#VT01-1 VALIDATION TOOL THE SETTING OF THE COMMUNITY PHARMACY The pharmacy settng can alter the qualty of patent care and may nfluence patent satsfacton. An approprate settng may ncrease the probablty of meetng the patent s expectatons from the pharmacst. General Informaton Tool ID Number Montor Date Tme Detals of the Pharmacy Name of Pharmacy Address Telephone Number Pharmacy Regstraton Number Number of years establshed Number of clncs Separate toletres area YES/ NO Separaton of dsplay of medcnes from other merchandse YES/NO The tool s used once for every communty pharmacy beng studed. It s advsable to perform the tool after the completon of all the other tools. In ths way the montor acqures more background nformaton on the pharmacy by the tme ths tool s used. Base the assessment on observatons made and where necessary on nformaton obtaned from the managng pharmacst. For each step choose the relevant statement(s) as approprate. When the assessment process s completed, enter the scores n the computer usng an Excel fle and work out the total score. Wrte the total score obtaned n the approprate box on page 7. Before proceedng any further refer to Defnton Sheet 01.
#VT01-2 1. PHARMACY LICENCES All pharmacy lcences and permts are current 2 v v All pharmacy lcences are properly dsplayed or fled as approprate 2 The name of the managng pharmacst, address and telephone number are dsplayed on the outsde of the pharmacy 2 The pharmaces openng on Publc Holdays accordng to the roster ssued by the Department of Health are dsplayed on the outsde of the pharmacy 2 The managng pharmacst and all pharmacsts workng at the pharmacy are legally qualfed and approprately lcensed 2 2. STAFFING Tck one The managng pharmacst s employed on a full-tme bass 10 The managng pharmacst has contacts wth locum pharmacsts when he takes leave 10 The managng pharmacst s employed on a part-tme bass and s asssted by addtonal pharmacsts to ensure that a pharmacst s avalable to gve servces to the communty at all tmes when the pharmacy s open One to two part-tme pharmacsts 8 Three to fve part-tme pharmacsts 7 Fve or more part-tme pharmacsts 6 3. APPEARANCE OF THE PHARMACY The pharmacy s sutably ventlated and lghted 3 The pharmacy s kept clean 4 The pharmacy s mantaned n an orderly and tdy condton 3
#VT01-3 4. THE PHARMACY IS ACCESSIBLE Doors are not obstructed by the exhbton of merchandse 5 Entrance and doorways are wde enough to allow puschars to enter 5 5. THE ENVIRONMENT WITHIN THE PHARMACY Dstrbuton of health promoton leaflets 2 Health promoton advertsements dsplayed 2 The pharmacy does not encourage sale of ordnary confectonery by mpulse purchase at tll ponts or at the medcnes counter 2 v In the pharmacy there s a separate area for counsellng 2 v The dspensng counter does not obstruct the communcaton between the patent and the pharmacst 2 6. PROFESSIONAL IMAGE IN THE PHARMACY Pharmacst wearng lab coat 4 Dress code for pharmacst 4 Background musc or other broadcasts n the pharmacy are not played at such a volume as to cause dstracton 2 7. TOILET FACILITIES AVAILABLE Tolet does not open drectly nto dspensary 2 Tolet s kept clean 2 Tolet s kept n good order 2 v There are hand washng facltes n the tolet 2 v There are hand dryer or towelng facltes n the tolet 2
#VT01-4 8. WINDOW DRESSING OF THE PHARMACY Sgn denotng pharmacy on the outsde 5 Man door s not obscured by notces, stckers or other materals 2 Dsplay of health promoton advertsements and dsplay of tems related to pharmacy n the shop wndow 3 9. THE SIZE OF THE DISPENSARY Is adequate for the volume of dspensng carred out 5 Allows effcent communcaton and supervson 5 10. AREA FOR DISPENSING Set n a separate part from the dspensng counter where personnel are not nterrupted 5 Set n a secluded area 4 Located wthn the dspensng counter 3 v Work surface s kept free of equpment, supples, records and labels 5 v Work surface s cleared pror to use 3 11. IN THE DISPENSARY There s a source of potable water 4 There s a wash hand basn wth hot and cold water 3 There s a wash hand basn wth cold water only 2 v There are facltes for waste dsposal 3
#VT01-5 12. FORMULARY There s a formulary that lsts medcatons readly avalable n the pharmacy 5 The health professonals are kept regularly nformed of addtons, deletons and changes n the formulary 5 13. FORMULARY SYSTEM Crtera for ncluson of tems to the stock lst Montorng of requests by clents 5 Montorng of prescrptons 5 14. NON-FORMULARY REQUESTS Tck one Patent s told to come agan and medcne s ordered 10 Request documented for consderaton for ncluson 8 Patent s told that medcne s not avalable and no further acton taken 2 15. MEDICATION QUALITY Tck one There s a system to retreve and safely dspose of dscontnued, expred or recalled medcatons Organsed and systematc procedure 10 Random check 5
#VT01-6 16. MEDICATION STORAGE Medcnes restrcted for sale from a pharmacy are not accessble to the publc for self-selecton or self-servce 3 Medcnes are stored away from sunlght and heat 3 v Antseptcs, other medcnes for external use and dsnfectants are stored separately from nternal and njectable medcatons 1 There s a refrgerator avalable for medcnes requrng low temperatures 3 17. POLICIES AND PROCEDURES Polces and procedures are developed on the orderng and dstrbuton systems of medcatons Wrtten and organsed n a manual that s readly avalable to pharmacy staff 4 Verbal 2 Are enforced 4 v Include a lst of medcnes whch are dspensed only on a prescrpton 2 18. PERSONAL MEDICATION RECORDS The pharmacy develops and mantans a medcaton profle for each patent whch contans Name 1 Date of brth 2 Sex 1 v Pertnent problems and dagnoses 2 v Current medcaton therapy ncludng prescrpton and non-prescrpton medcatons 2 v Medcaton allerges and senstvtes 2
#VT01-7 19. CONFIDENTIALITY OF PATIENT INFORMATION Tck one The patent medcaton records are avalable only to pharmacsts workng wthn the pharmacy 10 The patent medcaton records are avalable to all personnel workng n the pharmacy 2 20. USE OF PATIENT MEDICATION RECORDS Pror to dspensng The pharmacst consults the medcaton record to check for therapeutc duplcaton, potental nteractons, contrandcatons and ncompatbltes 3 The pharmacst uses patent medcaton records and current knowledge to suggest over-the-counter medcaton and help patents wth managng ther medcatons and to suggest prescrpton medcatons when dscussng patent medcal hstory wth other health professonals 3 Each dose of medcaton admnstered s recorded properly n the patent s medcaton record so as to montor therapeutc outcomes. 4 TOTAL SCORE REMARKS