NURSING MANAGEMENT

ASSIGNMENT
ON
MATERIAL
MANAGEMENT –
INDENTING

Submitted to:
DR. Mrs. T. Chandra M.Sc (N), Ph.D
Lecturer
GCON Cuddlaore

Submitted by:

M.Sc Nursing II year

Submitted on :
INTRODUCTION
Indenting is similar to a requisition which is used as inter-departmental
document and in which we indent or summarize the quantity of the ingredients
while making a standard recipe and standard purchase specification. Stores
scrutinize such indents and collectively places and an order with the suppliers to
send such material on the specified time and date.
DEFINITION OF INDENTING
• An indent is an official order or requisition for medicine and supplies from the
medical stores.
• The nurse acquires the equipment and supplies based on the need estimation,
availability and the budget.
• As the equipment is received it should be inspected and stored as per the
classification and according to the rate of consumption.
OBJECTIVES OF HOSPITAL INDENTING
 To ensure uninterrupted flow of materials.
 To buy economically in a competitive market; (i.e. to avail the materials,
medicines and equipments at minimum possible cost, ).
 To keep inventory investment low and increase et turn over.
 To develop good buyer-supplier re (i.e. to establish good relationship
with suppliers, leading to favorable image in business circles)
 To develop and reliable alternative source of supply.
MEDICINES PROCUREMENT
Procedure for indenting / purchase and receipt of medicines:
For the guidance of all concerned, the following procedure is laid-down for
indenting / purchase and receipt of medicines for the Financial Year 2011-12
and onwards.
 Initiation
 Annual Indent for medicines for the next finanical year
 Purchase Orders
 Review of Purchase Orders for supply of last instalment
 Procedure for Receipt & Accounting of Medicines
  Procedures to be followed at Hospital after receipt of medicines
 Release of payment against Purchase Orders (PO on Hospital Price) of
annual indent
 Purchase of medicines outside the Annual Indent
1. INITIATION
 Initiation of the process may be taken up simultaneously by MM
Department and the hospital preferably in the first week of September
every year. Indent for the financial year may be forwarded to MM Dept.
by the first week of November .
 MM Dept, in consultation with the hospital, may prepare a list of
manufacturers of medicines, every year, from whom most of the
medicines could be procure
 MM Dept. may then write to them, giving our commercial terms and
conditions (as vetted by the Project Finance), such as shelf-life, return of
short expiry medicines at the time of receipt, inspection, phased supply
etc., for confirmation of their consent to supply medicines as per the
commercial terms and conditions, including the following:-
1. That medicines would be supplied by them directly or through their
authorized dealers concerned for the project:
2. That the suppliers furnish the hospital price list of their products with
applicable discounts, if any;
3. In case the manufacturer is not willing to supply directly, they may give
the details of their authorised distributor / supplier who will be supplying
the medicines.
4. That medicines depending on the quantity, may be supplied in a phased
manner, i.e. 40% initially and then 30% each at two regular intervals
5. After obtaining consents and other details from the manufacturers, MM
Department, in consultation with the hospital, should shortlist the
manufacturers for the relevant medicines.
2. Annual Indent for medicines for the next finanical year
The annual indent for medicines may be categorized as:-
 Life saving drugs
 Proprietary medicines
 Vaccines & Antidotes
 Tonics
 Other Drugs.
  The annual indent of medicines may be made by a committee consisting
of in- charge of medical stores and other doctors nominated by CMO.
The annual requirement needs to be approved by CMO.
 Vaccines & Antidotes may be purchased from Govt. Agencies or from
manufacturers of repute / their nominated distributors/dealers.
 Separate annual indent may be raised by the hospital for general items
like syringes, needles, cotton, bandages, X-Ray films, laboratory items,
sanitary items (Phenyl) etc. MM Dept. may procure the medicines from
approved vendors once a year.
 The hospital may raise indents for other medicines.
 The quantities may be worked out based on the previous year's
consumption, indent/order status, stock position at issue/consumption
points and expiry dates of medicines.
 The indent should contain details of brand name (not exceeding six) and
 In cases of proprietary medicines, the proprietary certificate in the
prescribed format is to be given by CMO and approval of Head of
Project obtained.
 Ministry of Chemicals & Fertilizers, Govt. of India has circulated a list
of 102 medicines that are manufactured by PSUs like IDPL, HAL,
BCPL, KAPL and RDPL. The prices of these medicines are fixed by
National Pharmaceutical Pricing Authority (NPPA) and a discount of
35% is allowed. This has to be given due consideration while raising the
indent for medicines.
 Based on timely delivery and other parameters project may finalize the
Quantity of medicines to be procured from PSU with the approval of
Head of Project.
 The indent may contain the last purchase rate for purposes of cost
estimation and facilitating Finance Department to vet the indent.
 A committee comprising of officers from MM Dept, Finance and the
hospital in- charge may review the indent and record its
recommendations and obtain the approval of competent authority.
 The Indent with the recommendations of the committee may be
forwarded to MM Department, who will register it and forward it to
Finance for vetting and to C/A for sanction.
 Based on the approved indent, MM Dept may take procurement action.
 The whole process may be completed by November every year.
3. Purchase Orders
 Materials Dept. in consultation with Hospital In-charge, may prepare
Purchase Order along with all the terms and conditions.
  PO may contain the names and quantities of medicines, commercial
terms such as Unit Price (as per the Hospital price list forwarded by the
Manufacturer), Price basis, Freight, P&F, ST, Phased Delivery, Payment
Terms, Consignee and Shelf Life of min. 80%.
 In the payment terms, a condition may be incorporated that the
manufacturer shall furnish the applicable Hospital price list, to the
Materials Dept.
 The PO may be issued in the name of the manufacturer only with
flexibility to the manufacturer to supply the medicines through any of
their authorized dealers / distributors/stocklist.
 Where ever the quantity is substantial and supplies are required in
phases, the PO may clearly specify that 40% of the ordered quantity only
may be supplied in the first stage and the balance in two installments of
30% each with an interval of four months between each consignment,
after confirmation by the Materials Dept. to this effect. Any deviation
from phased delivery can be considered in exceptional cases with
approval of CA, upon written instructions issued by MM Dept. to that
effect.
 In case of annual Purchase Order value less than Rs.30,000/-, the supply
can be effected in one installment. However, the order shall be placed on
the authorised dealer/stocklists / distributors / manufacturer.
4. Review of Purchase Orders for supply of last installment
 Thorough review should be done by the CMO/Hospital In-charge before
giving clearance for the 30% final installment.
 If in the opinion of the Hospital In-charge, any medicines are required
before the scheduled supply, he may obtain specific approval from the
Head of the Project. It may be clearly indicated in the order that the
installments may be supplied as directed.
5. Procedure for Receipt & Accounting of Medicines
 On receipt of the medicines at Central Store Depot (CSD), the
consignments may be checked with packing list and after entering in the
relevant register, the packages may be handed over along with documents
to Hospital Medical Stores.
 In the receipt section of Hospital Stores, the consignments may be
opened in the presence of authorised hospital representative and the
representative from MM Dept. (at lease of the rank of JO).
  The medicines may be checked initially for damage / breakage and
against invoice for quantity, Batch No. Shelf life, and MRP vis-a-vis
hospital price list.
 The medicines may be taken into stock within a week from the date of
receipt and discrepancies, if any, are to be intimated to MM Dept: for
further action.
 The receipt voucher shall contain all these details and shall be duly
signed by Doctor In-charge and Materials Dept, representative.
 All the Project Hospitals will use uniform receipt voucher forms as per
HMS package.
6. Procedures to be followed at Hospital after receipt of medicines
 In the Hospital, all the medicines received in the first two consignments
of 40% and 30% respectively may be market with NMDC stamping.
Depending upon consumption, the medicines required in the third lot of
30% may be stamped periodically (say on daily basis) as per instructions
of the CMO/Hospital In-charge.
 Issue of medicines from Medical Main Stores to OPD and Wards shall
be properly accounted. The medicines returned to Main Medical stores
are to be taken into stock.
 Receipts and issues to be documented both manually in vouchers, cardex
system and to be fed in the Hospital Management System (HMS)
package simultaneously.
 Details of medicines with expiry during the next 3-6 months are to be
circulated among all the Doctors and also circulated to sister project
Hospitals on intranet for information and possible prescription. Efforts
may be made to retum the medicines within one month before expiry, as
far as possible.
 Expired medicines, if any, may be segregated and annually / bi-annually
processed for destroying in the presence of an authorised committee.
Record may be kept of the same for taking cognizance in indent
preparation for the subsequent year.
7. Release of payment against Purchase Orders (PO on Hospital Price) of
annual indent
 For release of payment, a certified copy of the complete hospital price
list directly from the manufacturer may be the basis.
 Materials Dept. may verify the price list for its authenticity and forward
the same to Finance along with the documents at para 5.3 for release of
payment after verification.
  In case of variation in prices at the time of supply, no amendment letter
is required since clause already exists in the Purchase Order for payment
as per price list ruling at the time of supply.
8. Purchase of medicines outside the Annual Indent
 The medicines required outside the annual procurement may be procured
from Manufacturer / authorized dealer / authorized stockist only for the
supplies on hospital rates.
 Quantity to be procured from local purchase to be restricted to maximum
of 5% of the annual indent value and reasons to be recorded for such
purchase and approved by Project Head in each case. The local purhcase
is to be done as per the existing delegation of powers.
 In case of non availability of medicines (prescribed by external doctors
or due to stock out) the patients are procuring the medicine for which
reimbursement is being done. To streamline the same the following
procedure may be followed:
1. The Project MM Dept, can enter into a tie up arrangement with one or
two local Medical Stores for supply of medicines at the discounted
rate of MRP.
2. For making tie up an open tender notice may be published in local
news paper indicating approximate value of purchase of medicines
for one year. The tenders may also be published in NMDC website.
3. Based on the offers received, project may finalize the agencies with
whom tie up can be made for supply of medicines.
4. CMO may forward the list of urgently required/stock out medicines
along with the details of manufacture, Qty required etc to MM Dept.
along with reason for purchase.
5. Based on the requisition of CMO, MM Dept. may issue a Letter
Order to supply the medicines to Hospital against the letter issued by
HOD MM Dept. In case of emergency the medicines can also be
supplied against the requisition of CMO which is subsequently to be
regularised by MM Dept.
6. Necessary Receipt voucher is to be prepared at hospital and
forwarded to MM Dept. and Finance.
7. The payment will be released by Finance as per the R.V., Letter
Order and as per the tie up entered with supplier.
8. The details of medicines purchased under the system are to be put up
to HOP every month.
9. The procedure may also be followed for such medicines where there
is a stock out.
9. General Points
 For purchase of sedatives such as Calmpose etc which fall under
Schedule X and Narcotics and Psychotropic drugs, license has to be
obtained from the Drugs Controller and the issue of such medicines to be
recorded as per the regulation.
 For life saving drugs the Stock position may be reviewed by CMO at
least once every month for replenishment.
 All the doctors may conduct surprise checking of medicines and other
items (at least 15 items) every month and the report may be submitted to
HOP on monthly basis signed by CMO.
 Medicines which are generally of shorter shelf life, or which may
deteriorate faster may not be stocked unless they are essential drugs like
life saving drugs.
CONCLUSION
Proper indent management ensures that essential supplies are always
available when needed, reducing the risk of treatment delays and improving
patient outcomes.

BIBLIOGRAPHY
1.Sudha. R. Nursing Education – Principles and Concepts. 1st edition,
Newdelhi: Jaypee brothers medical publishers.
2. Basavanthappa. B.T. Nursing Administration. 2nd edition. Newdelhi:
Jaypee brothers medical publishers.
NET SOURCE
https://www.sciencedirect.com