do la necesidad» [Discursos sobre la primera década de Tito Livio, 3.12]: el salto desde el reino de la necesidad hasta el
3. Una introducción al existencialismo de Heidegger
2. Stock cards are important for good accountability of stock movements. The cards should be made of stiff cardboard and be placed near the drug products that they refer to on the shelves. If one drug is available in two different strengths, open separate stock cards for each strength.
3. Stock cards are very useful tools in the management of stores. Follow these procedures:
a. Maintain a stock card for each drug or strength of a drug in the store where drugs are kept.
b. Enter quantity of any new stock with the “date, batch number, supplier and expiry date.
c. Enter balance of stock brought forward in “balance” column with date. d. Entries of receipt and issue of drugs are made after the event.
e. Always have an up to date balance of stock..
f. Always issue out required amount of drugs from the store and enter the quantity of drug issued in the “out” column.
g. Physically check the actual balance of stock against current balance in stock card monthly to detect any discrepancy.
Central unit store responsibilities:
Prepare quarterly consumption and inventory reports for the program (at central level).
for delivery.
Monitor all sites to ensure that inventory is current and complete. Oversee physical movement of stock between sites.
When an electronic stock management system is used, oversee management of electronic stock with help from store manager.
Verify the physical stock management tools used by pharmacy/TB ward personnel.
Provide stock cards, dispensing logs or consumption report forms. Confirm pharmacy personnel are preparing reports correctly. Train pharmacy staff on physical stock procedures.
Site pharmacist(s) at facility
If a pharmacist is not available, this position can be filled by a pharmacy
technician, a nurse or other health care worker with pharmacy experience.
Ensure adequate drug stock of SLD in hospital/clinic ward /outpatients Issue monthly supplies of SLDs to treatment supporters
Compile consumption reports and add up weekly totals
Enter weekly consumption information into Electronic Medical Record (EMR) or stock management system (when program uses such electronic systems)
Compile bimonthly drug reports as required by district, Regional or national authorities
Supervise other facility personnel dealing with drugs Maintain stock cards (see section below on stock cards)
Managing Stock
Managing the stock and supply of medications is essential for the provision of health care. This requires an effective system, either paper- or computer-based, for maintaining an accurate inventory of supplies as shipments of medicines arrive at a central storage facility and are then distributed to clinics and pharmacies to be dispensed to patients. DR-TB health care facilities should have systems to track DR-TB drug supplies that are currently available and to assess the quantities of medications that will be needed. A stock card is maintained for each product and is updated every time a shipment is received or supplies are dispensed to the pharmacy. A physical count should be conducted on monthly basis to reconcile the daily and monthly records and provide a reliable foundation for projections of orders and budgetary requirements.
Ordering and Delivering of Drugs and Supplies.
This will involve a mixture of the following systems backed by regular supervision to the treatment units by the ZTLSs who must verify requests.
“Push system”: Central level decides how much to deliver to each unit based on past deliveries and number of patients under treatment.
highly competent personnel and sufficient funding to keep the pipeline full).
There are two steps in making a drug request at the treatment center:
1. Determining the total consumption for each drug daily, monthly and bimonthly. a. Based on the MDR-TB Treatment Card of the patients in the Referral Center,
record the drugs to be taken per day per patient.
b. Calculate the DAILY consumption per drug for all patients receiving it. c. Calculate the MONTHLY consumption by multiplying the daily consumption
by 26 days.
d. Calculate the BIMONTHLY consumption by multiplying the monthly consumption by 2.
For instance, you want to know the total consumption of prothionamide in a Referral Center. If you have 4 patients taking 3 tablets of 250mg prothionamide a day, and 1 patient taking 2 tablets of the same drug per day, the total daily need would be 14 tablets; the monthly need would be 364 tablets (daily consumption X 26); and the bimonthly need would be 728 tabs (monthly consumption X 2). The stock to order would be 1092 tablets ( monthly consumption x 3 or 2 months’ supply plus 1 month of buffer . Repeat this procedure for all patients and drugs.
2. Once you calculate the needs, fill out the SLD/ Drug Requisition Form based on the total consumption.
a. Write the name of the Referral Center and the order period this request is made for.
b. In the first column of the TB Drug Requisition Form, write the drugs you will request.
c. Write the projected bimonthly consumption, then the one month buffer, same as quantity in the “Month” column of your calculation.
d. Follow the formula indicated above in each column. e. Always double check your calculations.
Once you determine the needs for each drug for the two months you will add one month’s supply to that sum as a buffer stock to have on hand in case of emergencies. After determining the total bimonthly needs plus one month buffer stock, complete the Requisition Form by subtracting the stock-on-hand from this number. The stock on hand is how much stock of each drug is presently in the facility. The last two columns of the form will be completed by the authorizing staff when the order is filled and sent to the Central stores.