Departments of the pharmacy
As the hospital pharmacy within Städtisches Klinikums Görlitz gGmbH, we are responsible for the selection, procurement, proper storage and distribution of medicines, anaesthetics, infusion solutions, blood and plasma preparations, disinfectants, bandaging, X-ray contrast media, liquid and special nutrition, care products and suture materials to the wards.
Our range of medicines include all preparations that, based on current scientific insight, possess therapeutic efficacy and that are regarded as necessary and ideal for the treatment of patients in our areas of medicine. This amounts to 99 % of all dispensed pharmaceuticals.
This list was compiled based on applications, discussions and resolutions of the Pharmaceuticals Commission, which meets on a quarterly basis.
We are also able to procure medicines on short notice that are not included in our list.
Moreover, our department manages some of the disaster management stocks of medicines kept by the Free State of Saxony.
Doctors and care staff approach our department with all kinds of questions. They may concern the selection of a particular medicine, adverse reactions, interactions with other medicinal products, dosages, foreign medicines, alternative treatment options in cases of supply bottlenecks, the use of medicinal products, incompatibilities between formulations and many other issues.
We research the necessary information and provide detailed answers using international databases, digitised primary and secondary literature and analogue tertiary literature.
Some of our patients at the Städtisches Klinikum Görlitz gGmbH receive daily supply by means of our unit-dose system. It is used to increase the safety of patient treatment, to ease the workload on nursing staff and to reduce costs. Other advantages include rapid packaging of the medicines and the avoidance of mistakes when assigning the products, as everything is checked using a scanner (scanning of the secondary packaging).
A pharmacist validates each patient's medication for interactions with other medicinal products or for dosage errors such as excessive or insufficient doses. Necessary changes are discussed with the doctors and then implemented. Afterwards the medicines are forwarded to a packing device, which places the individual tablets and capsules in small pouches that are then labelled. They state the patient's name and date of birth, the ward, name of the medicine, its shape and colour, the manufacturer's name, the medicine batch, the intake date and time, intake instructions, as well as the name and address of the hospital pharmacy.
The packed pouches are then checked and delivered to the wards.
A distinction is made between individual and bulk formulations in the pharmacy's medicinal production unit. Individual formulations are made specifically for one patient, while bulk formulations are produced in advance and then analysed prior to dispensing in order to validate their quality. Around 22,000 preparations are manufactured each year.
The main focus in dermatology is on the production of ointments, crèmes, solutions and suspensions; in ophthalmology on the manufacture of eye drops and ointments; in rhinology on the production of nasal drips and tampons and in paediatrics on the manufacture of capsules and suppositories.
Our department also produces laboratory diagnosis materials (requested reagents) for pathology and the laboratory.
The Pharmacy Operations Ordinance (ApBetrO) states that all starting materials used in individual or bulk formulations must be tested prior to use. For this purpose, starting materials used for pharmaceutical purposes are usually subjected to an identity test. It is performed according to the mandatory methods described in the pharmacopoeias or using other recognised test standards.
This procedure applies additionally to all medicines produced in bulk. Our hospital pharmacy conducts over 220 receiving inspections and around 200 bulk product inspections each year.
We also perform random testing of finished medicinal products. This is carried out by means of a sensory test (appearance, integrity, consistency between batch and shelf life on the pouch and the packaging ...). The competent authorities and the pharmaceutical company are notified of any identified defects, inconsistencies or complaints.
Cytostatics are highly potent pharmaceuticals that are an indispensable medicine group in the treatment of cancer. At the same time, however, they present a considerable risk (CMR – carcinogenic, mutagenic and reprotoxic) that may endanger doctors, nurses or even pharmacy employees when handled improperly. Aseptic production for individual patients takes place in our GMP rooms in order to guarantee adequate product and personnel protection.
Cooperating with the oncological wards, doctors and nurses, our department has supplied patients at the Städtisches Klinikum and other facilities with ready-to-use cytostatic preparations since 1994. Highly skilled and experienced pharmacists, pharmaceutical engineers and PTA work closely together in our team. This ensures standardisation of the entire production chain, including manufacture, labelling and packaging.
We moved to our new production facility in 2010, where the personnel and material lock systems ensure compliance with the safety technology required by law. Here we now manage doctors' requests for individual patient medication and also perform a plausibility check using a special computer program. It is also used for the documentation and archiving of patient and manufacturing data.
Production is organised to ensure efficient use of input materials, as well as proper separation and disposal of waste.
We also use microbiological blind testing to review our work, which involves weekly monitoring of the microbiological levels in production areas.
We offer seminars in the safe management and handling of cytostatics for our employees and the ward personnel.