We are considering the initiation of a new pharmacy-led sterile compounding service at our hospital.
- If you have the budget, use it all ASAP or you will lose it.
- Build the Clean Room as per available resources. Make sure you have the right space for the available workload> be strategic so no extension/construction for next 20 years.
- Leave a space for future technologies i.e. Robots of the future, IV Workflow needs extra electric and network sockets, other compounding devices, etc.
- Make sure the contractor has healthcare experience and knows a bit about USP 797
- Horizontal LAFH ONLY for ordinary drugs (not vertical)
Due to limited resources at this time and as a first step, we narrowed down the types of medications to be prepared in a hood to antimicrobials (antibiotics, antivirals, and antifungals), nutrition (total parenteral nutrition, and pediatric electrolyte solutions), ophthalmic products, +/- monoclonal antibodies. We then determined the overall daily number of preparations requiring sterile compounding as well as the number of hours needed to complete those preparations.
- Good strategy, although I feel it is important to give priority for non-antimicrobial agents since these drugs protect themselves naturally. Just theoretical judgement.
- Work on standardization of doses then invest on batches- batches- batches
One of our main concerns is the fact that the current pharmacy operating hours are limited to 11 working hours on week days, 8 hours on Saturdays, and 3 hours on Sundays and holidays. This schedule, if maintained as such, prevents the pharmacy department from being able to cater for new orders requiring sterile compounding during pharmacy off-hours. The solution that we thought of would be to extend pharmacy operating hours to 24 hours.
- Great thoughts by Naveed & Nawal as shown in previous replies
- JCIA will mercy you if the nurses are well trained under pharmacy supervision in using aseptic technique (strict when needed especially in immunocompromised patients) when mixing/transferring parenteral drugs outside the duty hours.
- Make sure there is a dedicated mixing Bench at the nursing medication room and away from traffic and bed side… I don’t favour LAFW hood in nursing units.
- Have a pharmacist on call to answer nursing queries