Improved aseptic technique can reduce variable contamination rates of ward-prepared parenteral doses

Austin, P.; Elia, Marinos

doi:10.1016/j.jhin.2012.10.009

Cited by 17 publications

(30 citation statements)

References 2 publications

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“…This left 137 records, which were individually subjected to a full text review to confirm relevance and compliance with the above criteria to yield a final total of 34 studies from 33 records. 8, Each of the final 19 studies from 17 records identified in our 2009 search were identified in the present search but five of those studies from four records were excluded due to inadequate and/or inadequately described pharmaceutical environments. 9,12,[14][15][16][18][19][20][21][22]24,33,36,[43][44][45][46][47] The methodological stages of the search are shown in Figure 1.…”

Section: Methodsmentioning

confidence: 99%

“…18,34,36,40 Overview of the rate of contamination of doses prepared in clinical and pharmaceutical environments A grand total of 16,552 doses eligible for inclusion were identified from 34 studies taken from 33 records, which are summarized in Table II. 8, The single record identified through other sources in our previous review was identified by the present literature search. 9,12 M A N U S C R I P T …”

Section: Quality Of Studiesmentioning

confidence: 99%

“…8 When reported, the types of micro-organisms found after preparation in pharmaceutical environments were generally of low pathogenicity.…”

Section: Hypothesis 1: Dose Preparation In a Clinical Compared To A Pmentioning

confidence: 99%

“…[5][6][7] For example, in the immediate area used to prepare parenteral medicines there could be more than 90 times the number of colony-forming units falling on to a 90 mm diameter trypticase soy agar plate in a 4 h period in a clinical environment than is allowed by the standards applied to pharmaceutical environments in some countries. 7,8 The use of a pharmaceutical environment is particularly important in the preparation of batch doses, which carry the risk of contaminating multiple lots of individual doses, and where there is likely to be a period of storage before administration to patients. However, since pharmaceutical environments meeting recognized standards for aseptic dose preparation are costly and require operational expertise that may not always be readily available, they are not always used.…”

Section: Introductionmentioning

confidence: 99%

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Systematic review and meta-analysis of the risk of microbial contamination of parenteral doses prepared under aseptic techniques in clinical and pharmaceutical environments: an update

Austin

Hand

Elia

2015

Journal of Hospital Infection

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Section: Methodsmentioning

confidence: 99%

Section: Quality Of Studiesmentioning

confidence: 99%

“…8 When reported, the types of micro-organisms found after preparation in pharmaceutical environments were generally of low pathogenicity.…”

Section: Hypothesis 1: Dose Preparation In a Clinical Compared To A Pmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Systematic review and meta-analysis of the risk of microbial contamination of parenteral doses prepared under aseptic techniques in clinical and pharmaceutical environments: an update

Austin

Hand

Elia

2015

Journal of Hospital Infection

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“…Three of the 12 key studies (table 1) compared practical aseptic techniques and contamination rates between nurses and pharmacists in medicine preparation or administration 10 11 17. Three studies had been conducted only among nurses 16 21 30.…”

Section: Resultsmentioning

confidence: 99%

Incorrect aseptic techniques in medicine preparation and recommendations for safer practices: a systematic review

et al. 2016

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Objective Many patient deaths have been reported because of administration of contaminated intravenous medicines due to incorrect aseptic techniques. Our aim was to review the literature for (1) incorrect practices in aseptic drug preparation and administration and (2) recommendations for safer practices in hospitals. Methods A systematic literature search was conducted in PubMed covering [2007][2008][2009][2010][2011][2012][2013][2014][2015]. Studies were included if they concerned aseptic medicine preparation and administration in hospitals by different healthcare professionals, assessed incorrect practices and made recommendations for safer aseptic preparation and administration.Results 26 studies were included of which 19 were original articles. 12 of the studies concerned description of incorrect practices that led to contamination. The studies reported 11 incorrect practices that increased the risk of contamination of parenteral medicines. The most reported incorrect practices were multiple use of phials and syringes (2/12 studies) and lack of overall disinfection during the aseptic preparation and administration (3/12 studies). 22 practices were recommended to avoid contamination, which were classified into six categories: equipment and medicines (7); disinfection (6); working environment (3); storing (3); catheter care (2) and quality of prepared medicines (1). The results indicate that pharmacists prepared syringes with less contamination than nurses because of the pharmacist's aseptic skills and environmental aspects in pharmacy units. Conclusions The review discusses many appropriate and enhanced practices in aseptic drug preparation and administration. As the change for the better in contamination rates of administered medicines seems to be challenging to achieve in hospitals, better and possibly international procedures for safe parenteral practices need to be developed.

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A systematic review and meta-analysis of microbial contamination of parenteral medication prepared in a clinical versus pharmacy environment

Larmené-Beld

Frijlink

Taxis

2019

Eur J Clin Pharmacol

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Purpose Preparation of parenteral medication in hospitals is a complex process with a risk of microbial contamination of the product, especially when inappropriately prepared. Contaminated parenteral medications can cause severe complications to patients and increase morbidity in hospitals. The aim of this literature review is to systematically evaluate the contamination rate of parenteral medications in hospitals prepared in a pharmacy environment and a clinical environment. Methods A literature search of PubMed and EMBASE from 2000 to 2018 was performed. Two different environments where preparation may be carried out were defined. Point estimates and 95% confidence intervals for contamination rates were calculated for each environment of medication preparation. The meta-analysis was performed using a random effects model. Results The contamination rates in the clinical environment (n = 13 studies) varied between 1.09 and 20.70%. In the pharmacy environment (n = 5), all contamination rates were 0.00% except for one study (0.66%). The point estimates (random effect model) for the overall contamination rate of doses prepared in the clinical environment was 7.47% (5.16-9.79%), and 0.08% for doses prepared in the pharmacy environment. The point estimates (random effect model) for the overall contamination rate of doses prepared by nursing/ medical staff was 7.85% (5.18-10.53%), and 0.08% for doses prepared by pharmacy staff. Conclusions Significantly higher contamination rates were found for the preparation of parenteral medication in the clinical environment compared to pharmacy environment. In accordance with recent guidance, the almost 100-fold higher changes of contamination when reconstitution is performed in the clinical environment should urge hospitals to review their reconstitution process and apply risk-reducing measures to improve patient safety of parenteral therapy.

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Improved aseptic technique can reduce variable contamination rates of ward-prepared parenteral doses

Cited by 17 publications

References 2 publications

Systematic review and meta-analysis of the risk of microbial contamination of parenteral doses prepared under aseptic techniques in clinical and pharmaceutical environments: an update

Systematic review and meta-analysis of the risk of microbial contamination of parenteral doses prepared under aseptic techniques in clinical and pharmaceutical environments: an update

Incorrect aseptic techniques in medicine preparation and recommendations for safer practices: a systematic review

A systematic review and meta-analysis of microbial contamination of parenteral medication prepared in a clinical versus pharmacy environment

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