Inpatient Pharmaceutical Management - hmislk/hmis GitHub Wiki

Inpatient Pharmaceutical Management

Overview

Inpatient pharmaceutical management covers the complete lifecycle of medicines for admitted patients: from prescribing in the ward, through requesting and receiving medicines from the pharmacy, to administering medicines to patients and returning unused stock.

The HMIS inpatient pharmacy module supports three coordinated workflows:

Ward Medicine Request, Issue, and Return — the full cycle of a ward requesting medicines for a patient, pharmacy issuing them (with substitution where needed), ward receiving them into ward stock, and returning unused medicines back to the pharmacy via a porter
Ward Medication Administration — recording that a specific medicine was administered to a patient, and deducting the administered quantity from ward stock
Direct Issue to BHTs — pharmacy issuing medicines directly to a patient's admission without a prior ward request

Key Workflows

Request-Based Workflow (Ward → Pharmacy → Ward)

Ward prescribes medication for patient
        ↓
Ward creates a medicine request to pharmacy
        ↓
Pharmacy reviews request, substitutes items if out of stock
        ↓
Pharmacy issues medicines to porter
        ↓
Porter carries medicines to ward
        ↓
Ward confirms receipt — medicines enter ward stock
        ↓
Nurse administers medicines to patient
        ↓
Nurse records administration event
        ↓
Ward staff deduct administered quantities from ward stock
        ↓
(Optional) Ward returns unused medicines to pharmacy via porter
        ↓
Pharmacy confirms receipt of returned medicines

See the full guides:

Ward Medicine Request, Issue, and Return Workflow — Steps 1–5 of the porter-mediated cycle
Ward Medication Administration and Stock Deduction — Recording administration and deducting stock

A request is automatically marked as fully issued once every line has had its full requested quantity issued (taking into account any cancellations or returns of earlier issues). Pharmacists can also manually mark a partially-issued request as completed using the "Complete the Request" option, which requires the PharmacyBhtRequestForceComplete privilege. See Issue Medicines for Ward Requests for details.

Direct Issue Workflow (Pharmacy → BHT)

Pharmacists can issue medicines directly to a patient's admission without waiting for a ward request. This is useful for urgent medications, after-hours dispensing, or when pharmacy staff are managing the full dispensing workflow.

See Direct Issue to BHTs from Pharmacy.

Key Pages

Page	Accessed From	Purpose
Request Medicines from Pharmacy	Admission Profile → Pharmacy BHT Request, or Ward Medications → Request Selected	Nurse creates a medicine request for a patient
BHT Issue Requests	Inward → Pharmacy → BHT Issue Requests	Pharmacist views pending requests and issues medicines
Receive Medicines from Pharmacy	Admission Profile → Receive Medicines from Pharmacy	Ward confirms receipt of medicines from porter
Return Medicines to Pharmacy	Admission Profile → Return Medicines to Pharmacy	Ward sends unused medicines back via porter
Accept Returns from Ward	Inward → Pharmacy → Accept Returns from Ward	Pharmacy confirms receipt of returned medicines
Mark as Administered	Clinical Assessment → Inward Medicines	Nurse records a medication administration event
Deduct from Ward Stock	Ward workbench	Bulk-deduct administered medicines from ward stock
Direct Issue to BHTs	Inward → Pharmacy → Direct Issue to BHTs	Pharmacist issues directly to a BHT
Direct Issue to Theatre Cases	Inward → Pharmacy → Direct Issue to Theatre Cases	Pharmacist issues to theatre/OT
Search Inpatient Direct Issues	Inward → Pharmacy → Search Inpatient Direct Issues	Find pharmacy issue bills by bill or item
Search Issue Returns	Inward → Pharmacy → Search Issue Returns	Find pharmacy return records
View Pharmacy Requests	Inward → Pharmacy → View Pharmacy Requests	Search and view request history

Stock Tracking

Ward-held stock is tracked separately from pharmacy stock. The system maintains:

Pharmacy stock — medicines held in pharmacy department stock, available for issuing
Porter in-transit stock — medicines that have been issued by pharmacy but not yet confirmed as received by the ward (held against the porter's staff record)
Ward stock — medicines that have been received by the ward and are available for administration to patients
Administered stock — medicines that have been given to patients and deducted from ward stock

Stock movements between these states are tracked through stock history records, providing a full audit trail from pharmacy issue through to patient administration or return.

Substitution During Issue

When the pharmacy issues requested medicines, pharmacists can substitute an out-of-stock item with an equivalent alternative. Substitutions are restricted to items with the same unit/pack type. See Ward Pharmacy BHT Substitute Functionality for detailed guidance.

Use Case 1

Use Case 2

Back to Pharmaceutical Logistics