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It is important to note that some CSPs are prepared and administered in clinics, at the bedside, in procedural areas, and in operating rooms with little direct pharmacy oversight.
While quality and safety programs exist within other health care professions, pharmacy knowledge and involvement in these activities ensures compliance with best practices and also provides an opportunity for pharmacy to take ownership of the complete medication use process.
The central pharmacy has quality assurance checks, including pharmacist verification of indication, dose, and patient-specific parameters to ensure safety prior to administration as well as verification of sterility and stability of the products dispensed.
Practices that increase pharmacy presence in patient care areas and decrease time to administration of medications compounded in the pharmacy decrease the need for immediate-use compounding.
Despite the lack of direct oversight of areas that carry out immediate use compounding, pharmacy departments can increase their contribution to ensure that best practices are met by addressing a variety of requirements.
In 2007, the Centers for Disease Control and Prevention published a guideline for preventing transmission of infectious agents in the health care setting.Best practice is using pharmacy services when possible to minimize immediate-use compounding.The use of a central pharmacy offers a number of advantages over immediate-use compounding in a patient area.The risk levels and requirements for each are summarized in Online Table 1.Table 1: USP BUD = beyond use date; ISO = International Organization for Standardization; TPN = total parenteral nutrition.The publication of the USP in 2004 represents the first official enforceable standard for sterile compounding in the United States.