We have so much technology around these days. I mean we have real-time patient monitoring, near field communication, telemedicine, smartphones, music and video in the cloud, and so on ad infinitum. So why is it that hospital pharmacies use the same old horizontal hoods that they’ve always used?
Technology in the IV room – its time has come
The cleanroom environment, a.k.a. the IV room, is one of my favorite areas inside an acute care pharmacy. It is often alive with activity, and can often be the busiest area of the pharmacy. It is also a unique place since the use of intravenous (IV) medications is vital to the successful outcomes of patients, but at the same time can result in some of the most egregious errors in healthcare. While the IV compounding process is under tight control as demanded by USP guidelines, the method of preparation and distribution is decidedly more conventional, i.e. IV rooms often rely heavily on humans. It’s an interesting dichotomy found nowhere else in the pharmacy. It is for these reasons that I find it interesting that pharmacy IV rooms have lagged behind other areas of pharmacy operations in automation and technology. However, that’s beginning to change.
Cleanrooms – the forgotten realm of acute care pharmacy
Cleanroom environments, a.k.a. IV rooms, inside acute care pharmacies compound some of the most complex and dangerous medications used inside a hospital. Unfortunately this area is often overlooked when implementing safety features such as bar-code verification, identification of high-alert medications, advanced training and competency and so on. I was reminded of the dangers of intravenous products by a recent story coming out of Alabama where the death of 9 patients was linked to TPN (total parenteral nutrition) contaminated with Serratia marcenscens.
While IV rooms remain a high risk area they tend to fall off the radar of many hospital administrators when it comes to implementing technology capable of reducing risk. USP <797> tends to get all the glory even though much of the guidelines proposed in this USP chapter have yet to be shown any more effective than diligent hand washing and impeccable technique.
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