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• IV Admixture Preparation

  OBJECTIVES

  • Done by _pharmacists

  • Drugs must be added to sterile intravenous fluids is an aseptic manner

  •“CLEAN” environments are provided by

  LAFW/LAFH

  • No drugs combined with intravenous solutions should result to an incompatibility
• IV Admixture Preparation

  OBJECTIVES

  • All prepared IV admixtures should have proper label on:

  – contents

  – _stability

  – caution
• IV Admixture Preparation

  OBJECTIVES

  • Proper labelling allows the nurses to spend their time in meeting patients’ emotional and physical needs
• Hospital Pharmacist Duties in IV Admixture

  Preparation

  • interprets the physician’s orders

  • consult with medical and nursing

  staff when necessary

  • monitor the proper storage and handling of drug products in the IV

  admixture area

  • Follows proper labelling practices
• Hospital Pharmacist Duties in IV Admixture

  Preparation

  • Checks and compares schedule cards, patient profile or computer entry with original prescription order for accuracy

  • Double checks the completed

  IV admixture for accurate and clarity

  • Documentation must include Pharmacist's signature
• Hospital Pharmacist Duties in IV Admixture

  Preparation

  • coordinate the overall requirements of the nursing and medical staff for essential pharmaceutical services
• General Procedures: IV Admixtures

  • ALL IV orders are considered STAT unless a specific time or a specific instruction is sent

  • IV orders should be filled and sent to the ward or floor ASAP
• General Procedures: IV Admixtures

  • All IV admixtures are double-checked by a different pharmacist (NOT the pharmacist who prepared it) before delivery

  • Labels should be already be prepared prior to IV admixture preparation
• General Procedures: IV Admixtures

  • ALL IV admixtures delivered to the nursing units should be stored in the refrigerator unless the drug has a “do not refrigerate” auxiliary label
• General Procedures: IV Admixtures

  • IV admixtures that require protection from light shall be stored and dispensed in brown light resistant cover bags.
• IV Admixtures Solution and Preparations

  • Large Volume Parenteral (LVP)

  • Small Volume Parenteral (SVP)
• Large Volume Parenteral (LVP)

  • Used to provide electrolytes and nutrition

  • With or without additives

  • Administered by IV infusion

  • For single dose

  • Volume of: 100-1000 mL
• Small Volume Parenteral (SVP)

  • Used to provide therapeutic effect

  • For single and multiple dose

  • Volume of less than or equal to 100 mL
• IV Admixture: Facilities

  • Centralized admixture service could be located in a reasonably small area of the pharmacy

  • May be a separate room, but it must be adjacent to the dispensing area

  • Admixture preparation area should belocated in a low foot traffic area within the pharmacy
• Laminar Air Flow Hood

  • Provides ultra-clean environment

  • Reduce the risk of airborne contamination during the preparation of IV admixtures

  • High-efficiency Particulate Air (HEPA) filter removes nearly all bacteria
• Laminar Air Flow Hood

  • Provides clean air in the working area

  • Prevents room air from entering the LFH

  • Suspends and removes contaminants introduced in the work area by the materials or personnel
• Application of LAFH in Hospital

  Pharmacy

  • Preparation of IV admixtures and sterile products

  • Filling unit dose syringes

  • Reconstitution of powdered drugs
• Personal Protective Equipment

  • AKA: protective clothing

  • mandatory for all healthcare staff involved in the preparation of IV admixtures

  • Examples:

  – sterile gowns

  – head caps

  – sterile gloves

  – surgical facemasks
• Physical Incompatibility

  • Occur when two drugs combined in a solution produce a change in appearance of that solution

  • visual change may be:

  – Change in color

  – Evolution of gas

  – Development of haze/ turbidity

  – Formation of _precipitate
• Chemical Incompatibility

  • Occur when two drugs react to cause the chemical degradation of one or both drugs

  • May not be detected visually, but can be detected by analytical methods
• Therapeutic Incompatibility

  • Occur when two drugs are administered together to produce a response that is different in nature or intensity from that intended