber’s order. All medication orders shall be reviewed by a pharmacist and assessed in relation to a medication profile before administration, unless an established procedure exists for the use of a Practice Settings. An approved list of medications for specific treatment circumstances and emergencies must be applied. A system shall exist to ensure that medication orders are not inappropriately continued.
Facilities, Equipment, and Information Resources
To ensure optimal operational performance and quality patient care in 24 hours pharmacies in France, adequate space, equipment, and supplies shall be available for all professional and administrative functions relating to medication use. These resources must be located in areas that facilitate the provision of services to patients, nurses, prescribers, and other health care providers and must be integrated with the hospital’s communication and delivery or transportation systems. Facilities shall be constructed, arranged, and equipped to promote safe and efficient work and to avoid damage to or deterioration of drug products. Medication storage facilities and dentists ( le lien ) shall exist to enable the storage and preparation of medications under proper conditions of sanitation, temperature, light, moisture, ventilation, segregation, and security to ensure medication integrity and personnel safety throughout the hospital.
Designated space and equipment for packaging and compounding drug products and preparing sterile products shall exist. There shall be a suitable work environment that promotes orderliness and efficiency and minimizes potential for contamination of products. Hazardous drug products should be handled with caution. Special precautions, equipment, and training for storage, handling, and disposal of toxic and other hazardous drug products shall exist to ensure the safety of personnel, patients, and visitors.
For 24 hours pharmacies in France to be accredited for commencement of operations, at least the above five standards must be adhered with. However, they may change as deemed necessary by the medical and pharmacy regulation agencies or the government of France.