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Many pharmacies have also now adopted practices of one-stop dispensing and robotic dispensing. One-stop dispensing involves the medicine supply for inpatients being supplied in a form ready for discharge. Robotic and automated systems can be used to pick and label medicines in order to reduce errors in these areas (RPSGB 2007a).

Methods for storage of medicines

The report The Safe and Secure of Handling of Medicines: A Team Approach (RPSGB 2005) details that the responsibility for establishing and maintaining a system for the security of medicines should be that of the senior pharmacist in the hospital. They should do this in consultation with senior nursing staff and appropriate medical staff. The appointed nurse in charge of the area will have the responsibility of ensuring that this system is followed and that the security of medicines is maintained. The nurse in charge may delegate some of these duties but always remains responsible for this task. The safe and secure handling of medicines on the ward is governed by the following principles.

Security

All drugs should be stored in locked cupboards with separate storage for internal medicines, external medicines, controlled drugs and medicines needing refrigeration or storage in a freezer.

Diagnostic reagents, intravenous and topical agents should also be kept separately in individual storage.

Stability

No medicinal preparation should be stored where it may be subject to substantial variations in temperature, for example not in direct sunlight.

The normal temperature ranges for storage are as follows.

Cold storage: products to be stored between 2°C and 8°C. Refrigerators should be placed in an area where the ambient temperature does not affect the temperature control within it. Most refrigerators will function effectively in an environment of 10–32°C. Refrigerators should have a minimum and maximum thermometer fitted which should be read and reset daily (MHRA 2001).

Cool storage: products that need to be stored in a cool place or between 8°C and 15°C. If these temperatures cannot be achieved, these products should be stored in a fridge provided that temperatures below 8°C do not affect the stability of the product. If lower temperatures do affect the stability, it is recommended that they are stored in an area where the temperature will not exceed 18°C (MHRA 2001).

Room temperature: for products that need to be stored at room temperature or not above 25°C (MHRA 2001).

Containers

The type of container used may have been chosen for specific reasons. Therefore all medicines should be stored in the containers in which they were supplied by pharmacy. Medicinal preparations should never be transferred (in bulk) from one container to another except in the pharmacy.

Stock control

A system of stock rotation must be operated (e.g. first in, first out) to ensure that there is no accumulation of old stocks. Only one pack/container of a named medicine should be in use at any one time. A list of stock medicines to be kept on the ward should be regularly reviewed according to usage figures. The medicines to be held on the ward should be discussed between the nurse in charge and a pharmacist with relevant medical staff.

Storage requirements of specific preparations

Aerosol containers should not be stored in direct sunlight or over radiators: there is a risk of explosion if they are heated.

Creams may deteriorate rapidly if subjected to extremes of temperature.

Eye drops and ointments may become contaminated with micro-organisms during use and thus pose a danger to the recipient. Therefore in hospitals, eye preparations should be discarded 7 days after they are first opened. For use at home, this limit is extended to 28 days.

Mixtures may have a relatively short shelf-life. Most antibiotic mixtures require refrigerated storage and even then have a shelf-life of only 7–14 days. Always check the label for details.

Tablets and capsules are relatively stable but are susceptible to moisture unless correctly