Medicines should be placed so that the right medicine can be quickly found.

In the department at the post, medications are stored in a special cabinet (under lock and key) on separate marked shelves depending on the route of administration (internal, external, for injection).

Medicinal substances that decompose in light(therefore they are produced in dark bottles) and stored in a place protected from light.

Flammable substances are stored separately - alcohol, ether, dressings, instruments, strong-smelling medications (iodoform, Lysol), disinfectants.

Strong smelling medicines are stored separately.

Perishable medicines (infusions, decoctions, mixtures), as well as ointments, vaccines, serums are placed in a refrigerator intended for storing medicines. The shelf life of infusions, decoctions and mixtures in the refrigerator is no more than 3 days. Signs of unsuitability of such dosage forms are cloudiness, discoloration and appearance unpleasant odor. Ointments are considered unsuitable if they appear following signs: discoloration, delamination, rancid odor.

It should be remembered that tinctures, solutions, extracts prepared with alcohol become more concentrated over time due to the evaporation of alcohol. Therefore these dosage forms should be stored in bottles with tightly ground stoppers or well-screwed caps.

Powders and tablets that have changed their color are unsuitable for use.

Vaccines, serums, antibiotics, water infusions and decoctions must be stored in a refrigerator specially designated for this purpose at a temperature of +2 - +4°C.

Poisonous and narcotic medicines (sublimate, morphine, promedol, etc.) are stored in metal cabinets or safes attached to the floor and wall, which must be locked. On the inside of the safe or cabinet doors there must be the inscription “A” and a list of poisonous and narcotic drugs. medicines indicating the highest single and daily doses. Hard-to-find and expensive items are also stored in the safe.

After the end of the working day, metal cabinets or safes are sealed or sealed. The keys and seal are kept by persons authorized to do so by order of the healthcare institution, under conditions that ensure their complete safety. At night, the keys are handed over to the doctor on duty or the nurse on duty, which is recorded in a special journal and signed by the persons who handed over and accepted the keys and supplies of the specified medications.

Stocks of narcotic drugs in departments should not exceed a 5-day need for them, and psychotropic drugs - 7 days.

Medicines containing narcotic substances, as well as drugs that have an intoxicating effect, are subject to substantive and quantitative accounting in special book, numbered, laced, sealed with the signature of the chief physician and the seal of the medical institution:

Narcotic drugs are used as prescribed by a doctor by a treatment or ward nurse with a note about their administration in the medical record of the inpatient and the medical prescription sheet. If part of the dose is administered, a note is made about the time of administration and dilution, destroying the remaining amount in the hospital patient's medical record. Records are confirmed by the signature of the doctor and nurse

Used ampoules of narcotic drugs are submitted with a report on the same day, with the exception of weekends and holidays, a person authorized to do so by order of the chief physician of the institution.

The fact that nurses hand over empty ampoules of narcotic drugs is recorded in a special book, numbered, laced, sealed and signed by the head of the institution according to the form.

Remember!

The refrigerator and cabinet with medicines must be locked with a key.

At the nurse’s station, as well as in the treatment room, there must be a safe for storing List A and List B medications.

A nurse does not have the right:

– change the form of medicines and their packaging;

– combine identical medicines from different packages into one;

– replace and correct labels on medicines;

– store medicines without labels.

Drawing up a delivery note for receiving medicines from a pharmacy

1. Requirements are written out by the head nurse of the department.

2. The requirement is written out on forms (form 026-AP), bearing the stamp of the medical institution, certified by the seal of the medical institution, signed by the head of the department, the chief physician of the medical department or his deputy (see sample).

3. Requirements are numbered in order from the beginning of the year and are written out at the medical institution in triplicate, if the medical institution is supplied from the hospital pharmacy (1 copy remains in the pharmacy, the 2nd - with the head nurse of the department, the 3rd is transferred to the accounting department ).

4. For poisonous, narcotic, expensive medications, ethanol requirements are written out in four copies.

5. The requirements indicate the full name of the drug, packaging, dosage, dosage form, packaging and quantity (these details are extremely necessary, as they allow you to determine the cost of the drug).

6. A separate requirement is drawn up for finished medicinal products, extemporaneous, for dressings, for narcotic drugs, for medicinal products subject to quantitative accounting, for poisons, and pure ethyl alcohol.

7. To obtain narcotic drugs, the name of the drug in the request is written on Latin, underlined in red pencil, the quantity is indicated in numbers and in words, the medical history number, last name, first name, patronymic of the patient for whom this remedy is prescribed are indicated. For emergency room, traumatology, surgery, intensive care units it is allowed to prescribe narcotic substances without indicating the medical history number with the note “for the provision of emergency assistance» taking into account the 5-day requirement.

An important factor influencing the quality of service medicinal assistance in the conditions of a medical institution, is to comply with the requirements for storage conditions of medicines and products medical purposes at all stages of their promotion: from the pharmacy to the patient. Meanwhile, analysis of the existing legal framework revealed that all documents are focused, as a rule, on retail pharmacies and wholesale organizations, and the information for medical institutions and pharmacies of healthcare institutions (hospital pharmacies) present in them is fragmentary.

medicinal storage medical legal

Rules for storing medicines and medical products

The head of the department (office) is responsible for the storage and consumption of medicines and medical products, as well as for order at storage sites, compliance with the rules for issuing and prescribing medicines. The direct executor of organizing the storage and consumption of medicines and medical products is the senior nurse.

In rooms where medicines are stored, a certain temperature and humidity must be maintained. Checking the compliance of their condition with established requirements is carried out at least once a day based on the indicators of hygrometers and thermometers, its results are reflected in special log books.

Storage of medicines in departments (offices) must be organized in locked cabinets, and the storage conditions for medicines are given on the packaging of each dosage form. Provision is made for placement in storage areas, taking into account the division into groups: toxicological - narcotic drugs, psychotropic substances, potent and poisonous drugs; by method of application: “External”, “Internal”; by release form: “Injection”, “ Eye drops" and etc.; pharmacotherapeutic: “Hypotensive”, “Hypertensive”, “Diuretic”, as well as according to the physico-chemical properties of drugs and the effect various factors external environment. In addition, in each compartment of the cabinet (for example, “Internal”) there should be a division into powders, mixed urns, ampoules, tablets, which are placed separately, and powders and tablets are stored, as a rule, on the top shelf, and solutions - on the bottom .

Odorous and coloring substances should be placed in a separate cabinet, and medicines that require storage in a cool place should be placed in refrigerators equipped with thermometers.

Storage of medications in the operating room, dressing room, and treatment room is organized in instrumental glass cabinets or on surgical tables. Each bottle, jar, and package containing a medicinal product must have an appropriate label.

Narcotic drugs and psychotropic substances, potent and toxic substances must be stored in sealed or sealed safes. In technically fortified premises, it is allowed to store narcotic drugs and psychotropic substances in metal cabinets. Safes (metal cabinets) must be kept closed. After the end of the working day, they must be sealed or sealed. Keys to safes, seals and seals must be kept by financially responsible persons authorized to do so by orders of health authorities or institutions.

Narcotic drugs and psychotropic substances, potent and toxic substances received by shift medical personnel must be stored in a closed and sealed safe attached to the floor or wall in a specially designated room.

On the inside of the safe door there should be a list of narcotic drugs and psychotropic substances indicating the highest single and daily doses.

Narcotic drugs and psychotropic substances for parenteral, internal and external use should be stored separately.

Health care facilities must have tables of the highest single and daily doses of narcotic drugs and psychotropic substances, as well as tables of antidotes for poisoning with them, in storage areas and at the posts of doctors and nurses on duty.

In the departments and offices of health care facilities, all narcotic drugs and psychotropic substances are subject to quantitative recording by the head nurse, by the head nurse, at posts and in treatment rooms.

Medicines included in lists “A” and “B” (regardless of the dosage form) are stored separately, in locked metal cabinets under lock and key (list “A”) and in wooden cabinets under lock and key (list “B”).

On the inside of the doors of the cabinet in which medicines of list “A” are stored there must be the inscription “A”, and on the inside of the doors of the cabinet in which medicines of list “B” are stored there must be the inscription “B” and lists of drugs in list “A” ” and “B” indicating the highest single and daily doses.

Medical products should be stored separately in groups: rubber products, plastic products, dressings and auxiliary materials, medical equipment products.

Lecture

Subject: " Rules for prescribing, storing and distributing medicines in the department"

Prescribing medications in medical department

Main document drug therapy patients for the nurse - a sheet of medical prescriptions.

Form of medical prescription sheet:

Appointments	Exec.	Assignment and completion notes
date
Mode
Diet
	Doctor
	Sister
	Doctor
	Sister

The sheet is filled out by the patient’s attending physician after the daily round. Guard and nurses treatment room Every day after visiting the doctor, they make a selection from the sheets of medical prescriptions. For drugs that are missing or available in insufficient quantities, a requirement is issued: the name, dose, and required quantity are written in Russian. The requirements are submitted to the head nurse of the department, who summarizes them, writes out a single requirement, and signs it with the manager. department and takes it to the pharmacy.

Requirements for poisonous, narcotic drugs and ethyl alcohol are prescribed in Latin, on special forms with a stamp, seal and signature of the head of the medical facility or his deputy for the medical department. In addition to the name, the route of administration of the drug and the concentration of ethyl alcohol are indicated. Requests for poisonous, narcotic and acutely scarce drugs indicate the medical card number, full name. the patient and his diagnosis.

The head nurse receives ready-made dosage forms daily or on certain days according to the schedule, and drugs prepared in the pharmacy - the next day.

Upon receipt, checks: the compliance of the drugs with the application, the names on the labels, the presence of concentration and dosage indications. In addition, the production date, the integrity and tightness of the packages, and the signatures of the persons responsible for the manufacture of medicines are checked. Drugs prepared in a pharmacy must have a label indicating the name, dose, quantity of the drug, date of preparation and the name of the pharmacist. Depending on the method of use of the medicine, the labels should be of a certain color:

· yellow – for external use;

· white - for internal use;

· blue – for parenteral injection use.

In the department, the head nurse issues medications for 3 days to the guard and procedural nurses, according to the submitted requirements. It is prohibited to trust the receipt of medications to strangers.

When receiving medications, you must pay attention to the integrity of the packaging, consistency of name and dose, and expiration date. Dosage forms prepared in a pharmacy must have a label of the appropriate color, which, in addition to the name, dose and quantity of the drug, must contain the date of preparation and the name of the pharmacist.

Storage of medicines in the department

Responsibility for the consumption and storage of medications in the medical department is carried out by the head. department. Elder sister carries out management and control over the use and safety of medications in the medical department. Guard and procedural nurses are responsible for storing medications at their workplaces.

The placement of medications is carried out according to toxicological groups:

Ø list A - poisonous (atropine, arsenic, strychnine, mercury preparations ) and narcotic (morphine, omnopon, fentanyl, promedol ) ;

Ø list B - potent (clonidine, barbital);

Ø medicines from the general list - dispensed without a doctor's prescription - drugs from the general list (acetylsalicylic acid).

Storing medications at the post:

preparations for external and internal use are stored on nurse's station in the medicine cabinet;

· medicinal products are located on separate marked shelves: “For external use”, “ Internal use»;

· for quick search the right drug Medicines are systematized according to their intended purpose and placed in separate containers: “Antibiotics”, “Hypotensives”.

· during storage, it is necessary to take into account the physicochemical properties of medications:

ü products that decompose in light should be in a dark glass container and stored in a place protected from light,

ü strong-smelling products should be located separately from the rest,

ü tinctures and extracts are stored in bottles with ground stoppers and tight lids,

ü perishable products (potions, suppositories, infusions, decoctions, ointments) should be stored in a refrigerator for medicines: on different shelves of the refrigerator, T ranges from +2 0 C to +10 0 C; The storage temperature of the drug is indicated on the packaging;

· the nurse must monitor the storage of medications, remove drugs that have expired and show signs of unsuitability:

ü powders and tablets – change in color, structure,

ü decoctions, mixtures - color change, cloudiness, appearance of flakes and unpleasant odor,

ü ointments – discoloration, delamination, rancid odor;

· shelf life of infusions, mixtures, sterile solutions from a pharmacy is no more than 3 days, eye drops– no more than 2 days; sterile solutions by metal rolling – 30 days;

· the nurse is prohibited from storing medications without labels, correcting packaging and labels, transferring medications from different packages into one, changing the form of the medication;

· the cabinet and refrigerator for storing medications must be disinfected on schedule;

· the cabinet and refrigerator are locked with a key, preventing access to medications by patients and other unauthorized persons.

Storing medications in the treatment room:

· in a glass cabinet on marked shelves, packs for emergency measures, antibiotics and their solvents, boxes with ampoules of drugs included in the general list of drugs, sterile solutions in factory-made bottles are stored;

· solutions prepared in a pharmacy, blood products and products in original packaging that require a certain temperature regime are stored in the refrigerator;

· List A and B drugs are stored in a safe.

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Order No. 646n in paragraph 3 gives the head of the subject of circulation of medicinal products (hereinafter referred to as medicinal products) the obligation to provide a set of measures to ensure that employees comply with the rules for storing and (or) transporting medicinal products. Under the subject of treatment in in this case means any of the organizations that are subject to the said order, including a medical organization and its separate divisions (outpatient clinics, paramedic and paramedic-obstetric stations, centers (departments) of general medical (family) practice) located in rural areas populated areas, in which there are no pharmacy organizations. It follows from the above that every medical organization involved in the storage of medicines must, starting in 2017, comply with the “new” rules for good storage practices.

A set of managerial measures medical organization is called a quality system and includes the most various activities to ensure compliance with the Storage and Transportation Rules. In particular, to implement a quality system for storing medicinal products, a medical organization requires:

1. Approve regulations for employees to perform actions during the storage and transportation of medicines.
2. Approve procedures for servicing and checking measuring instruments and equipment.
3. Approve the procedure for maintaining entries in journals and reporting procedures.
4. Organize control over compliance with standard operating procedures.

At the same time, the new rules for storing and transporting medicines require the head of a medical organization to approve additional documents regulating the procedure for receiving, transporting, and disposing of medicines. These actions are called standard operating procedures.

Approval of regulations (standard operating procedures) for employees to perform actions during the storage and transportation of medicines

To introduce a quality system and implement standard operating procedures, the head of a medical organization issues an order and instructs the responsible person to develop and submit for approval regulations (instructions) for performing various actions during drug storage. The Rules for Good Storage Practices have not established a specific list of such instructions. Taking into account the “breakdown” of standard operating procedures for the reception, transportation and placement of drugs, it is advisable to divide the process of storing drugs in a medical organization into the same stages and detail each stage in the instructions, for example, approve the following documents:

1. Instructions for accepting medications from the carrier

Instructions on the procedure for taking medicines from the carrier (transport organization) must set out a list of actions of an employee of a medical organization upon receipt of a batch of medicines and contain instructions on what circumstances the employee should clarify when preparing documents for each batch of medicines. Thus, the employee should be aware that, in accordance with the Good Storage and Transport Practices, drugs with a shorter expiration date are released for transportation first. The remaining shelf life is agreed upon with the recipient of the medicine in preparation for transportation. If the remaining shelf life of the drug is short, when agreeing to receive the drug, it is better for the medical organization to refuse such a delivery in order to avoid subsequent write-off of the entire received batch.

When accepting a drug, the employee must check the compliance of the drug being taken with the accompanying documentation in terms of assortment, quantity and quality (checks the name, quantity of drugs with the delivery note or delivery note and invoice, checks appearance containers).

As part of standard operating procedures, a medical organization, before taking medications, must plan the transportation of medications, analyzing and assessing possible risks. In particular, before delivery, the carrier finds out whether the medicine has special storage conditions and whether the carrier will be able to provide them during transportation. Although this is the responsibility of the carrier and not the medical organization, the latter also has an interest in ensuring that the transport company is aware of the conditions for transporting a particular drug in order to obtain it suitable for use. In this connection, it is recommended to provide, upon the carrier’s request, full information about the qualitative features of medicinal products, the conditions of their storage and transportation, including temperature, lighting, requirements for containers and packaging.

We should also pay attention to the packaging. A worker involved in taking medications should pay attention to the quality of the container, as well as the presence on the container of information about the name, series of drugs being transported, the date of their release, the number of packages, the name and location of the drug manufacturer, their expiration date and conditions of storage and transportation. . The absence of this information may indirectly indicate possible violations conditions of transportation or even about counterfeit goods. If discrepancies or damage to the container are detected, the drugs should not be taken - they must be returned to the supplier with the drawing up of an appropriate report and the implementation of the return procedure provided for in the contract. An employee of a medical organization must be instructed on the procedure for completing the procedure for returning such a product.

According to the new Rules of Good Practice for Storage and Transportation, carrier employees sent on a flight are instructed on the procedure for preparing insulated containers for the transportation of medicines (taking into account seasonal characteristics), as well as on the possibility reuse cold elements. In addition to the new transportation rules, they must take into account the instructions for the drugs, as well as the conditions of transportation mentioned in other regulations. For example, the conditions for transporting immunobiological medicinal products are contained in SP 3.3.2.3332-16, approved. Resolution of the Chief State Sanitary Doctor of the Russian Federation dated February 17, 2016 N 19, which, among other things, strictly prohibits the use of “cold chain” equipment for the joint transportation of the specified drugs and food products, other drugs, raw materials, materials, equipment and items that may affect the quality of the transported drugs or damage their packaging. When transporting medical products, the readings of each temperature indicator must be monitored during loading and unloading of drugs; the readings are recorded in a special journal for recording the movement of medical products twice a day - at the first, second and third levels of the “cold chain”, and once a day on working days - at fourth level. Also in the log should be noted facts of planned or emergency shutdown of refrigeration equipment, breakdowns and violations of temperature conditions.

IN real life Of course, one cannot rely on the carrier’s strict compliance with the specified obligations to instruct its employees, as well as on the responsible attitude of such employees to the performance of their labor functions. During transportation, it is difficult to exclude the human factor, which entails a violation of the conditions of transportation - in order to save money, faulty cold elements are used several times, food and other raw materials are placed along with medicines, the temperature is entered into the log “as you please,” usually right before arriving at the recipient of the medicine. There are cases when the carrier’s refrigeration equipment is not equipped with thermometers at all or they do not work, always showing the same value. It happens that an arriving car technical specifications or, due to the route laid out, obviously could not meet the temperature requirements, but was released transport company on the flight.

Although transportation rules require that information about cases of violation of the temperature storage conditions and damage to packaging identified during the transportation of a medicinal product be communicated to the sender and recipient of the medicinal products, in practice, of course, this requirement is not always observed. Carriers do not want to accept the risk of compensation for damage caused due to non-compliance with transportation rules and may seek to conceal this information.

All these points must be taken into account when accepting the medicine and noted in the instructions of the employee of the medical organization that if there are reasonable doubts about compliance with the temperature regime and other conditions during transportation, the identified circumstances should be reflected in documentary form and reported to management. The new storage rules give a medical organization the right to send a request to the supplier demanding confirmation of the circumstances of compliance with the conditions of transportation of a particular drug. If such confirmation is not received, the organization has the right to refuse to accept medications delivered in violation of the conditions of transportation.

2. Instructions for placing (transporting) medicinal products into the storage area

The instructions should reflect that when an employee accepts medications, the transport container is cleared of visual contamination - wiped, dust, stains, etc. are removed, and only after that is brought into the premises or storage area of ​​the medicine, and further storage of the medicine is carried out taking into account the requirements registration dossier for medicinal products, instructions for medical use, information on packages, on shipping containers.

The instructions should describe the rules for disposing of medicinal products, taking into account the Rules for Good Storage Practices. It is worth noting and conveying to the employee what not to do: for example, placing medications on the floor without a pallet, placing pallets on the floor in several rows, storing with medications food products, tobacco products, etc.

Since, in accordance with the Rules of Good Storage Practice, racks (cabinets) for storing medicinal products must be marked, must have rack cards located in the visible area, and ensure the identification of medicinal products in accordance with the accounting system used by the subject of medicinal products circulation, in the storage instructions drugs and job description The employee must reflect the responsibility for labeling racks (cabinets) and filling out rack cards.

If a medical organization uses an electronic data processing system instead of rack cards, the employee must be required to fill out data in such a system. New storage rules allow the identification of drugs in such a system using codes. This means that there is no need to enter the full names of the types of drugs or their locations each time - it is enough to assign a code for a particular value and approve a code correspondence table, which greatly simplifies office work.

Because in rooms and areas must be maintained temperature conditions storage and humidity corresponding to the storage conditions specified in the registration dossier of the medicinal product, instructions for medical use and on the packaging; the instructions for placing medicinal products should mention the placement of drugs in accordance with the specified regimes and the obligation to monitor changes in temperature and humidity by the employee.

The same instructions may reflect the procedures for cleaning premises (areas) for storing medicines - they are carried out in accordance with standard operating procedures that are the same for all subjects storing medicines. In this case, standard operating procedures mean the measures described in section 11 of SanPin 2.1.3.2630-10 “Sanitary and epidemiological requirements for organizations carrying out medical activities"- these measures are the same for all premises of a medical organization (with some exceptions): treatment at least 2 times a day, spring-cleaning at least once a month, washing windows at least 2 times a year, etc. In the storage instructions, you can simply make a reference to the instructions for wet cleaning of premises of a medical organization, so as not to clutter the document with unnecessary information.

An employee of a medical organization must be instructed that persons who do not have access rights determined by standard operating procedures are not allowed into the premises (areas) for storing medicinal products, i.e. faces, job responsibilities which are not related to the administration, transportation, placement and use of drugs.

3. Instructions for storing medications that require special storage conditions

This document should examine point by point the features of storing various categories of drugs, for example, it should be noted that flammable and explosive drugs are stored away from fire and heating devices, and workers must avoid mechanical impact on such drugs. It should be stated in the instructions that medicines subject to subject-quantitative accounting, with the exception of narcotic, psychotropic, potent and poisonous medicines, are stored in metal or wooden cabinets, sealed or sealed at the end of the working day. The list of such drugs is established by Order of the Ministry of Health of Russia dated April 22, 2014 N 183n; an employee of a medical organization must know this list and be able to sort medications taking into account the specified list.

Medications containing narcotic drugs and psychotropic substances must be stored in accordance with the law Russian Federation O narcotic drugs and psychotropic substances - first of all, taking into account the requirements of Order of the Ministry of Health of Russia dated July 24, 2015 N 484n. Thus, this Order prescribes the storage of narcotic and psychotropic medicines in premises belonging to the 4th category, or in places of temporary storage in safes (containers) located in the appropriate premises or places. Therefore, the employee who is given the keys to the safe must be identified. Typically, such an employee is a financially responsible person and receives a key “on signature.” The instructions should note the inadmissibility of handing over the keys to strangers, the procedure for handing over the key to the post and the prohibition on taking the keys home.

The said order also indicates that at the end of the working day, narcotic and psychotropic medicines must be returned to the place of main storage of narcotic and psychotropic medicines - medical worker it should be obligatory to verify compliance with this requirement and reflect the procedure for action when a shortage is detected.

In medical organizations internal sides On the doors of safes or metal cabinets where the specified drugs are stored, lists of the stored drugs should be posted indicating their highest single and highest daily doses. Additionally, in medical organizations, tables of antidotes for poisoning with these drugs are placed in storage areas. It would be correct to assign to a specific employee the responsibility for generating these lists and monitoring the relevance of the information contained in them.

Medical organizations must store narcotic and psychotropic drugs manufactured by drug manufacturers or pharmacy organization, therefore in the instructions you can note the inadmissibility self-made employee of such drugs. The safe or cabinet with the specified drugs is sealed or sealed at the end of the working day - the sealing procedure must also be reflected in the instructions.

Storage of medicinal products containing potent and toxic substances controlled in accordance with international legal norms, is carried out in premises equipped with engineering and technical means security similar to those provided for the storage of narcotic and psychotropic drugs. The list of such drugs is contained in Decree of the Government of the Russian Federation of December 29, 2007 N 964. Taking into account these requirements, a medical organization must provide a security alarm, familiarize employees with the principles of its operation, appoint an employee responsible for servicing this system (personal service or with the help of a third party). organizations under contract).

Medicines are prescribed in accordance with the Order of the Ministry of Health and social development RF dated December 14, 2005 N 785 “On the procedure for dispensing medicines.”

The doctor, conducting a regular examination of patients undergoing treatment in a hospital, writes down in the “Inpatient Medical Card” and in the “Medical Prescription Sheet” the medications required for the patient, their doses, frequency of administration and route of administration. Information about injections prescribed to patients is transmitted to the treatment room. The list of necessary medications is provided to the ward and procedure nurses by the senior nurse department, which summarizes this information and issues a request in two copies according to a certain form (on special demand forms) to receive medicines from the pharmacy of the medical institution.

The names of medicines in the demand forms are written in Latin, indicating the concentration, quantity (volume), and method of administration. The forms are certified by the seal and signature of the head of the medical institution or his deputy for the medical department.

The head nurse receives ready-made dosage forms available in the pharmacy according to the MO schedule (daily or once every three days), and dosage forms that require preparation (infusions, decoctions, etc.) are received after their manufacture.

When receiving medications at the pharmacy, the head nurse checks that they comply with the order. Medicines manufactured in a pharmacy must have labels of a certain color:

Ø blue – on solutions for parenteral administration;

Ø white – on means for oral administration;

Ø yellow – on products for external use.

The label must contain a clear name of the drug with a dose designation, date of manufacture, expiration date, storage conditions, and the signature of the pharmacist who prepared the drug.

The department contains a three-day supply of necessary medications.

At the nurse's post Medicines are stored in a locked cabinet, distributed according to the method of administration on various shelves, respectively marked: “external”, “internal”, “inhalation”. Solid, liquid and soft dosage forms must be placed separately on the shelf.

Medicines that decompose in light are released in dark vials and stored in a place protected from light.

Rules for prescribing, accounting and storage of narcotic, potent, acutely scarce and expensive medicines. Storage of drugs listed “A” and “B”. Routes of drug administration.

The rules for storing medicines in departments are carried out in accordance with Order No. 706n dated August 23, 2010 of the Ministry of Health and Social Development of the Russian Federation “On approval of the rules for storing medicines”.

Strongly smelling medicines are stored separately.

Tinctures, solutions, extracts prepared with alcohol become more concentrated over time due to the evaporation of alcohol, so these dosage forms must be stored in bottles with tightly ground stoppers.

Powders and tablets that have changed color are not suitable for use.

Perishable medicines (infusions, decoctions, mixtures), as well as ointments, suppositories are placed in a refrigerator designed for storing medicines. On different shelves of the refrigerator, the temperature ranges from +2 (on the top) to +10 o C (on the bottom). The temperature at which the medicine should be stored is indicated on the packaging. The shelf life of infusions and mixtures in the refrigerator is no more than 3 days. Signs of the unsuitability of such medicines are cloudiness, color change, and the appearance of an unpleasant odor.

The refrigerator and cabinet with medicines must be locked with a key.

At home, a separate place should be allocated for storing medicines, inaccessible to children and people with mental disorders. But at the same time, medications that a person takes for heart pain or choking should be available at any time.

In the treatment room Sterile solutions in ampoules and vials are stored in a closet. On one shelf there are antibiotics and their solvents, on the other - bottles for drip administration of liquids with a capacity of 200 and 500 ml, on other shelves - packages with ampoules - solutions of vitamins, dibazol, papaverine, etc. Vaccines, serums, etc. are stored in the refrigerator at a certain temperature. insulin, etc.

The shelf life of solutions prepared in a pharmacy for parchment rolling is 3 days, sterile solutions prepared in a pharmacy for metal rolling is 30 days. If they are not implemented within this time, they must be returned to the head nurse.

Nursing staff has no right:

Ø change the packaging of medicines;

Ø combine identical medicines from different packages into one;

Ø replace and correct the inscriptions on the drug label;

Ø store medicines without labels.

Request forms to the pharmacy for poisonous, narcotic drugs and ethyl alcohol are drawn up in triplicate. Requests for poisonous, narcotic, and expensive drugs indicate the number of the “Inpatient Medical Card”, last name, first name, patronymic, and diagnosis of the patient.

List A includes poisonous and narcotic drugs, list B includes potent drugs. Medicines of lists A and B are stored in safes. On the inside of the safe door there should be a list of medications indicating the maximum single and daily doses.

The transfer of the contents and keys to the safe is registered in the “Journal of transfer of keys and contents of the safe” (date; name of narcotic drugs; full name, signature of the person who handed over; full name, signature of the person who accepted). To record the consumption of medicines stored in the safe, a “Logbook of accounting for narcotic medicines in the office” is kept (date of receipt; where received from, number of documents; quantity; full name, signature of the nurse; date of issue; full name. Patient's statement, card number; number of ampoules used; balance; person responsible for storage and dispensing). All sheets in these magazines must be numbered and laced. To record each drug from list A and list B, a separate sheet is allocated in the journals. These logs are also kept in a safe and filled out according to a certain form.

Nursing staff have the right to open the ampoule and administer a narcotic analgesic to the patient only after the doctor has recorded this prescription in the “Inpatient Medical Record” and in his presence. A record of the completed injection is made in “ Medical card inpatient”, certified by the signatures of the attending physician and nurse indicating the name, dose and time of administration of the drug.

Oral administration of narcotic drugs is also carried out in the presence of a doctor and a nurse and is noted in the “Medical record of an inpatient” according to the same scheme.

The senior nurse of the department also keeps records of the consumption of drugs from lists A and B.

The procedural nurse does not throw away empty ampoules and syringe tubes for narcotic drugs, but stores them in a safe. treatment room and hands it over to the head nurse of the department every day.

When transferring duty, the correspondence of the entries in the accounting log (number of ampoules used and balance) with the actual number of ampoules is checked.

Empty ampoules and syringe tubes for narcotic drugs are destroyed only by a special commission approved by the head of the medical institution.

For violation of the rules for recording and storing medicines of lists A and B medical staff brought to criminal liability.

Rules for the distribution of medicines. Concepts: taking medications “before meals”, “during meals”, “after meals”. Features of taking certain medications with food