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Reducing the risk of non-sterility of aseptic handling in hospital pharmacies, part A: risk assessment
  1. Frits A Boom1,
  2. Judith M Ris1,
  3. Tjitske Veenbaas2,
  4. Paul P H Le Brun3,
  5. Daan Touw4
  1. 1Zaans Medical Centre, Zaandam, Noord-Holland 1502DV, The Netherlands
  2. 2Albert Schweitzer Hospital Location Dordwijk, Dordrecht, Zuid-Holland 3318 AT, The Netherlands
  3. 3Department of Clinical Pharmacy and Toxicology, Leiden University Medical Centre, Leiden, The Netherlands
  4. 4Clinical Pharmacy, UMCG, Groningen, The Netherlands
  1. Correspondence to Frits A Boom, Zaans Medical Centre, Zaandam, Noord-Holland 1502DV, The Netherlands; fritsboom70{at}


Objectives To determine prospectively the sources of risk of non-sterility during aseptic handling and to quantify the risks of each of these sources.

Methods A risk assessment (RA) of non-sterility according to Failure Mode and Effect Analysis was executed by a multidisciplinary team of (hospital) pharmacists and technicians, a consultant experienced in aseptic processing and an independent facilitator. The team determined the sources of risk of non-sterility, a 5 point scale for severity, occurrence and detection, and risk acceptance levels. Input about general applied risk reduction was collected by audits in 10 hospital pharmacies. The results of these audits were used for determining the remaining risks. The results, as well as scientific information and the experience of the team members, was used to determine scores for severity, occurrence and detection.

Results Multiplying the scores for severity, occurrence and detection results in the risk prioritisation number (RPN) which is a relative value of the remaining risks of non-sterility for each source. Incorrect disinfection techniques of non-sterile materials and the chances of touching critical spots were estimated as the greatest risks. The risk of non-sterility via the airborne route was low. RPN values were helpful in prioritising measures for additional risk reduction (this will be described in an accompanying article).

Conclusion The RA, described here, was a systematic survey related to all sources of risk of non-sterility during aseptic handling. The determined RPN values were helpful in prioritising measures for additional risk reduction.

  • aseptic preparation
  • audit, self-inspection
  • compounding (individualised preparation)
  • disinfection
  • Good Manufacturing Practice (GMP)
  • manufacturing, small scale
  • protocols & guidelines
  • reconstitution
  • risk management
  • validation preparation process

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