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These guidelines outline the recommended processes and techniques for hospital drug formulary management and describes the pharmacist’s responsibilities and roles in managing the Formulary System in consonance with other healthcare professionals. These guidelines also provide assistance to pharmacists in the organization and operation of the pharmacy and medical stores. There is a committee or equivalent body, evaluation of medications for formularies, and development and implementation of strategies to manage medication use through the Formulary System.


A Formulary is a continually updated list of medications and related information, representing the clinical judgment of physicians, pharmacists, and other experts in the diagnosis, prophylaxis, or treatment of disease and promotion of health. A Formulary includes, but is not limited to, a list of medications and medication-associated products or devices, medication-use policies, important ancillary drug information, decision-support tools, and organizational guidelines.

The P&T Committee is responsible for managing the Formulary System. This Committee is composed of hospital’s consultant doctors, other prescribers, pharmacists, nurses, administrators, quality-improvement managers, and other healthcare professionals and staff of the hospital who participate in the medication-use process. The Committee guides the following :-

How medications are requested for addition to or deletion from the Formulary?
How medications are reviewed for addition to or deletion from the Formulary, including who performs the reviews?
The process for developing, implementing, and monitoring medication-use guidelines.
Methods for ensuring the safe prescribing, distribution, administration, and monitoring of medications.
Methods for selection of suitable manufacturers for specific medications (a pharmacist is responsible for specifications for the quality, quantity, and source of supply of all medications, chemicals, biologicals, and pharmaceutical preparations used in the diagnosis and treatment of patients).
The process for using no Formulary agents within the institution.
The process for managing drug product shortages.
The process for developing an organization-specific MUE plan.
Policies regarding specific medication-use processes (e.g., procurement, prescribing, distribution, administration, monitoring).
The process for disseminating medication-use policies and how users will be educated regarding the process.
Evaluating medications at regular intervals for inclusion in the Formulary.

Desun Hospital has introduced a unique Hospital Drug Formulary for the commonly used Molecules used for treatment both in In-Patient Department (IPD) and Out-Patient Department (OPD). A set of four brands has been selected, and catalogued, for each Molecule, depending on the usage and also the current requirements of the Hospital.This unique endeavour enables Desun to restrict and implement Evidence Based Antibiotic Policy and other usages of medicines thereby helping in rational usages of medication. Being an NABH Accredited Hospital, Desun earnestly focuses on detailed strict and scientific prescription for all the patients admitted or attending the Hospital.

How DESUN’s Critical Care Team delivers stunning clinical outcomes!

Constantly implementing techniques based on latest global standards has transformed DESUN Hospital Services from Good to Great!


In the previous issue of DESUN Update we had focused on measures adopted by DESUN for prevention of CLABSI. The basic measures, the risk factors, the complications & the precautionary measures followed at DESUN to prevent CLABSI

A ventilator is a machine that helps a patient to breathe by giving combination of air and oxygen through a tube inserted into the respiratory tract. The tube can be placed in a patient’s mouth, nose, or through a hole in the front of the neck. The tube is connected to a ventilator.

Ventilator Associated Pneumonia or VAP is a lung infection or pneumonia that may develop in a person who is on ventilator.

VAP can be a very serious life threatening infection. Most of the time, these infections can be treated with antibiotics. The choice of antibiotics depends on which specific bacteria are causing the infection.

Desun’s 1st Line Preventive Approach

Patient’s Bed Alignment : Head of the patient’s bed is raised & kept aligned unless barred by other medical conditions.
Proper Breathing Exercise : Monitoring if the patient is able to breathe on their own regularly so that the ventilator can be taken off as soon as possible.
Maintaining Proper Hand Hygiene : Assuring cleanliness of care-giver’s hands with soap & water or an alcohol-based hand rub before & after handling the patient or the ventilator.
Proper Mouth Washing : Cleaning the inside of the patient’s mouth on a regular basis with candid mouth paint.
Proper Cleaning of Equipment : Cleaning the equipment between the use on different patients.

Selection of Proper Intubation Methods : Orotracheal intubation is preferrable rather than naso-tracheal intubation.
Maintainence of Proper Hand Hygiene During Intubation : Performing endo-tracheal intubation with proper hand hygiene & sterile techniques.
Maintaining Proper Procedures : Proper suctioning procedures are followed under sterile conditions.

Humidifier is kept empty for high flow Oxygen (more than 4 ltrs/min).
Using R.O.Water in humidifier.
Routinely verifying appropriate placement of the feeding tube.
Maintaining good oral hygiene for prevention of pharyngeal colonization and subsequent aspiration.
Performing surveillance of tracheal cultures in intubated patients as & when required.

Instructing pre-operative patients, especially those at high risk for contracting Pneumonia, about taking deep breaths and ambulating as soon as medically indicated in the post-operative period.
Using incentive spirometry on post-operative patients who are at high risk for Pneumonia.