Video Presentation Guide

The goal of this course is to educate supervisory and technical personnel involved in the Hazardous Drug Compounding process in both the theory and practices that assure the safety and efficacy of the IV products they compound and dispense, and the protection of operative personnel and the environment.

Schedule either one 4-hour session per group, or two 2-hour sessions. This will allow time for discussion and practice of concepts and techniques. Pause at the end of each part of the program to allow staff to ask questions, and discuss the specific ways in which the material presented relates to your institution’s practice setting.

Part 1: Quality Assurance and Discussion

Immediately following completion of this segment, discuss specific Quality Assurance measures carried out within your institution, such as logging of cleaning and disinfection procedures, or refrigerator and freezer temperatures. It is important to emphasize the appropriate corrective actions to be taken in the event a monitored parameter does not meet criteria. For example, what should be done if the refrigerator temperature is too high? What corrective action should be taken? How should this corrective action be documented?

Part 2: Engineering Controls and Discussion

Immediately following completion of this segment, discuss the engineering controls used in your setting. Be sure all personnel understand each type of engineering control, and know which controls are appropriate in a particular compounding situation.

Part 3: Barrier Controls and Discussion

Immediately, following completion of this segment, discuss gowning policies, and make certain all personnel know which barrier controls are to be employed, and how each is to be used. Also, emphasize proper de-gowning procedures, and that gowning must not be worn outside the compounding area.

Part 4: Aseptic Technique and Discussion

Immediately following completion of this segment, demonstrations and/or practice sessions should be held to help personnel apply the theoretical knowledge they have gained to practical compounding skills. The easiest way to teach compounding skills to a group is to have them try out the core techniques, while watching and guiding one another. It is often easier to understand how fingers may block first air, or to notice incorrect set-up of materials when observing someone else. The emphasis in such an exercise should be on building a friendly and supportive IV team.

The two most troublesome core techniques for personnel to master are low-pressure technique and manipulation of ampules. The importance of mastering low-pressure technique cannot be over-emphasized. It is an essential skill for personnel who will compound hazardous substances, and it greatly reduces drug residues in any compounding environment. Isolator compounding workstations will likely be introduced to pharmacy operations in the near future. These units are difficult to clean, and minimizing spillage and accumulation of debris will be important to maintain internal cleanliness.

Ampules also pose special problems which are covered in the Compounding Manual and the AV Program. Personnel are often too timid in their approach to handling ampules. A quick, but balanced snap is required to correctly open an ampule. When drawing up the contents, ampules should be tilted over so that the liquid pools close to the neck. Many personnel are hesitant to tip them as far as is needed to facilitate easy filling of the syringe.

Part 5: Pharmaceutical Calculations and Discussion

Immediately following completion of this segment, have personnel work through some commonly-encountered calculations, together. It is important that personnel confirm and cross-check all calculations, even those performed by a computer system. Misplacement of a decimal point, or confusing units of measure can easily result in severe harm or death of the patient.

Documentation: Document that each staff member has viewed the video in the software documentation system.