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Implementation of safety standards of compounded sterile preparations in hospital pharmacies: a multinational cross-sectional study
  1. Nouf Al-Fadel1,
  2. Mansour A Mahmoud2,
  3. Rabih Dabliz3,
  4. Osama Tabbara4,
  5. Hisham Aljadhey2
  1. 1Vigilance and Benefit-Risk Assessment Executive Directorate, Saudi Food and Drug Authority, Riyadh, Saudi Arabia
  2. 2Medication Safety Research Chair, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
  3. 3Quality & Medication Safety Services, Cleveland Clinic Abu Dhabi (CCAD), Abu Dhabi, United Arab Emirates
  4. 4Department of Pharmacy Services, CCAD, Abu Dhabi, United Arab Emirates
  1. Correspondence to Nouf S Al-Fadel, Vigilance and Benefit-Risk Assessment Executive Directorate, Saudi Food and Drug Authority, PO Box 6288, Riyadh 13312, Saudi Arabia; noufalfadel{at}


Objectives To evaluate implementation of safety standards of compounded sterile preparations in different hospitals.

Methods This 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.

Results 124 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.

Conclusions Minimum 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.

  • Cross-sectional study
  • Saudi Arabia
  • Compounded sterile preparations
  • Institute for Safe Medication Practice (ISMP)
  • Intravenous and Parenteral Nutrition (IV PN ) experts network

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