Pharmacy Services

Pharmacy Services Residency

Sterile Product Compounding

 (PGY1 Elective Rotation)

 
Preceptor:

Tom Sanders, PharmD

 
Site Description:

University of Utah Hospital Inpatient Pharmacy IV Center (IVC) supports a 450 bed hospital and supplies specific products to other hospitals in our system. This service supplies sterile products to the hospital and infusion room 24 hours a day. It is a 797-compliant clean room with IV specialists staffing the IVC 16 hours a day.

 
Rotation Description:

This rotation is focused on the compounding of intravenous admixtures in a hospital pharmacy setting. The rotation will cover aseptic technique, USP 797 guidelines, stability and compatibility of compounded products, and other issues related to intravenous medications. This is a 2 week rotation.

 
RLS Goals:

R1.3: Prepare and dispense medications following existing standards of practice and the organization’s policies and procedures
R1.5: Provide concise, applicable, comprehensive, and timely responses to requests for drug information from health care providers
R2.2: Place practice priority on the delivery of patient-centered care to patients
R2.4: Collect and analyze patient information

 
Activities Evaluated:

Objective Number and Description

Teaching Method

Rotation activity

R 1.3.3 (Application) Prepare medication using appropriate techniques and following the organization's policies and procedures.

Indirect Instruction
Coaching
Modeling
Facilitation

Develop proficiency in compounding sterile products. Pass media fill test. Resident must be capable of accurately and efficiently calculating component amounts and compounding sterile products, including syringes, infusion bags, TPNs, etc.

R1.5.1 (Analysis) Discriminate between the requester’s statement of need and the actual drug information needed by asking for appropriate additional information.
R1.5.2 (Synthesis) Formulate a systematic, efficient, and thorough procedure for retrieving drug information.

Coaching
Modeling
Facilitation

Resident must be able to articulate the difference between questions a provider asks and the actual information needed.
Clearly and accurately answer at least 10 drug information requests from providers regarding IV medications or administration plans.

R2.2.1 (Organization) Choose and manage daily activities so they reflect a priority on the delivery of appropriate patient-centered care.

Coaching
Modeling
Facilitation

Facilitate delivery of parenteral medications per hospital policies and procedures.

R2.4.1 (Analysis) Collect and organize all patient-specific information needed by the pharmacist to prevent, detect, and resolve medication-related problems and to make appropriate, evidence-based, patient-centered medication therapy recommendations as part of the interdisciplinary team.
R2.4.2 (Analysis) Determine the presence of medication therapy problems in a patient’s current medication therapy.

Coaching
Modeling
Facilitation

Evaluate and process at least three days of TPN orders, making recommendations regarding appropriateness of macro- or micronutrients to decentralized pharmacists or physicians.

R2.4.2 (Analysis) Determine the presence of medication therapy problems in a patient’s current medication therapy.

Coaching
Modeling
Facilitation

Evaluate at least three days of orders for compounded medications, making recommendations regarding appropriateness of doses, dilutions, infusion time, and issues regarding compatibility or stability.

 
Readings and Preparatory Work:

Watch the ASHP sterile products compounding DVD. Read USP Chapter 797 and be ready to discuss how it relates to IV Center practice. Review sterile technique with the IV Center staff in the hood. Take the media fill test.

 
Project/Presentation Description:

A short quality-related project will be assigned to the resident at the beginning of the rotation based on the IVC needs at the time.

 
Typical Daily/Weekly/Monthly Activities:

The goal of this rotation is to develop the resident’s practical and clinical skills as they relate to working in an IV Center. The resident should be capable of working as a pharmacist in the IV Center following orientation and training with minimal guidance or coaching.

 
Evaluation:

The resident will receive intensive training and instruction with the IVC staff with direct observation of their skills during the first days of the rotation. The resident will receive verbal feedback throughout the rotation with a summative evaluation posted in ResiTrak on the last day.