Patient Medication Distribution Log Template printable pdf download

Administrative

Policies and Procedures

Originating Venue: Medication Management

Policy No.: MM-2702

Title: Sample Medications Policy Procedure

Cross Reference:

Date Issued: 05/09

Date Reviewed: 11/14

Date: Revised: 10/14

Attachment: Patient Distribution Log – Medications

Page 1 of 2

Purpose:

Premier Medical Group (PMG) accepts sample medications from pharmaceutical drug representatives and dispenses

them to our patient population. The distribution of sample medication allows patients a "trial run" on a new

medication without financial expense. Although the samples are free-of-charge, this does not lessen the physician's

continuing responsibility to the patient.

Policy:

PMG will ensure patient safety in accepting and distributing sample medications.

Procedure:

1. All sample medications will be stored in a locked room or cabinet. Medications should not be in exam rooms

where patients are left unattended.

2. The storage area should not be subject to extreme temperatures. All refrigerators containing medications

will have daily temperature checks. Logs of these checks will be kept in accordance with the Medication

Refrigerator Policy and Procedure.

3. Lighting in the storage room/cabinet should allow easy reading of medication names and dosages.

4. Samples should be well-organized by drug or drug group. Medications with similar names should be located

in separate areas.

5. All medications in the practice will be checked monthly for outdates, deterioration and appropriate location.

Include all areas in which medications are stored including refrigerators.

6. Expired sample medications will be discarded in accordance with federal, state and local laws.

7. An inventory of sample medications will be maintained. A form should reflect the names of patients who

received medications, including the lot number. If preferred the office may use a sheet for each different

medication. These sample logs are intended to provide PMG with a methodology to track the sample

medications that are dispensed as well as to aid in identifying those that have expired and require disposal.

The Patient Distribution Log (See form attached) is a means to keep track of the lot numbers of the

medications given to each patient. Use of this log will simplify the process of identifying those patients that

have received a medication whose lot number has been recalled or has had other warnings or issues

associated with it.

Patient Medication Distribution Log Template