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NTA Level 4 • Semester 2 • PST04212 Process of Handing Over of the Store …………………………………………………………….. 80 Medical Stores Keeping • Source Session/Topic 11 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 11: Process of Handing Over of the Store …………………………………………………………….. 80 PST 04101 Dispensing NTA Level 4 Semester 1 Facilitator Guide iii Background There is currently an ever increasing demand for pharmaceutical personnel in Tanzania. This is due to expanding investment in public and private pharmaceutical sector. Shortage of trained pharmaceutical human resource contributes to poor quality of pharmaceutical services and low access to medicines in the country (GIZ, 2012). Through Public-Private-Partnership (PPP) the Pharmacy Council (PC) together with Development Partners (DPs) in Germany and Pharmaceutical Training Institutions (PTIs) worked together to address the shortage of human resource for pharmacy by designing a project named “Supporting Training Institutions for Improved Pharmaceutical Services in Tanzania‖ in order to improve quality and capacity of PTIs in training, particularly of lower cadre pharmaceutical personnel. The Pharmacy Council formed a Steering committee that conducted a stakeholder‘s workshop from18th to 22ndAugust 2014 in Morogoro to initiate the implementation of the project. Key activities in the implementation of this project included carrying out situational analysis, curriculum review and harmonization, development of training manual/facilitators guide, development of assessment plan, training of trainers and supportive supervision. After the curricula were reviewed and harmonized, the process of developing standardised training materials was started in August 2015 through Writer‘s Workshop (WW) approach. The approach included two workshops (of two weeks each) for developing draft documents and a one-week workshop for reviewing, editing and formatting the sessions of the modules. The goals of Writers Workshops were to build capacity of tutors in the development of training materials and to develop high-quality, standardized teaching materials. The training package for pharmacy cadres includes a Facilitator Guide, Assessment plan and Practicum. There are 12 modules for NTA level 4 making 12 Facilitator guides and one Practicum guide. PST 04101 Dispensing NTA Level 4 Semester 1 Facilitator Guide iv Acknowledgement The development of standardized training materials of a competence-based curriculum for pharmaceutical sciences has been accomplished through involvement of different stakeholders. Special thanks go to the Pharmacy Council for spearheading the harmonization of training materials in the pharmacy after noticing that training institutions in Tanzania were using different curricula and train their students differently. I would also like to extend my gratitude to St. Luke Foundation (SLF)/Kilimanjaro School of Pharmacy –Moshi for their tireless efforts to mobilize funds from development partners. Special thanks to John Snow Inc (JSI), Deutsche Gesellschaft Für Internationale Zusammenarbeit (Giz), Merck Kgaa, Boehringer Ingelheim Gmbh and Bayer Pharma Ag and action medeor.V for the financial and technical support. Particular thanks are due to those who led this important process to its completion, Mrs Stella M. Mpanda Director, Childbirth Survival International, and Members from the secretariat of National Council for Technical Education (NACTE) for facilitating the process. Finally, I very much appreciate the contributions of the tutors and content experts representing PTIs, hospitals, and other health training institutions. Their participation in meetings and workshops, and their input in the development of this training manual/facilitators guide have been invaluable. These participants are listed with our gratitude below: Mr.Wilson A.Mlaki Director Saint Luke Foundation Mr.Samwel M. Zakayo Pharmacy Council Ms. Ester A. Tuarira MUHAS Ms. Tumaini H. Lyombe MUHAS Mr, Wensaa E. Muro KSP Ms. Dilisi J. Makawia KSP Ms. Julieth Koimerek KSP PST 04101 Dispensing NTA Level 4 Semester 1 Facilitator Guide v Rev.Baraka A.M. Kabudi MEMS Mr. Kelvin E. Mtanililwa Royal Pharmaceutilcal Training Institute Ms. Rose Bulilo CEDHA Ms. Diana H. Gamuya CEDHA Dr.Melkiory C. Masatu CEDHA Dr.Benny Mboya CEDHA Mr. Habel A. Habel City College of Health and Allied Sciences Ms. Zaina Msami Meru District Council Director of Human Resources Development Ministry of Health, Community Development, Gender, Elders and Children PST 04101 Dispensing NTA Level 4 Semester 1 Facilitator Guide vi Introduction Module Overview This module content is a guide for tutors of Pharmaceutical schools for training of students. The session contents are based on sub-enabling outcomes and their related tasks of the curriculum for Basic Technician Course in Pharmaceutical Sciences. The module sub- enabling outcomes and their related tasks are as indicated in the Basic Technician Certificate in Pharmaceutical Sciences (NTA Level 4) curriculum. Target Audience This module is intended for use primarily by tutors of pharmaceutical schools. The module‘s sessions give guidance on the time, activities and provide information on how to teach the session. The sessions include different activities which focus on increasing students‘ knowledge, skills and attitudes. Organization of the Module The module consists of eleven (11) sessions; each session is divided into several parts as indicated below: • Session Title: The name of the session • Total Session Time: The estimated time for teaching the session, indicated in minutes • Pre-requisites: A module or session which needs to be covered before teaching the session. • Learning Tasks: Statements which indicate what the student is expected to learn by the end of the session • Resources Needed: All resources needed for the session are listed including handouts and worksheets • Session Overview: The session overview box lists the steps, time for each step, the activity or method used in each step and the step title • Session Content: All the session contents are divided into steps. Each step has a heading and an estimated time to teach that step as shown in the overview box. Also, this section includes instructions for the tutor and activities with their instructions to be done during teaching of the contents • Key Points: Key messages for concluding the session contents at the end of a session This step summarizes the main points and ideas from the session, based on the learning tasks of the session • Evaluation: The last section of the session consists of short questions based on

NTA Level 4 • Semester 2 • PST04212 Stock Control Practice Medical Stores Keeping • Source Session/Topic 10 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 10: Stock Control Practice Total Session Time: 120 minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Define Common Terms Used in Stock Control Of Medicines and Medical Supplies • List Stock Control Records and Documents Used in Physical Inventory • Explain the Process of Stock Taking and Reconciliation • Explain the Process of Recording and Reporting the Unserviceable Stocks Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • LCD projector and computer • Handout 10.1: S.F 15 Form SESSION OVERVIEW Activity/ Step Time Content Method 1 5 minutes Presentation Introduction, Learning Tasks Definitions of Common Terms Used in Stock Presentation 2 10 minutes Control of Medicines and Medical Supplies Buzzing Presentation Stock Control Records and Documents Used in 3 10 minutes Brainstorming Physical Inventory 4 40 minutes Presentation Process of Stock Taking and Reconciliation Process of Recording and Reporting the 45 minutes Presentation 5 Unserviceable Stocks Small Group Discussion 6 5 minutes Presentation Key Points 7 5 minutes Presentation Evaluation 73 SESSION CONTENTS STEP 1: Presentation of Session Title and Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Definitions of Common Terms Used in Stock Control of Medicines and Medical Supplies (10 minutes) Activity: Buzzing (5 minutes) ASK students to pair up and buzz on the following question for 2 minutes • What is o Inventory? o Lead time? o Pull system? o Push system? o Re order level? o Buffer stock? o FEFO? o FIFO? o Stock taking? o Unserviceable stock? ALLOW few pairs to respond and let other pairs to add on points not mentioned WRITE their response on the flip chart/board CLARIFY and SUMMARIZE by using the content below • Terms Commonly Used in Stock Control of Medicines and Medical Supplies include; o Inventory  The stock on hand at any given time o Lead time  The time interval between when new stock is ordered and when it is received and available for use o Pull (request) system  In a pull system, quantities to be issued are determined by personnel who receive the supplies o Push (allocation) system  In a push system, quantities to be issued are determined by personnel who issue the supplies o Re-order level  Is the level of stock when you place an order o Buffer stock/Safety stock  I s a stock used during lead time o FEFO  First expiry first out 74 o FIFO  First in first out o Stock taking  Is a process of counting physically o Unserviceable stock  This include products with one or more of the following characteristic, expired, damaged, has contaminated items, has items instituted for recall, un repairable or obsolete for medical equipment‘s and prohibited STEP 3: Stock Control Records and Documents Used in Physical Inventory (10 minutes) Activity: Brainstorming (5 minutes) Ask students to brainstorm on the following question: • What are the stock control records and documents used in physical inventory? ALLOW few students to respond WRITE their responses on the flip chart/ board CLARIFY and SUMMARISE by using the content below • Common stock control records and documents used in physical inventory include: o Ledger books o Bin cards o Stock taking sheets STEP 4: Process of Stock Taking and Reconciliation (40 minutes) Checking the Stock The store keeper makes a physical count of the stock, and makes an entry on the card. The stock check can be done on the routine basis for all stock (e.g. Once a month) It is better if the stock count is done without looking at any other stock information and then any differences can be investigated later. To calculate the theoretical balance which should be present, the formula used Theoretical Balance = Opening balance – Stock Issued + Stock Received If stock count and theoretical balance agree, then the stock is said to be reconciled If the stock count and theoretical balance do not agree, then the stock is not reconciled When the stock is not reconciled, that is when there is a difference between the stock count and the theoretical balance, it is vital to investigate the reasons for the difference. There may be a simple explanation (accidental breakage),but it may be that there is some theft or pilfering occurring, and if this is so, then random and unannounced spot checks on the stock balance should be made. 75 STEP 5: Process of Recording and Reporting the Unserviceable Stocks (45 minutes) Activity: Small Group Discussion ( 20 minutes) DIVIDE students into small manageable groups ASK students to discuss on the following question • What are the processes of recording and reporting the unserviceable stocks? ALLOW students to discuss for 20 minutes ALLOW few groups to present and the rest to add points not mentioned Refer students to Handout 10.1: S.F 15 for Further Reading CLARIFY and SUMMARIZE by using the contents below • Health facilities should conduct inspection and physical inventory for their medical stores monthly. • During the inspection and physical inventory the medical stores in charge should look for the following criteria that may render the product unserviceable o Expiry o Damage o Contaminated items o Items instituted for recall o Un repairable or obsolete medical equipment o Prohibited • Any item deemed to be unserviceable should be separated from usable items, removed from normal stores ledger and recorded into the Unserviceable goods ledger. • A separate marked area should be identified. All unserviceable medical stores should be in an identified separate marked area For easy access and verification •

NTA Level 4 • Semester 2 • PST04212 Receiving Medicines and Medical Supplies Medical Stores Keeping • Source Session/Topic 9 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 9: Receiving Medicines and Medical Supplies Total Session Time: 120 minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Define Receiving of Medicines and Medical Supplies • Explain the Procedures for Receiving Medicines and Medical Supplies • Identify Stock Records Required for Receiving of Medicines and Medical Supplies • Practice Filling and Completing Order Forms Used in the Facility Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • LCD projector and computer • Handout 9.1: receiving of medicines and medical supplies • Worksheet 9.1: Sample of Good Received Note SESSION OVERVIEW Activity/ Step Time Content Method 1 5 minutes Presentation Introduction, Learning Task Definition of Receiving of Medicines and Medical 10 minutes Presentation Supplies 2 Brainstorming Presentation/ Procedures for Receiving Medicines and Medical 3 25 minutes Buzzing Supplies Stock Records Required for Receiving Medicines 4 10 minutes Presentation Presentation Filling and Completing Receiving Forms Used in 5 60 minutes Small Group the Facility. Discussion 6 5 minutes Presentation Key Points 7 5 minutes Presentation Evaluation 64 SESSION CONTENT STEP1: Introduction, Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Definition of Receiving of Medicines and Medical Supplies (10 Minutes) Activity: Brainstorming (5 minutes) ASK students to brainstorm on the following question: • What is receiving of medicines and medical supplies? ALLOW few pairs to respond and let other pairs to add on points not mentioned WRITE their response on the flip chart/board ` CLARIFY and SUMMARIZE by using the content below • Receiving of medicine and medical supplies o Is a process of receipt medicine and medical supplies from selected qualified vender. • When receiving medicines and medical supplies the following information should recorded in the store ledger and bin card: o date of received medicines and medical supplies o the name of the supplier o quantity of medicines and medical supplies received Unit price STEP 3: Procedures for Receiving Medicines and Medical Supplies (25 Minutes) Activity: Buzzing (5 minutes) Ask students to pair up and buzz on the following question for 2 minutes: • What are the procedures for receiving medicines and medical supplies? ALLOW few students to respond WRITE their responses on the flip chart/ board CLARIFY and SUMMARISE by using the content below 65 • Within a facility, items should be received by the pharmaceutical personnel and approved by Hospital/health facility Therapeutic Committee (HTC) • Products received should also be entered into stock cards/bin cards and the store ledger • Delivery note and sales invoice should be used for comparing with the actual receipts • If any discrepancy is observed, verification claim forms must be filled out and sent to MSD or other suppliers • A room for keeping pharmaceutical products should meet all the specification required • , Keep medicines and medical supplies in their appropriate storage conditions e.g. refrigerated medicines to be kept in the refrigerator Refer students to Handout 9.1 Receiving of Medicines and Medical Supplies for further reading STEP 4: Stock Records Required for Receiving Medicines (10 minutes) Stock records required for receiving medicines in a store are: o Verification and claim form o Goods Received Note ( GRN ) REFER students to worksheet 9.1 for further reading. STEP 5: Filling and Completing Receiving Forms Used in the Facility. (60 minutes) Activity: Small Group Discussion ( 30 minutes) DIVIDE students into small manageable groups ASK students to discuss on the following question INSTRUCT students to fill in verification and claims form for the exercises 1 and 2 below. Exercise 1: 100 tins of Lamivudine 150mg, ordered, listed on the MSD sales invoice but not received. Use the name of any facility, supplier, transporter and driver that you know. Assume the ordered quantity was 500 tins in the form number 034. Exercise 2: 3 tins of Abacavir 300mg tablets, received on 30th June 2009, with less than 3 months shelf life remaining. Expiry date 30th September 2009 ALLOW students to discuss for 30 minutes ALLOW few groups to present and the rest to add points not mentioned CLARIFY and SUMMARIZE by using the contents below 66 67 STEP 6: Key Points (5 minutes) • Receiving of medicine and medical supplies is a process of receipt medicine and medical supplies from selected qualified vender. • Within a facility, items should be received by the pharmaceutical personnel and approved by Hospital/health facility Therapeutic Committee (HTC) o Stock records required for receiving medicines include verification and claim forms and goods received note ( GRN ) STEP 7: Evaluation (5 minutes) • What is receiving of medicines and medical supplies? • What are the procedures for receiving medicines and medical supplies? • What are stock records required for receiving of medicines and medical supplies? . 68 References Ministry of Health and Social Welfare (MOHSW) (1997). Wizara ya afya na ustawi wa jamii cha muongozo wa utoaji sahihi na dawa . Dar es Salaam: Tz Ministry of Health and Social Welfare Guidelines on the storage of essential drug in eastern and southern Africa (1991) by WHO with the cooperation of the pharmaceutical industry through the International Federation of Pharmaceutical Association IFPMA Management Science for Health and World Health Organization. (1997). Managing Drug Supply, (2nd e.d.).West Hartford, Connecticut, USA: Kumarian Press 69 Handout 9.1: receiving of Medicines and Medical Supplies A. Dispensary and Health Center Level It is the responsibility of the DMO to ensure that the pre-packaged supplies received Quarterly from MSD are delivered to each facility in time. The process by which the supplies are received at the facility. 1) Facility waits

NTA Level 4 • Semester 2 • PST04212 Ordering of Medicines and Medical Supplies Medical Stores Keeping • Source Session/Topic 8 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 8: Ordering of Medicines and Medical Supplies Total Session Time: 120 minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Define Ordering of Medicines and Medical Supplies • Explain the Procedure for Ordering Medicines and Medical Supplies • Identify Stock Records Required for Ordering Medicines • Practice Filling and Completing Order Forms Used in the Facility. Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • Handout 8.1. Ordering of Medicines and Medical Supplies • Worksheet 8.1.Sample of report and Request Form • Worksheet 8.2: Answers for Small Group Discussion • LCD projector and computer SESSION OVERVIEW Activity/ Step Time Content Method 1 05 minutes Presentation Introduction, Learning Task 10 minutes Definition of Ordering of Medicines and Medical Presentation Supplies 2 Buzzing 25 minutes Presentation Procedures for Ordering Medicines and Medical 3 Buzzing Supplies 10 minutes Stock Records Required for Ordering Medicines 4 Presentation 60 minutes Presentation Filling and Completing Order Forms Used in the 5 Small Group Facility. Discussion 6 05 minutes Presentation Key Points 7 05 minutes Presentation Evaluation 55 SESSION CONTENT STEP1: Introduction, Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Definition of Ordering of Medicines and Medical Supplies (10 Minutes) Activity: Buzzing (5 minutes) Ask students to pair up and buzz on the following question for 2 minutes: • What is ordering of medicines and medical supplies? ALLOW few students to respond WRITE their responses on the flip chart/ board CLARIFY and SUMMARISE by using the content below • Ordering of medicine and medical supplies o Is a process of placing a request to a supplier to get needed stock. • Things to consider while planning to order new stock are o What to order o When to order o How much to order STEP 3: Procedures for Ordering Medicines and Medical Supplies (25 Minutes) Activity: Buzzing (5 minutes) Ask students to pair up and buzz on the following question for 2 minutes: • What are the procedures for ordering medicines and medical supplies? ALLOW few students to respond WRITE their responses on the flip chart/ board CLARIFY and SUMMARISE by using the content below • The ordering process starts with pharmaceutical personnel and medical officers in charge of the facility filling out a monthly/quarterly R&R (Report and Request) form 56 • The completed form is sent to the District Medical Officer for approval and with the assistance of District Pharmacist these forms are compiled together and then sent to MSD • MSD reviews the order and delivers the required items with sales invoice to the District • The District Medical Officer/Pharmacist receives the medicines and related supplies for the district and distributes them to the facilities according to the order • The ordering of medicines is normally done quarterly or monthly • Excessive stock is wasteful and should be avoided and on the other hand ordering too little will result in shortages Refer students to Handout8. 1. Ordering of Medicines and Medical Supplies for further reading STEP 4: Stock Records Required for Ordering Medicines (10 minutes) • Stock record and Bin Cards o Very important tools used to control the stock movement of items in the store o Each item has its own bin card and should be displayed on the shelf where the product is located o It is necessary to do actual counts of stock on hand to check the stock balance on regular basis (monthly) o The inventory taking should certify that the recorded transactions are accurate • Store ledger o Usually kept in the office of the store in-charge o Contains information similar to bin cards o Each item has its own page and in additional to a part where one has to fill in the amount of medicine expired, broken or lost and the remarks. • Report and Request Form (R&R) o A form used for reporting the movement of medicines and commodities through the facility, and also requesting quantities of stock needed to replenish supplies • Dispensing register o This is the book which used to record medicine dispensed 57 STEP 5: Filling and Completing Order Forms Used in the Facility. (60 minutes) Activity: Small Group Discussion ( 30 minutes) DIVIDE students into small manageable groups ASK students to discuss on the following question Today is 1st of January 2008 and it is time for Jamhuri hospital of Kisarawe district to complete R & R for HIV test kits. The following information was obtained for the past three months usage data. The facility code is 00475534 Group work • The store ledger shows that by 30th September 2008 the physical inventory for SD Bioline was 24 kits, Determine 1 kit, Unigold 3 kits • For the period of October 1st to December 31st 2008 the facility received 16 kits, of SD Bioline, 1 kit of Determine and 0 kit of Unigold • During the same period daily usage records from VCT/PITC indicates that 355 tests of SD Bioline, 21 of Determine and 4 of Unigold were used whereas from PMTCT 250 tests of SD Bioline, 21 of Determine and 3 of Unigold were used for PMTCT purposes • For the same period the usage record from lab indicated that 250 tests of SD Bioline, 10 of Determine and 5 of Unigold • A nearby health centre called Mwendapole Health centre borrowed 100 tests (given: 1 kit of SD Bioline has 25 tests, Unigold as 25 tests, Determine 100 tests) ALLOW students to discuss for 15 minutes ALLOW few groups to present and

NTA Level 4 • Semester 2 • PST04212 Factors Affecting the Quality of Medicines and Medical Supplies During Storage Medical Stores Keeping • Source Session/Topic 7 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 7: Factors Affecting the Quality of Medicines and Medical Supplies During Storage. Total Session Time: 120 minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Define Quality of Medicines and Medical Supplies • List Factors Affecting Quality of Stored Medicines and Medical Supplies • Explain the Consequences of Poor Storage of Medicines and Medical Supplies • Describe Ways to Avoid the Effects of Medicines and Medical Supplies Deterioration. • Identify Signs of Deteriorated Medicines Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • LCD projector and computer SESSION OVERVIEW Activity/ Step Time Content Method 1 05 minutes Presentation Introduction, Learning Tasks 10 minutes Definition of Medicines and Medical Presentation 2 Supplies Brainstorming 15 minutes Factors Affecting Quality of Stored Presentation 3 Medicines and Medical Supplies Buzzing 30 minutes Presentation Consequences of Poor Storage of Medicines 4 and Medical Supplies 35 minutes Presentation Ways to Avoid the Effects of Medicines and 5 Small group Medical Supplies Deterioration. discussion 15 minutes Presentation Identification of Signs of Deteriorated 6 Medicines 7 5 minutes Presentation Key Points 8 5 minutes Presentation Evaluation 49 SESSION CONTENTS STEP1: Introduction, Learning Tasks (5 minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Definition of Quality of Medicines and Medical Supplies (10 minutes) Activity: Brainstorming (5 minutes) ASK students to brainstorm on the following question: • What is quality of medicines and medical supplies? ALLOW few pairs to respond and let other pairs to add on points not mentioned WRITE their response on the flip chart/board ` CLARIFY and SUMMARIZE by using the content below • Quality of medicines and medical supplies o Quality of medicines and medical supplies can be defined in terms of suitability for the intended use. Thus, several aspects are of importance are efficacy and safety of the product conformity with specifications in terms of identity strength, purity and other characteristics as specified in pharmacopoeia or pharmaceutical regulations. STEP 3 Factors Affecting Quality of Stored Medicines and Medical Supplies (15 minutes) Activity: Buzzing (5 minutes) ASK students to pair up and buzz on the following question for 5 minutes • What are factors affecting quality of stored medicines and medical supplies? ALLOW few pairs to respond and let other pairs to add on points not mentioned WRITE their response on the flip chart/board CLARIFY and SUMMARIZE by using the content below 50 The following are factors which affect the quality of stored medicines and medical supplies • Heat • Temperature • Moisture • Light • Microbial contamination • Air • Humidity • Cold • Rats and mice STEP 4: Consequences of Poor Storage of Medicines and Medical Supplies (30 minutes) • Heat o Heat leads to chemical decomposition, protein denaturation • Temperature o Temperature may cause some compound to melts e.g. ointment and become useless. • Moisture o Moisture can cause tablet to crumble • Light o Strong light will damage many medicine • Microbial contamination o Microbial contamination may contaminate with medicines ingredients and cause infection • Air o The chemicals in drugs can slowly react with the oxygen in the air • Humidity o Too high humidity may cause growth of fungus and mould in the stored medicines • Cold o In very cold condition liquid medicine may freeze. Some vaccines, if they have been frozen should not be used. • Rats and mice o Can chew through containers made of most materials around the content to become contamination 51 STEP 5: Describe Ways to Avoid the Effects of Medicines and Medical Supplies Deterioration (35 minutes) Activity: Small Group Discussion ( 15 minutes) DIVIDE students into small manageable groups ASK students to discuss on the following question • What are the ways to avoid the effect of medicines and medical supplies deterioration? ALLOW students to discuss for 15 minutes ALLOW few groups to present and the rest to add points not mentioned CLARIFY and SUMMARIZE by using the contents below • Temperature o Temperature effect is avoided by storage in cold conditions, refrigerator, room temperature and other temperature depending on a specific type of drug. o In the storage room one must  Maintain a refrigerator temperature 2-8 C using thermometer  Keep freezers and refrigerators in shady, ventilated area  Record temperature in room and refrigerator three times a day  Compare the recorded temperature with the recommended temperature of their medication  Minimize frequency and duration of opening the refrigerator  Keep the refrigerator well organized  Use refrigerator exclusively for medical product, not for food • Humidity o In humid climate, dehumidifiers are used for preventing moisture damage o If there is no dehumidifiers use ventilating fans or opens windows • Light o Keep liquids in tinted glass o Keep light sensitive items in their originally package o Protect from sun • Air o Well-fitting lids on containers o When you open containers keep it open for the shortest possible time o Replace their lids securely and promptly • Rats and mice o Make your store as ―rat-proof‖, o Use fine wire mesh in wall cracks and windows o Stores good in pallets or shelves not on the floor o Use rats trap or poison to kill rats • Moisture o Moisture effect is avoided by ensuring aeration in the store, ensure the store is dry, some drugs contain sachets, ensuring drugs are retained in their original container, drying of hands when handling drugs, the use of pellets 52 • Heat o Store should be built in the shade or

NTA Level 4 • Semester 2 • PST04212 Zoning of Premises/Store for Storage of Medicines Medical Stores Keeping • Source Session/Topic 6 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 6: Zoning of Premises/Store for Storage of Medicines and Medical Supplies Total Session Time: 120minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Define Zoning • Explain Zoning of Stock Within the Store • Describe Criteria for Establishing Zones Within a Store • Identify Types of Stock Location Within a Zone • Describe Stock Classification • Describe the arrangement of Stocks in Zones Resources Needed • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • LCD projector and computer SESSION OVERVIEW Activity/ Step Time Content Method 1 5 minutes Presentation Introduction, Learning Task Presentation Definition of Zoning 2 5 minutes Brainstorming 3 20 minutes Presentation Zoning of Stock within the Store Criteria for Establishing Zones within a Store 4 10 minutes Presentation Presentation 5 30 minutes Group discussion Types of Stock Location Within a Zone Presentation 6 30 minutes Stock Classification Presentation 7 Stock Within a Zone 10 minutes Buzzing 8 5 minutes Presentation Key Points 9 5 minutes Presentation Evaluation 40 SESSION CONTENTS STEP1: Presentation of Session Title and Learning Tasks (5minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Definition of zoning (5 minutes) Activity: Brainstorming (3 minutes) ASK students to brainstorm on the following question • What is zoning? ALLOW few students to respond WRITE their answers on flip chart/ board CLARIFY and SUMMERIZE by using the content bellow • Definition of zoning o Is the process of separating an area (building or room, a locked cupboard, a refrigerator, a freezer, or a cold room), which should provide distinct environmental conditions, a certain level of safety or the required level of security. STEP 3: Zoning of Stock within the Store (20 minutes) • Medicines and medical supplies must be stored in a zone/part of the store with the correct combination of temperature and security as well as the required level of safety and security. This initial zoning process is the most basic way in which supplies can be arranged. • Follow to the extent possible, the product manufacturer‘s storage conditions • If no specific storage conditions are given, normal storage conditions apply. Normal storage conditions for medicines have been defined as storage in dry, well-ventilated premises at temperatures of 15ᴼC-25ᴼC , or depending up climatic conditions, up to 30ᴼC (WHO 2003). • The 15ᴼC to 25ᴼC-30ᴼC temperature zone is assumed to be air-conditioned and humidity controlled. In temperate climates this temperature range can be achieved without air- conditioning, but humidity control may still be necessary • Each storage zone should have at least one thermometer, and temperature should be recorded daily at the hottest time of the day. • Storage at uncontrolled room temperature: o Many stocks can be safely stored at uncontrolled room temperature. • Cold storage: o example of drug products which usually require refrigeration:  insulin  Ergometrine for injection  vaccines,  antitoxins  sera and blood products  test kits/diagnostic tests 41 o These must be stored in refrigerator or cold chains because their potency depends on cold storage. • Secure storage: o This is necessary to protect drug products, which have higher risk of theft, or to comply with national laws o Narcotics and other controlled drugs should be kept in a secure room, a safe or steel cupboard/ cabinet to prevent access to unauthorized persons o The keys to the secure store should be kept in a safe by a store in-charge o Entry to the store must be controlled or restricted • Flammables e.g. alcohol/spirit, halothane, ether, must be stored in special buildings or rooms. A separate building is the best because it greatly reduces the risk of a fire spreading to the main store. The flammables store must be well ventilated and fire proof; use water paints on the walls. STEP 4: Criteria for Establishing Zones within a Store (10minutes) • The selection of the storage zones (as well as suitable storage equipment) is determined by various criteria: o Required storage temperature and humidity o Size of the product o Volume of batch o Weight of batch o Requirement for special storage equipment o Dangers posed by products o Required level of security o Requirements of national legislation • The required level of security for internationally controlled drug products is determined by national legislation and regulations. • The level of security will also depend on the risk of theft which may be high for internationally controlled drug products as well as antibiotics, for example. • The number of items requiring specific storage conditions as well as their average stock levels will determine the required size each zone should have. For example a medical storage facility may require only a small steel safe or a reinforced vault for storage of internationally controlled drug products. Cold chain loads may require only a single refrigerator or require a walk-in cold room. • Every product must be put away in the zone with the storage conditions recommended by the manufacturer and indicated on the packaging as well as according to the requirements by national drug legislation. • While the storage in refrigerators or locked rooms leaves no choice, many health care stock items can be stored on floor pallets or on shelves. This choice is determined by the volume of batch of each product. • Possible changes in the need for different zones as well as the capacity of individual zones should be taken into account from the very beginning. The zoning plan should be as flexible as possible to allow future changes such as extension of the cold room

NTA Level 4 • Semester 2 • PST04212 Premise Suitable for Storage of Medicines and Medical Supplies Medical Stores Keeping • Source Session/Topic 5 Full source-text version: all educational wording from the extracted learning source is retained; only presenter/tutor metadata and web-layout noise are removed, while formatting is improved for readability. Session 5: Premise Suitable for Storage of Medicines and Medical Supplies Total Session Time: 120 minutes Prerequisites • None Learning Tasks By the end of this session students are expected to be able to: • Define Storage of Medicines and Medical Supplies • Explain the Importance of Proper Storage of Medicines and Medical Supplies • List Requirements of Premises for Storage of Medicines and Medical Supplies Resources Needed: • Flip charts, marker pens, and masking tape • Black/white board, chalk and whiteboard markers • LCD projector and computer SESSION OVERVIEW Activity/ Step Time Content Method 1 05 minutes Presentation Introduction, Learning Tasks Presentation Definition of Storage of Medicines and Medical 2 20 minutes Supply Brainstorming Presentation Importance of Proper Storage of Medicines and 3 40 minutes Small Group Medical Supplies Discussion Presentation Requirements of Premises for Storage of 4 45 minutes Brainstorming Medicines and Medical supplies 5 05 minutes Presentation Key Points 6 05 minutes Presentation Evaluation 35 SESSION CONTENTS STEP1: Presentation of Session Title and Learning Tasks (5minutes) READ or ASK students to read the learning tasks and clarify ASK students if they have any questions before continuing STEP 2: Definition of Storage of Medicines and Medical Supplies (20 minutes) Activity: Brainstorming (5 minutes) Ask students to brainstorm on the following question: • What is storage of Medicines and Medical Supplies? ALLOW few students to respond? WRITE their responses on the flip chart/ board CLARIFY and SUMMARISE by using the content below • Storage of medicines and medical supplies o Is the safekeeping of medicines and Medical Supplies to avoid spoilage and losses STEP 3: Importance of Proper Storage of Medicines and Medical Supplies (40 minutes) Activity: Small Group Discussion ( 40 minutes) DIVIDE students into small manageable groups ASK students to discuss on the following question • What are the importance of proper storage of Medicines and Medical Supplies? ALLOW students to discuss for 20 minutes ALLOW few groups to present and the rest to add points not mentioned CLARIFY and SUMMARIZE by using the contents below • Proper storage of Medicines and Medical Supplies are important in order to: o Avoid contamination or deterioration o Avoid disfiguration of labels o Maintain integrity of packaging and so guarantee quality and potency of Medicines and Medical Supplies during shelf life 36 o Prevent or reduce pilferage, theft or losses o Prevent infestation of pests and vermin STEP 4: Requirements of premises for storage of Medicines and Medical Supplies (45 minutes) Activity: Brainstorming (5 minutes) Ask students to brainstorm on the following question: • What are the requirements of premises for storage of Medicines and Medical Supplies? ALLOW few students to respond? WRITE their responses on the flip chart/ board CLARIFY and SUMMARISE by using the content below • The following are requirements of premises for Medicines and Medical Supplies: o Capacity/space: storage facilities must have the capacity for both storage and handling o Cold storage: in larger facilities it is more efficient to use cold rooms rather than numerous refrigerators or freezers (which generate heat) o Secure storage: all Medical stores should have a secure storage area for product that are likely to be stolen or abused o Ventilation: the location designed should ensure maximum air circulation to avoid concentration of fumes or gases and to prevent condensation of moisture on products or walls o Roof: design a slanting roof to allow water runoff o Ceiling: install a double ceiling to provide insulation and ensure that supplies are kept cool o Walls and floor: the walls and floors should be permanent and smooth for easy cleaning o Doors: plan doors wide enough to allow for the free and easy movement of supplies and handling equipment o Lighting: plan the storeroom with as much natural light (sunlight) in the day as possible to avoid the use of florescent or incandescent bulb lighting o Windows: plan windows that are high and wide to allow adequate ventilation o Cupboards: provide cupboards for the storage of specific products that must be kept free from dust or light o First aid: keep well stocked first aid kits to treat employees or visitors who are injured in your facility o Shelves: arrange shelves and racks in lines with a passage way not less than 90 cm wide 37 STEP 5: Key Points (5 minutes) • Storage of Medicines and Medical Supplies Is the safekeeping of medicines and Medical Supplies to avoid spoilage and losses • Proper storage of Medicines and Medical Supplies are important in order to maintain the their quality during the whole period of their shelf life • Requirements of premises for Medicines and Medical Supplies include: capacity/space, shelves, first aid kit, cupboards, windows, lighting, doors, walls and floor, ceiling, roof, ventilation secure storage and cold storage STEP 6: Evaluation (5 minutes) • What is the storage of Medicines and Medical Supplies • What are the importance of proper storage of Medicines and Medical Supplies? • What are the requirements of the suitable premise of Medicines and Medical Supplies 38 References Management Science for Health and World Health Organization. (1997). Managing Drug Supply, (2nd ed.).West Hartford, Connecticut, USA: Kumarian Press Shirima, L. L (1988): Basic Store-keeping and Warehouse Management. General Publication United Republic of Tanzania, Public Procurement Act, 2004, Dar es Salaam Njau, E. (2002). Pharmacology and Therapeutics (2nd ed.). Nairobi: African Medical and Research Foundation 39 ← Previous TopicNext Topic →View all Medical Stores Keeping topicsOpen Complete Full Notes PDF / OFFLINE NOTES Unataka kutumiwa notes hizi kupitia WhatsApp?Kwa notes zilizopangiliwa vizuri kwa kusoma offline au PDF, bonyeza kitufe hapa chini. Ujumbe wenye Level, Semester, Module na Topic utaandaliwa moja kwa moja.TUMIWA NOTES WHATSAPP WhatsApp: 255620339260