Implementation of safety standards of compounded sterile preparations in hospital pharmacies: a multinational cross-sectional study

Abstract

ObjectivesTo evaluate implementation of safety standards of compounded sterile preparations in different hospitals.MethodsThis cross-sectional study included 124 hospitals from 19 countries. A survey was developed based on the guidelines and safety practices of the Institute for Safe Medication Practices (ISMP) for sterile preparations compounding, and was sent to the members of the Intravenous and Parenteral Nutrition experts’ network (IV PN experts’ network) in the Gulf region and beyond using SurveyMonkey software.Results124 pharmacists were invited to participate in this study. Only 39 (31.5%) pharmacists from seven countries responded: 16 (41%) of the participants were pharmacy supervisors, and 23 (59%) had >10 years of work experience. However, a majority, 27 (69%), of the respondents were from Saudi Arabia. Written policies and procedures for sterile preparations compounding were available in 37 (95%) hospitals. The concentrated electrolytes were removed from all patient care areas in 28 (72%) hospitals, and 30 (77%) hospitals clearly labelled those as high-alert medications. The use of advanced technologies, such as bar code verification or IV robotics, for compounding sterile preparations were not implemented in 27 (69%) hospitals.ConclusionsMinimum standards and best practice recommendations to ensure safety of sterile preparation compounding were implemented in many hospitals of different countries. However, advanced technologies were not implemented by the majority of the hospitals.

Implementation Status and Challenges Associated With Implementation of the Targeted Medication Safety Best Practices in a Tertiary Hospital

“…The findings from our study are similar to published evidence in SA. One study across hospitals in SA found that written policies for sterile preparations were available and implemented [18]. However, when compared to the ISMP survey, they had a low implementation rate (34%) [12].…”

“…However, they might not know why. Evidence shows that knowledge is one of the important factors that affect the performance of healthcare providers and the quality of care they provide [18][19][20]. Findings from the ISMP survey did not include knowledge as one of the challenges/barriers to implementation [12].…”

A Comparative Analysis of Public Hospital Pharmacy Systems in Norway and Pakistan: A Pilot Implementation of the American Society of Health-System Pharmacists’ (ASHP) Guidelines

“…Compounded drugs are usually prepared extemporaneously in the community as well as in hospital pharmacies for custom orders [49]. According to Fadel et al [50], minimum standards and best practice recommendations to ensure the safety of sterile compounding were reported in hospitals in Saudi Arabia, the United Arab Emirates, Bahrain, Kuwait, Egypt, Malta, the USA, and others. However, advanced technologies were not implemented by the majority of the hospitals.…”

Evaluation of an intravenous preparation information system for improving the reconstitution and dilution process

“…Therefore, our findings need to be confirmed in multiple hospital settings, to enable generalization, and more studies of IPISs are needed. In most countries where IV preparation errors were reported, ready-to-use IV bags, eMARs, and smart pumps with bar codes are not in common use yet [12,13,[22][23][24][25][48][49][50][51][52][53][54]. However, these systems will likely be implemented in the future.…”