Table 1

The key findings and recommendations of the included articles (n=12) with empirical evidence on incorrect practices that lead to contamination in aseptic preparation and/or administration of medicines in hospitals and recommendations to avoid contamination according to the type of the recommendation (studies presented in alphabetical order)

Study	Reasons/incorrect practices that lead to contamination	Recommendations to avoid contamination	Profession	Clinical or pharmacy-based preparation or administration
Disinfection
Austin and Elia10	Nurses did not clean the working surface or ampoule necks and did not use gloves	Cleaning the working surface with detergents and disinfectants (eg, 70% isopropyl alcohol or ethanol) with proper technique Use of gloves Cleaning each ampoule neck and rubber septa with alcohol swab before opening	Nurses and pharmacists	Clinic
Gargiulo et al19	Lack of hand hygiene, no disinfection of phial septa or intravenous ports and multiple use of syringes	Hand washing and hand disinfection Disinfection of the intravenous ports	Anaesthetists	Clinic
Gorski21	Lack of infection prevention in peripheral intravenous catheter use and alternative site infusions	Skin antisepsis before catheter placement	Nurses	Clinic and home
Catheter care
Gorski21	Lack of infection prevention in peripheral intravenous catheter use and alternative site infusions	Checking and caring the catheter site daily	Nurses	Clinic and home
Yoshida et al27	Character of ward and catheter placement time	Catheter placement not more than 30 days	Nurses and pharmacists	Clinic and pharmacy departments
Equipments and medicines
Bertoglio et al11	Manually filled (filled by a nurse or a pharmacist in a hospital ward) syringes	Using of manufactured prefilled syringes	Nurses and pharmacists	Clinic
De Smet et al16	Multiple dose phials with a high nutrient content	Singe use of flushing solutions with low nutrient content	Nurses	Clinic
Buerke et al12	Multiple use	Single use of syringes in automatic injectors	Technical and medical staff	CT department (clinic)
Nakataki et al30	Improper handling	Aseptic handling of infusion set needles	Nurses	Clinic
Rangel-Fausto et al24	Open infusion containers	Use of closed infusion containers	Physicians, nurses and paramedical staff	Clinic
Dolan et al18	N/A	Single use of syringes, disposable tubes and connectors of automatic injectors Discarding all opened phials, intravenous solutions and opened syringes	N/A	N/A
Storing
Dolan et al18	N/A	Storing medications in a clean area on a clean surface Storage of needles and syringes never unwrapped Preparation of IV solutions as close as possible to administration	N/A	N/A
Working environment
Dolan et al18	N/A	Drug preparation in laminar flow hood Avoiding to contact sterile drugs or sterile areas with non-sterile objects	N/A	N/A
Stucki et al26	Environmental aspects	Working in cleanrooms when ever possible	Single operator	Clinic and pharmacy department
Quality of prepared medications
Gershman et al20	No auditing for suppliers	Checking suppliers to ensure that medications ordered are produced according to manufacturing regulations	N/A	Pharmacy department

N/A, not available.