S100 Pharmacist Site Visit Report

• Document No.

• S100 Pharmacist Site Visit Report

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Clinic Staff Involved?

• Primary Health Care - Remote policies and procedures re provided in the Remote Health Atlas. The Pharmacy and Pharmacy Forms web pages provide detailed pharmacy related documents.

Section 1 - Audit

Drug Storage Room

• Is the drug room secure?

  Yes

  No

  N/A

• Is the drug room air conditioned (<25 deg C) 24 hours per day?

  Yes

  No

  N/A

• Is there adequate shelving and storage?

  Yes

  No

  N/A

• Is the drug room laid out according to SDL categories?<br>- Refrigerated<br>- S8 & RS4 drug safe<br>- Oral<br>- Injectable<br>- Topical<br>- infusion<br>- Inhalational<br>- Non-drug

  Yes

  No

  N/A

• Are medication information posters displayed?<br>- Approved Section 250 medicines<br>- Sedation earning label poster<br>- Antibiotic table

  Yes

  No

  N/A

• Is there a networked computer and label (zebra) printer available and working?

  Yes

  No

  N/A

• Is dispensing equipment present and in good working order? <br>- labels<br>- cautionary labels<br>- time of administration ( sun and moon) stickers<br>- paper bags<br>- purified water<br>- Measuring cylinder<br>- medicine cups<br>- paper cups<br>- syringes <br>- dosette boxes<br>- pill cutters<br>- pestle and mortar<br>

  Yes

  No

  N/A

• Are tamper evident bags available for return of unwanted S8 & RS4 medicines?

  Yes

  No

  N/A

• Are client specific chronic condition medications stored appropriately?

  Yes

  No

  N/A

• Are dose administration aids stored appropriately?

  Yes

  No

  N/A

• Is there a folder present for containing all valid client prescriptions

  Yes

  No

  N/A

• Any additional comments regarding the Drug Storage Room

Stock Management

• Are all mandatory Standard Drug List (SDL) items stocked?

  Yes

  No

  N/A

• Is each SDL item organised neatly behind the the corresponding shelf label? I.E only the correct form and strength are present behind each label)

  Yes

  No

  N/A

• Are stock labels appropriate for the size of the health centre?

  Yes

  No

  N/A

• Is stock rotation adhered to?

  Yes

  No

  N/A

• Are all stock items in date (not expired)

  Yes

  No

  N/A

• Is the agreed ordering process in place and adhered to, including procedures for regular order and urgent orders?

  Yes

  No

  N/A

• Are imprest order forms/ electronic ordering system up to date with all current SDLs and local additional items?

  Yes

  No

  N/A

• Is the Return of Unwanted Medicines bin in use?

  Yes

  No

  N/A

• Is there an adequate supply of client prescription medication (chronic med, DAAs)

  Yes

  No

  N/A

• Are DAAs and chronic medications current against the valid current prescription?

  Yes

  No

  N/A

• Are DAAs in date? ( to be discarded 6 months from packing)

  Yes

  No

  N/A

• Any comments regarding Stock Management

Cold Chain

• Where are vaccine / medication fridges located?

• If vaccine/medication fridges are located outside the drug storage area, are they locked when unattended?

  Yes

  No

  N/A

• Are vaccines stored in a purpose built, temperature controlled, monitored refrigerator?h

  Yes

  No

  N/A

• Are medicines requiring refrigeration store in a purpose built, temperature controlled, monitored refrigerator/ dedicated temperature monitored refrigerator?

  Yes

  No

  N/A

• Is the power point for each vaccine/medication refrigerator identified to avoid accidental disconnection?

  Yes

  No

  N/A

• How many days in the last month was the refrigerator temperature monitored and recorded on the vaccine cold chain graph correctly? (twice a day on weekdays)

• Is there an additional digital maximum/minimum thermometer used in each refrigerator?

  Yes

  No

  N/A

• Are cold chain monitoring cards used correctly?

  Yes

  No

  N/A

• Are freeze alert monitors used correctly?

  Yes

  No

  N/A

• Are items store correctly with adequate space between items to allow for it flow?

  Yes

  No

  N/A

• Are stock management standard adhered to, including appropriate stock levels, stock rotation and expiry check?

  Yes

  No

  N/A

• Any other comments regarding cold chain

Schedule 8 (S8) & Restricted S4 (RS4) Medicines

• Are S8 medicines secured in an S8 drug safe located in the drug storage room?

  Yes

  No

  N/A

• Are RS4 medicines secured in an S8 drug safe or dedicated lockable cupboard located in the drug storage room?

  Yes

  No

  N/A

• Is access to S8 & RS4 medicines limited to clinicians registered under AHPRA?

  Yes

  No

  N/A

• Is the S8 drug safe key kept in the possession of the responsible clinician?

  Yes

  No

  N/A

• Is a 2nd key in the possession of the PHCM?

  Yes

  No

  N/A

• Are stock of S8 & RS4 medicines in accordance with the SDL and approved local additions?

  Yes

  No

  N/A

• Are client dispensed S8 & RS4 medicines correct against a current valid prescription?

  Yes

  No

  N/A

• Are stock management standard adhered to, including appropriate stock levels, stock rotation and expiry check?

  Yes

  No

  N/A

• Is the S8 &RS4 Drug Register maintained in a neat and ordered manner and is in accordance with MPTGA, MPTGR & PHCM Remote policy?

  Yes

  No

  N/A

• Ia a checked and correct count recorded in the S8 &RS4 register at least weekly?

  Yes

  No

  N/A

• Is a checked and correct count by the pharmacist and another clinician completed during this visit?

  Yes

  No

  N/A

• For S8 & RS4 orders that are dispatched from the pharmacy, have they been received and approached paperwork retained?

  Yes

  No

  N/A

• Are unwanted / expired S8 & RS4 medicines disposed of appropriately and documentation recorded and retained

  Yes

  No

  N/A

• Any comments regarding S8 & RS4 Medicines

Standard Reference List

• Are the current editions of all mandatory medicines references accessible?<br>- CARPA STM (1 per clinical area)<br>- Women's Business Manual (1 per clinical area)<br>- Clinical Procedures Manual (1 per clinical area where procedures performed)<br>- Additional Cliivl Protocols Manual (1 per Heath Centre Emergency room)<br>- Australian Medicines Handbook (current/ previous year edition)<br>- Australian Immunisation Handbook (latest edition)<br>- injectable Drugs handbook ( one per health centre)<br>- medicines book for Aboriginal Health Workers ( one per health centre)<br><br><br><br>

  Yes

  No

  N/A

• Any comments regarding standard reference list

Section 2 - Related Activities

Client Medication Review

• Number referred - Number Completed- Was feedback given to the Medical Practitioner?

In-Service Training

• Topics

• Attendees

General comments and follow up

• Signature

  Sign