PROJECT ON HOSPITAL TRAINING

A Project submitted
In Partial Fulfillment of the
Requirements for the Degree of

BACHELOR OF PHARMACY
by
ARMAN ALAM

Roll no.

(2108820500025)

Under the Supervision of

Mr. AJIT KUMAR

to the

TAHIRA INSTITUTE OF MEDICAL SCIENCES,

GIDA, GORAKHPUR

DR. APJ ABDUL KALAM TECHNICAL UNIVERSITY

LUCKNOW
2024-25

1
 DECLARATION

I hereby declare that the work presented in this report entitled "HOSPITAL
TRAINING", was carried out by me. I have not submitted the matter embodied in
this report for the award of any other degree or diploma of any other University or
Institute.

I have given due credit to the original authors/ sources for all the words, ideas,
diagram, graphica, computer programs, experiments, results that are not my original
contribution. I have used quotation marks to identify verbatim sentences and given
credit to the original authors/ sources.

Name : ARMAN ALAM

Roll no. : 2108820500025

Branch : B.Pharm

Student Signature

2
 ACKNOWLEDGMENT

This thesis is the result of three years of work, during which several people have
played a crucial role in its completion. It is a great pleasure that now have the
opportunity to express my gratitude to all of them.

Above all I thank the almighty for giving me courage to undertake it as my project,
the patience for completing it and for a guide, so supportive, without whom this task
could never have been fulfilled.

I took this opportunity to thank the TAHIRA INSTITUTE OF MEDICAL

SCIENCES College and our secretary MR. SHOEB AHMAD for giving me chance
to do this project.

I would like to thank my principal DR. RAHUL KUMAR MISHRA , Head Of

Department MR. AMIT KUMAR, Coordinator MR. AJAY YADAV, Proctor DR.
SHAHEEN PARVEEN KHAN for providing the necessary facilities required for
completion of this project.

I would also like to express my sincere gratitude towards my project guide MR.
AJEET KUMAR whose guidance and care made this project successful.

I would also like to thank my faculty members Ms SAUMYA MISHRA, MR.

AJEET KUMAR SINGH, Ms. SAMAN FATIMA, MR. VAGHESWAR JAISWAL,
MRS. SANDHYA YADAV, MR . LOKESH BRIND .

ARMAN ALAM

B.PHARM 7th sem

Roll no. 2108820500025

3
 Date:

CERTIFICATION

Certified that ARMAN ALAM (2108820500025) has carried out the work
presented in this project “HOSPITAL TRAINING” for the award of Bachelor of
Pharmacy from Dr. APJ Abdul Kalam Technical University, Lucknow under my
supervision. The project embodies results of work, and studies are carried out by the
student himself / herself and the contents of the project do not form the basis for the
award of any other degree to the candidate or to anybody else from this or any other
University / Institution.

Signature Signature

(Mr.AJEET KUMAR) (Dr. RAHUL KUMAR MISHRA)

(Proctor) (Principal)

(TIMS) (TIMS)

4
HOSPITAL TRAINING PROJECT

5
 INDEX

1. Introduction of Hospital 7

2. List of Hospital staff 8

3. Hospital Pharmacy 9

4. List of Prescription 10

5. Drug storage management in hospital pharmacy 11

6. Disease and their treatment 13

7. Handling of prescription 16

8. Patient Counseling 17

9. Training at hospital 19

10. Conclusion 20

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 INTRODUCTION

The report provides an introduction to health care organization, practice and

policy, presenting an overview of healthcare that emphasizes the interplay between
science, society and individuals. It aims to develop understanding of how
healthcare organizations shape the practices of professionals working within them.
A public or government hospital is a hospital which is owned by a government and
receives government funding. In some countries, this type of hospital provides
medical care free of charge, the cost of which is covered by government
reimbursement. In India, public hospitals (called Government Hospitals) provide
health care free at the point of use for any Indian citizen. These are usually
individual state funded. However, hospitals funded by the central (federal)
government also exist. State hospitals are run by the state (local) government and
may be dispensaries, peripheral health centres, rural hospital, district hospitals or
medical college hospitals (hospitals with affiliated medical college). In many states
(like Tamil Nadu) the hospital bill is entirely funded by the state government with
patient not having to pay anything for treatment.

The main aims of healthcare are:

 Safe: Care should be as safe for patients in health care facilities as in their
homes.
 Effective: The science and evidence behind health care should be applied and
serve as the standard in the delivery of care.
 Efficient: Care and service should be cost effective, and waste should be
removed from the system.
 Timely: Patients should experience no waits or delays in receiving care and
service.
 Patient centered: The system of care should revolve around the patient,
respectpatient preferences, and put the patient in control.
 Equitable: Unequal treatment should be a fact of the past disparities in care
should be eradicated.
Objective of the Internship:-

 Observing comparing, analyzing and commenting on the management of

different pathologies, clinical and preclinical approaches.
 Integrate fully the family medicine service participate in the activates of the
other services.
 Observations of Procedures.
 Rotations in family medicine, internal medicine, pediatrics, obstetrics and
gynecology, surgery, especially pediatric and adult emergencies.

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 LIST OF HOSPITAL STAFF

 Specialized Doctor
 Silent Doctor
 Junior Doctor
 Practitioners
 Pediatric Doctor
 Surgeon
 Physician
 Medical students (house staff)
 Physician Assistant
 Attending physician
 Dentist
 Ophthalmologist
 Chief Pharmacist
 Pharmacist
 Intern Pharmacist
 Nurse Administrator.
 Nurse
 Nurse Practitioners
 Therapist
 Medical Technician
 Medical Staff
 Residents
 Interns
 Health Educator
 Financial analyst
 Patient Advocate
 Patient Care technician
 Ward boys
 Peons
 Sweepers
 X-ray Technician
 OT Technician
 Lab Technician
 MRI Technician
 Store Room Manger
 Patient Service Technician
 Ambulance Controller and Driver

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 HOSPITAL PHARMACY

The practice of pharmacy within the hospital under the supervision of a

professional pharmacist is known as hospital pharmacy.

FUNCTIONS OF HOSPITAL PHARMACY:

 Selection of reliable suppliers.

 Prescribing specifications of the required medicament.
 Manufacturing of sterile or non-sterile preparations.
 Maintenance of manufacturing records Quality control of purchased or
manufactured products.
 Dispensing of medicaments of out-patients.
 Drug information sources in hospitals.
 Centre for drug utilization studies.
 Implement recommendations of the pharmacy and therapeutic committee.
Patient counseling.
 Maintaining liaison between medical, nursing and the patient.

OBJECTIVES OF HOSPITAL PHARMACY :

 To professionalize the functioning of the pharmaceutical services in

hospitals.
 To ensure availability of the required medication at an affordable cost at the
time.
 To plan, organize and implement the policies of the pharmacy.
 To perform functions of management of material, purchase, storage of
items.
 To maintain strict inventory of all items received and issued.
 To counsel the patient, medical staff, nurses and others involved in patient
care on the use of drugs, possible side effects, toxicity, adverse effects, drug
interactions etc.
 To serve as a source of information on drug utilization.
 To manufacture drug, large/small volume parenteral which are critical for
use in patients.
 To participate in and implement the decisions of the pharmacy and
therapeutics committee.
 To organize and participate in research programmers, educational,
programmers.
 To provide training to various members of the patient team on various
aspects of drug action, administration and usage.
 To engage in public health activities to improve the well-being of the
population.
9
 LIST OF PRESCRIPTION

Sr. No. Name of Medicine Dosage Form

ANTIBIOTICS
01 Sifrofloxacine Tablet
02 Norfloxacin Tablet
03 Lioflazacine Tablet
04 Amoxyciline Tablet
05 Ofloxacine Tablet
06 Ampiclacacikine Injection
07 Seftrinezone Injection
08 Solvectome Injection
09 Tejobectome Injection
10 Ofloxacine Syrup
11 Amoxyclacacikine Injection

ANALGESIC ANTI SPASMODIC/ ANTIPYRETIC

01 Paracetamol (pcm) Tablet
02 Nimupara Tablet
03 Diclopara Tablet
04 Aceclopara Tablet
05 Aceclofinac Tablet
06 Aceclofinal Injection
07 Diclofinac Injection
08 Aceclopara Syrup
09 Diclofinal cream Ointment
10 Amicacine Injection

ANTI DIARRHEAL DRUG

01 Tinadazole Tablet
02 ORS Powder
03 Ofloxacine + ornidazole Syrup
04 Metronidazole Tablet

ANTACID
01 Aluminium Hydroxide Syrup
02 Ranitidine Tablet
03 Omeprazole Capsule
04 Pantoprazole Capsule
05 Rabeprazole Capsule

ANTI DIABETIC DRUG

01 Metformin Tablet

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 DRUG STORAGE MANAGEMENT IN HOSPITAL
PHARMACY

OUTPATIENT DEPARTMENT

The OUT-PATIENT DEPARTMENT is located at the Clinical Division. It is a

unit in the hospital where walk-in patients are attended to and treated. Its primary
objective is to render health service at minimal cost. It serves as a training ground
for residence, interns, clerks, and other paramedical trainees.
It likewise provides health education, moral and spiritual guidance to patients and
their relatives. Lastly, it offers opportunities for research.
The objective of OPD Pharmacy Dispensing will be to provide enhanced
standards in its Pharmacy Outpatients Offering within a contract for the provision
of prescribed medication including the provision of outpatient and home delivery
pharmacy dispensing supplies with one provider.

The solutions offered should demonstrate a flexible approach to the delivery of

medication and pharmacy and health related supplies to patients. The principal
activity during the life of the Contract will be the dispensing of Outpatients
Pharmacy prescriptions and ancillary supplies such as home delivery and a near
home prescription collection facility.

 OPD (outpatient department) is defined as a hospital department where

patients receive diagnoses and /or treatment but do not stay overnight. Thus,
OPD treatment is for patients who do not require hospitalization.
 OPD is very important wing of hospital serving as mirror.
 OPD is visited by large section of community.
 First point of contract between patient and hospital staff.
 The human relation skill / public relation functions are of most importance.
 OPD staff should be polite, cheerful, cooperative & efficient.

Types And Role of OPD Services

 Ambulance Care Centre
 Polyclinic
 Health Centre
 Walk-in clinic Day hospital
 Dispensary

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 IN-PATIENT DEPARTMENT

Inpatient care is the care of patient whose condition requires admission to a

hospital. Progress in modern medicine and the advent of comprehensive outpatient
clinics ensure that patients are only admitted to a hospital when they are extremely
ill or have severe physical trauma.

The patients enter inpatient (I.P.D) care mainly from previous ambulatory care
such as referral from a doctor or through emergency departments.

The patient formally becomes an “inpatient” at the writing of an admission ticket.

In patient services, including the ward and nursing staff room and all other facilities
necessary for good patient care.

To provide good care to the patient at the time of illness, a well monitoring drug
therapy are done under a supervision of doctor.. N.N.M.C.O.P. IN Common
Health Centre Dudahi” the Inpatient Department consist of about 100 beds.

These are further divided in following wards:-

 Male Medical Ward

 Female Medical Ward
 Maternity Ward
Paediatric Ward

 Burn Ward/Isolation Ward

 T.B & Leprosy Ward Surgical Ward

Surgical Ward

 JE & A.E.S Ward

 Orthopaedic War

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 DISEASE AND THEIR TREATMENT

MALARIA
DEFINITION:- It is an infection of liver and RBCs cause by Plasmodium.

SPECIES OF PLASMODIUM:-
There are 5 species of plasmodium-

1. Plasmodium Falciparum (Most common and most dangerous)

2. Plasmodium Vivax
3. Plasmodium Ovale
4. Plasmodium Malariae
5. Plasmodium Knowlesi

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 EPIDEMIOLOGY

 Malaria affecting 400 million people worldwide.

 It causes 2 million death each year.
 P.vivax is the most common cause of malaria and is found in subtropical and
tmperate areas of the world.
 P.vivax and P.ovale causes relapsin malaria.
 P.ovale is the least common malerial species and is endemic in Africa.
 P.falciparum is found in the tropical region and causes the most severe and fatal
disease.

RISK FACTORS

 Traveling to area where maleria is common.

 Pregnant women.
 Children under 5 years of age.
 HIV/AIDS patients.

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 VECTOR OF MALARIA

 VECTOR:- Any agent which carries and transmits an infectious pathogen

into another living organism.
 Female Anopheles Mosquito is vector of malaria.

LIFE CYCLE OF MALARIA

INCUBATION PERIOD

 P. Falciparum:- 7-14 days

 P.Vivax:- 12-17 days
 P.Ovale:- 9-18 days
 P.Malariae:- 13-40 days

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 SIGNS AND SYMPTOMS

 High grade fever

 Sweating
 Chills
 Headache
 Weight loss
 Dry cough
 Dark pigmented urine
 Jaundice
 Muscle or back pain or both
 Enlarged spleen.

DIAGNOSIS

 Medical History: e.g. travel history

 Physical examination : hepatomegaly and spleenomegaly
 Laboratory diagnosis:
- RDT (Rapid diagnostic test)
- ELISA (Enzyme-linked immunosorbent assay)
- PCR (Palymerase chain reaction)

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 PREVENTION
 Sleeping under mosquito nets
 Stagnant water shouid be avoided
 Using insect repellents
 Covering the limbs

TREATMENT

 To provide prompt and complete treatmentto all suspected/confirmed cases of

malaria.
 To prevent transmission of malaria.
 To prevent deaths from severe and complicated malaria.
 To prevent progression of mild cases of malaria in to severe or complicated from
of malaria.
 To minimize risk of spead of drug resistant parasites by use of effective drugs in
appropriate dosage by everyone.

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Fig: Treatment of malaria

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 HANDLING OF PRESCRIPTION

The handling of the prescription is crucial. The Pharmacist should follow step
when processing a prescription for compounding and dispensing.

1. Received

2. Reading and Checking

3. Collecting and Weighting the materials

4. Compounding ,Packaging and Labeling

Received:-The pharmacist must get the prescription. While accepting a

prescription, a pharmacist should not alter his/her facial expression in any way. It
creates the appearances that the patient is puzzled or stunned after seeing the
presReading and Checking:- Behind the counter, the prescription should be
checked after it is received. The validity of this prescription should be verified.
Verify the prescriber’s signature and the date of prescription. In order is properly fill
up a prescription, the pharmacist must read all of the lines and words. He/ she must
not make any guesses about the words. ASA he or she has any doubts, a pharmacist
should call another pharmacist or a prescriber.

Collecting and Weighting the materials:- Materials should be retrieved from

shelves or drawers prior to compounding a script. On the left hand side of the
balance, all of the materials are maintained. Each Material should be placed on the
correct side of the balance once it has been measured. After the prescription
components have been compounded , they are returned to the shelves or drawers.

Three times each container of materials should be inspected during compounding

1. As soon as they are removed from the shelves / drawers

2. Measurement of materials

3. When the containers are placed back on the shelves or drawers the process is
complete.

Compounding , Packaging and Labeling :- It is recommended that just one

prescription be prepared at one time. Cleans surfaces should be used during
compounding. Each piece of equipment must be thoroughly cleaned and dried
before use. It should be created under the supervision of the doctor and pharmacist
or in accordance with pharmacopeia or formulary instructions. It is important to
fill the containers with the prepared compounds. The container should be clearly
marked with a tablet.

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 PATIENT COUNSELLING
Patient counseling is defined as during of the medication information to the patients
or their representative either orally or in written form regarding how to use the
medicine, instruction on possible side effects, precautionary measures, storage
conditions, consumption of diet and modifications of life style if any requires.

Steps during patient counselling:-

• Preparing of the session

• Opening of the session

• Counseling content

• Closing the sessions

Preparing for the Session:The knowledge and skill of the counsellor is an

important key for the success of counselling. Counsellor is nothing but the
pharmacist. Before proceed to counselling, the pharmacists should establish the
caring relationship with patient in the stage of patient health care management.
First of all pharmacist should introduce himself, explain the purpose of counselling
and expected length of the session. Pharmacist should able to understand the
patient primary spoken language and if possible he should stick to that language
only. The pharmacist should know about the possible treatments of patient in
details. If the pharmacist does not know about medicines which is receiving by
patient, then pharmacist should consult drug information reference before
commencing of counselling.

Opening the Session:In the first phase of counselling, there should be gathering of
the information. After completion of introduction and the pharmacist should
respond him by the name. The pharmacist should use the title such as; Ms’, Mr,
Mrs and then shift over to first name. For example, "Hello Mr Rahul, I am Sachin,
your Counsellor/Pharmacist. I Would like to state your medication details. Do you
have a few minutes to spend with me?" Pharmacist should know the condition of
patient, he may be worried and upset due to their illness, so a few caring words will
establish sympathy and the patient may support in the process of counselling.
Pharmacist should assess the knowledge of patient about his/her health problems
and medications, physical and mental health, attitude, their health problems and
medication. Pharmacist should ask open ended questions about purpose of each
medication and their expectation with medications. Pharmacist should ask any
problem or hesitations are experiencing with prescribed medications. During this
counselling session, the pharmacist should avoid following:

 Do not ask the question directly or in the way of distressing.

 Do not show excessive curiosity.
 Do not discuss the patient's personal problems.
 Do not pass moral judgments.
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Counselling Content:The content of counselling is considered to be the heart of the
counselling session. So, during this stage the pharmacist should provide the
information orally and use visual aids or demonstration to fill the patient's gap in
knowledge and through on medication and treatment regimen which are prescribed
to him/her. In this session, pharmacist can provide the information on medications
such as oral solid by showing the colour, size, shape and marking on
tablet/capsules. Oral liquid and injectable can be shown by showing the measuring
mark on devise of dosage form. Should demonstrate the use of administration
devices such as oral and nasal inhaler. There should be face to face oral
communication, show them written hand-out so it can be helpful to recall the
information. In it un his session the topic which are mostly cover are:

 Name and strength of the medication.

 The reason why it has been prescribed.
 How the medication will work.
 How to administer the medication.
 Expected duration of the treatment.
 Expected duration required to show therapeutic benefit.

Expected benefits of the treatment.

Special monitoring requirements, for example, blood tests.

Pharmacist should remember that, the information which are given should be
tolerated to patient. It is important to note that, in some situation, pharmacist
should not directly jump on the conclusion regarding why such medication has
been prescribed.

Closing the Session:It is essential to check the patient's knowledge and

understanding of medication use before closing of the counselling session. In this
closing session, the patient knowledge and understanding can be assessed by
following feedback question by asking

 Can you remember what this medication is for?

 How long should you need to take this medicine?
 Can you show how you will use this medicine?
 How you will identify the effects of medicine?

During this discussion, the patient may have some new questions or doubt. So,
before closing of this session, summarized the main point in the logical order. If
there is need and requirement, the pharmacist can give their phone number and
encourage to make contact if they need any advice or any other information.

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 TRAINING AT HOSPITAL
The training in hospital at different wards:-

 Emergency Ward
 General Ward
 Ward

Emergency Wards:-An emergency department(ED), also known as an accident

& emergency Department (A&E),emergency room(ER ) or casualty department.
An emergency is a medical treatment facility specializing in emergency medicine,
the acute care of patients who present without prior appointment; either by their
own means or by that of an ambulance. The emergency department is usually
found in a hospital or other primary care center. Due to the unplanned nature of
patient attendance, the department must provide initial treatment for a broad
spectrum of illnesses and injuries, some of which may be life threatening and
require immediate attention. In some countries, emergency departments have
become important entry points for those without other means of access to medical
care. The emergency departments of most hospitals operate 24 hours a day,
although staffing levels may be viridian attempt to reflect patient volume.

FIRSTAIDS:-First aid is the assistance given to any person suffering a sudden illness
or injury, with care provided to preserve life, prevent the condition from worsening,
and/or promote recovery.

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Aims:-The key aims of first aid can be summarized in three key points, sometimes
known as 'the three P’s.

Preserve life: the overriding aim of all medical care, including first aid,is to save
lives and minimize the threat of death.

Prevent further harm :- Also Sometimes called prevent the condition from
worsening, or danger of further injury, this covers both external factors, such as
moving a patient away from any cause of harm, and applying first aid techniques to
prevent. worsening of the condition, such as applying pressure to stop a bleed
becoming dangerous.

Promote recovery:- First aid also involves trying to start the recovery process from
the illness or injury, and in some cases might involve completing a treatment, such
as in the case of applying a plaster to a small wound.

General Wards :-A general ward is a large room in a hospital where people who
need medical treatment stay general in the wards.

Intravenous mean within vein . Therapies administered intravenously are often

included in the designation of specialty drugs . Intravenous infusions are commonly
referred to as drips because many system administration employ to a drip, which
prevent air from entering the blood stream and allows as estimation of flow rate.

Intravenous therapy may be used to correct electrolyte imbalance, to deliver

medication, for blood transfusion are as a fluid replacement to correct, for example
dehydration intravenous therapy can also be used for chemotherapy. Compare with
other route of administration, the intravenous route is the fastest way to deliver
fluids and medication throughout the body. The bioavailability of the medication is
100% in IV therapy. During intravenous therapy.

 Administration of drips
 Administration of cannula
 Administration of injection
 Measurement of blood pressure and temperature
 Provides oxygen

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Surgical Wards:-Surgical wards contain different types injured patients,
accidental patient etc.

Surgical wounds can be classified as follows:

Secondary intention than six hours old, manage with surgical toilet, leave open and
then close 48 hours later. This is delayed primary closure.

Dressing techniques:-

The following dressing techniques are easy to do and require no sophisticated

equipment. Clean technique is usually sufficient. Pain medication may be required
as dressing changes can be painful. Gently cleanse the wound at the time of
dressing change.

A. Wet-to-dry

Indication: to clean a dirty or infected wound.

Technique: Moisten a piece of gauze with solution and squeeze out the excess
fluid. The gauze should be damp, not soaking wet. Open the gauze Photo A and
place it over top of the wound to cover it Photo B. You do not need many layers of
wet gauze. Place a dry dressing over top. The dressing is allowed to dry out and
when it is removed it pulls off the debris. It’s ok to moisten the dressing if it is too
stuck. How often: Ideally, 3-4 times per day. More often on a wound in need of
debridement, less often on a cleaner wound. When the wound is clean, change to a
wet-to-wet dressing or an antibiotic ointment.

B. Wet-to-wet

Indication: to keep a clean wound clean and prevent build-up of exudates.

Technique: Moisten a piece of gauze with solution and just barely squeeze out the
excess fluid so it’s not soaking wet. Open the gauze and place it over top of the
wound to cover it. Place a dry dressing over top. The gauze should not be allowed
to dry ostick to the wound. How often: Ideally, 2-3 times a day. If the dressing gets
too dry, poor saline over the gauze to keep it moist.

C. Antibiotic ointment

Indication: Antibiotic ointment is used to keep a clean wound clean and promote
healing.

Technique: apply ointment to the wound- not a thick layer, just a thin layer is
enough. Cover with dry gauze.

24
25
 CONCLUSION

1. Many factors influence the decision of where to complete residency training.

Above information can help guide this decision, as it provides that how to
hospitals manages the patients with chronic illnesses and provide
discretionary procedures, both of which are critical aspects of residency
training.

2. Physicians who train at institutions with better, more patient-cantered and

efficient care will be better prepared to lead the transformation of health
care when they are in practice.

3. In the view of health care Most health care systems seek and need
further improvements in care so better services provided by hospital to the
patient.

We had done a deep training about all above mentioned services and all the other

Roles of pharmacist in clinical pharmcy.

26