Institutional Pharmacy Final

Sterile compounding

preparation and mixing of a medication in an environment free from bacteria, viruses, or any other potentially infection organisms

What USP is followed in aseptic technique

USP 797

Examples of CSP’s prepared in a hospital pharmacy

Large volume and small volumer parenteral, hazardous drugs, and intrathecal prepataions(medications that go into the spine)

Stock room

where all the supplies for sterile compounding

What is in the stock room

medications, SWI, needles, syringes, tubing, IV fluids, and other supplies need to prepare a CSP

Ante room

place where you don and doff PPE, scrub, perform claculations, and gather supplies

What is prohibited in the Ante Room

CARDBOARD BOXES

Clean room/buffer area

where you actually PREPARE your CSP

The buffer area has an iso class of

7

The PEC has an iso class of

5

Where do you prepare the sterile product

6 inches inside the PEC hood

What is a PEC

Primary Engineering Control, which is a device or room that creates a controlled environment for compounding medications. PECs are also known as hoods.

Two types of PECs

Horizontal and Vertical

What is required for sterile compounding

sterile syringe

What are critical sites on the syringe

inner plunger shaft and needle hub

Nosocomial infection

an infection that develops while a patient is in the hospital or receiving medical care

If there was a nosocomial infection outbreak who would investigate

ICC

What is the similarity between a compounding aseptic isolator and horizontal hood?

both vent air through a high-efficiency particulate air (HEPA) filter ventilation system

“Spiking“ is what?

common term used by nurses when they have to pierce an IV bag

Where are the PECs located

the clean room/buffer area

Clean room airflow

airflow is always blowing out of the high positive pressure in this area

When should the prefilters in a PEC be changes

according to the manufacturers instructions

PPE order

Shoe cover, hair cover, face mask, hand wash, and gloves

When preparing an ampule

a filtered needle must be used in addition to a regular needle

Filter needles

is only for ONE DIRECTIONAL use only

How often will your aseptic practices be tested

6 monhsw

what is sterility testing

checking if your aseptic practices are good and if you fail you could lose your job

What drugs need to be protected from light

Doxycycline and Amphotericin B

What will a nurse use to administer insulin

10-drop set

When is a 24 hour supply stocked

each morning

STAT orders should be prepared immediately ___

usually within 15 minutes or less

Can you return unit doose medications?

yes, as long as the package is unopened

ADMS

automated dispensing system

Benefits of ADMS

organized work flow, invnetory management, and keeps medication secure

Purpose of eMAR tech(electronic medication administration record)

to keep track of medication administration (helps staff communicate and know when a patient has received medication)

Benefits of Electronic health records

they allow interoperability with in the hospital setting

Class I drug recall

most serious. Death or irreversible damage

Class II drug recall

The drug may cause temporary or reversible health effects, but serious harm is unlikely.

Class III drug recall

The drug is unlikely to cause harm but violates FDA regulations (e.g., packaging issues, minor defects)

Class IV drug recall

known as a "notification" or "market withdrawal", is for situations where a drug does not violate FDA regulations but has a known, minor default, and no threat to patient

Sentinel event

someone has been seriously injured or has died

FDA reporting systems

MedWatch, MEdication Error Reporting System (MERP)

Importatn thing to remember regarding penicillin countring

ALWAYS wipe the counting tray with alcohol just in case the next patient is allergic to this drug

Medication error

a preventable event that may cause of lead to inappropriate medication use or patient hardm

Nuclear medicine

involves the preparation of radioactive pharmaceuticals (agents used to diagnose certain medical problems or treat certain diseases)

Prescription error

Mistake in writing the prescription (e.g., wrong drug, incorrect dose, or unclear instructions).

Omission Error

Failing to give a prescribed dose of medication.

Wrong time error

Giving medication at the incorrect time (outside the allowed time frame).

Unauthorized error

Giving a drug not authorized for the patient (wrong prescription or order).

Improper dose error

Giving too much, too little, or an unapproved dose.

Administration error

Mistake in how the drug is given (wrong route, technique, or preparation)

Wrong drug error

Giving the incorrect medication (mix-up in selection or dispensing).

Wrong patient error

Giving the medication to the wrong person (due to ID confusion).

Comission error

Documenting or carrying out a medication order incorrectly.

Distraction error

Errors caused by interruptions or multitasking.

Harmful effects of hazardous drugs

teratogenicity, genotoxicity, and organ toxicity

Where are hazardous drugs prepared

Vertical PEC aka. biological safety cabinet

When receiving inventory for chemo drugs ___

always wear gloves to check the order in

Who are most hospitals accredited by

The Joint Commission (TJC)