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10 Dizon, Patricia Paula Marie M.

Hospital Pharmacy
2F Pharmacy May 03, 2017

Chapter 14
1.) What is the evidence supporting the role of the pharmacist in compounding
sterile preparations?
Complacency can arise in pharmacies undermining the potential benefits of a
pharmacy-based intravenous admixture program. Sander et al. reported that
pharmacists had an error rate of 7.24% and a contamination rate of 7%. There were
higher than that, from observations for pharmacy technicians. Pharmacists made
fewer errors and contaminated fewer IV preparations when they knew they were
being observed, suggesting the emergence of complacency and need for continuing

2.) To what degree should pharmacists take responsibility for compounding sterile
Responsibility for compatibility and stability of formulated preparations rats
with the pharmacists.

3.) What about medical emergencies in which compounded sterile preparations are
In an institution that relies on written medication orders, a process should be
developed to address the medication order review process through collaboration
between the pharmacy and emergency departments. An alert system should be
developed to notify the EMP to any medication orders requiring immediate
pharmacist intervention, while all other routine medication orders would be sent to
central pharmacy for review, processing and preparation.

4.) Describe how to justify the cost of secondary engineering controls to an

The surfaces of the work area should be smooth, impervious, free from cracks
and crevices, and non-shedding, thus making them easy to clean and disinfect.
Work surfaces should be constructed of durable, smooth, and impervious materials,
such as stainless steel or folded plastic. Carts should be of stainless steel wire or
sheet construction with good quality, cleanable casters.
5.) How would you explain the need to remove all jewelry and cosmetics before
donning sterile garb?
Before entering the buffer area, compounding personnel must remove outer
garments, all cosmetics (they shed flakes and particles) and all hand, wrist and
other visible jewelry/piercings that can interfere with the effectiveness of personal
protective equipment (PPE). Wearing of artificial nails is prohibited while working in
the sterile compounding environment. These are all done because the chemicals
that make up a cosmetic may react while sterilizing, or it may contaminate the stuff
being sterilized.