Background and importance Parenteral nutrition (PN) is a high-risk medication. Its compounding is a complex process that must be controlled and evaluated periodically. Pharmacy staff involved must present appropiate technical skills and perfect knowledge of aseptic technique and preparation aspects.
Aim and objectives To objectively evaluate the PN compounding process by pharmacy staff, using a specifically designed checklist.
Material and methods Each pharmacy technician (PT) was evaluated by an experienced pharmacist through direct visual inspection, using a checklist containing 57 items: 29 related to aseptic technique and 28 regarding compounding. Each item scored 1 point; final evaluation score was calculated on a 0–10 scale.
PT were divided in two groups: with experience (PN compounding for >6 months) and without experience.
A descriptive analysis was performed using measures of central tendency, dispersion and position for quantitative variables, and frequency distribution for qualitative variables.
Results 30 operators were examined, 19 with experience and 11 without experience (the results are in Table 1).
Total number of errors was 307. Error prevalence was 18%. The most frequent errors involved: electrolyte addition sequence (10.7%); stable intermediate admixtures (7.8%); mixing after additions (7.2%); renew/disinfect gloves (5.9%); mix glucose and lipids without amino acids (5.5%); inspect intermediate/final admixtures (5.5%); mix incompatible electrolytes (phosphate-calcium, phosphate-magnesium, magnesium-calcium) (4.23%). Most relevant considered errors were related to incompatibilities/correct mixing of components, visual control, use of gloves and disinfection processes.
Conclusion and relevance Evaluation of PN compounding through a checklist containing the key elements allowed us to objectively detect errors and areas of improvement. Our study revealed a lack of training in compounding aspects, more than in aseptic technique, that was greater in those PT without experience. This study enabled us to implement a targeted training plan to improve staff qualifications and therefore quality/safety of PN.
Conflict of interest No conflict of interest
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