Sterile Compounding Supplies

Topics2

Chapter 3

Sterile Compounding Supplies

2012 Paradigm Publishing

Topics3

Learning Objectives Discover the origins of several sterile compounding supplies. Identify a variety of supplies used for preparing sterile

compounds. Describe various components of the most frequently used

sterile compounding supplies. Understand the rationale for using particular supplies in specific

compounding situations. Identify the critical sites of commonly used sterile compounding

supplies.


Topics4

Topics Learning Objectives Introduction Correct Opening and Placement of Supplies Needles Specialty Needles Syringes IV Base Solutions IVPB Solutions Premixed Parenteral Products Vials Ampules IPA Swabs, Vented Dispensing Pins, IVA Seals, Sharps Containers Sterile IV Tubing Repeater Pumps Miscellaneous Sterile Compounding Supplies Chapter Summary


In Slide Show view, click the desired topic to the left to link directly to the related slide. To return to this slide at any point in the presentation, click the Topics button below.

Topics55

Introduction

The critical site is the part of the supply item that includes any fluid-pathway surface or fluid-pathway opening that is at risk for contamination by touch or airflow interruptioncritical sites must only be touched by a sterile tool to avoid

touch contamination Anything that interrupts the airflow from the HEPA

filter to the critical zone causes shadowing, another form of potential contamination


Topics66

Correct Opening and Placement of Supplies

Take great care when opening the outer packages of all supply itemsthe outer packaging is sometimes called a dust coverkeep the sterile supply item within the clean air zone

Along the entire outer edge of the hood’s work surface, measuring six inches into the hood, sterile air from the hood’s HEPA filter mixes with turbulent room airthis area is referred to as the outer six-inch zone, or the

zone of turbulence


Topics77

Correct Opening and Placement of Supplies…/2

All sterile compounding procedures must take place at least six inches inside of the hood, thereby avoiding the outer six-inch zone


Topics88

Needles

The needle is attached to a syringe and is then used to either draw fluid into the syringe, (also known as a straight draw) or push fluid out of the syringe and into an IV bag or bottle

Regular needles, the most commonly used, are used specifically to withdraw or inject fluids for parenteral administration

Several components are common to every needle


Topics99

Needles…/2 The needle tip is at the

very end of the needle and is razor sharp

The tip of the needle has a slanted opening called the bevel

The heel is the rounded part of the bevel at the point where the slanted opening ends


Topics1010

Needles…/3 The needle shaft provides length to the needle and

extends from the point where the colored needle hub attaches to the metal needle, to the needle tip

The inner core of the needle shaft is called the lumen, a hollow space through which fluid moves into or out of the syringe

The needle hub is the end point, which attaches to the syringe

A hard plastic cap covers the needle shaft and tip until the moment of use


Topics1111

Needles…/4

Needle gauge refers to the diameter of the opening, or lumen, of a needlewhen drawing up a viscous liquid the IV technician would

choose a needle with a large gauge size but would select a needle with a small lumen when providing an IM medication for a neonate


Topics1212

Needles…/5

IV technicians choose needle lengths according to the task being performed for most sterile

compounding procedures, they select a regular needle with a standard 1 ½" length


Topics1313

Needles…/6 The standard recapping method requires the

technician to hold the filled syringe as she or he would a dart and then recap the needle by holding the cap between the thumb and forefinger of the nondominant hand and carefully slipping it over the tip of the needle

The scoop recapping method involves placing the tip of the needle into the cap that is lying on an IPA swab on the hood’s work surfacethe IV technician uses the needle-and-syringe unit to scoop

the needle cap onto the needle


Topics1414

Specialty Needles The filter needle is a needle with a small, built-in

filter (sometimes referred to as a depth filter) between the needle’s shaft and hubused to remove particulate matter from a solution

Technicians use the vented needle primarily to dilute large-volume or multiple containers of parenteral medications in powder formthese medications must be reconstituted prior to use

The transfer needle transfers fluid from one vial or container to another


Topics1515

Syringes Sterile compounding technicians use syringes to

withdraw or inject solutions as part of the preparation of almost all sterile products


Topics1616

Syringes…/2

The syringe tip may be either Luer-lock or slip-tipto make a secure connection, you screw the needle onto a

Luer-lock syringea slip-tip syringe slides onto the hub of the needle


Topics1717

Syringes…/3

The barrel of the syringe contains the calibration marks for measuring fluid volume

Inside the barrel of the syringe is a black, rubber-tipped piston plunger


Topics1818

Syringes…/4

Behind the piston plunger is the inner shaft of the plunger

The flat end of the plunger, most distant from the needle end, is referred to as the flat knob, lip, or heel of the syringe

You can touch or hold the syringe only on the outer barrel or the flat knobthe critical sites of a syringe are the tip or hub, the piston

plunger, and the inner plunger shaft


Topics1919

IV Base Solutions

A large volume of sterile fluid that is delivered via sterile IV tubingalso known as a large-volume

parenteral (LVP), base solution, primary IV, IV, or IV bag

contains a small plastic hang loop

the IV technician injects additives through the injection port


Topics2020

IV Base Solutions…/2

The nurse removes the rubber cap covering the bag’s tubing port and inserts the tubing’s universal spike adaptor into the tubing port

The LVP is commonly the primary source of hydration for the patient and is run continuously while the patient is unable to take oral liquidsmost LVP solutions are made with varying concentrations of

sodium and/or dextrose mixed with sterile water During the sterile compounding process, personnel

prepare IV solutions that require medication additives2012 Paradigm Publishing

Topics21

Your Turn


1) Most sterile compounding procedures use a regular needle with this length.a. 1″b. 1 ¼″c. 1 ½″d. 1 ¾″

2) Sterile compounding technicians use these to withdraw or inject solutions.a. adaptorsb. syringesc. portsd. plungers

In Slide Show view, click here to see the answer to Question 1. Then click again to advance to Question 2.

In Slide Show view, click here to see the answer to Question 2.

Topics2222

IVPB Solutions

An IVPB solution is a small volume of fluid mixed with an IV medication and administered via sterile IV tubingIVPBs are a type of small-

volume parenteral (SVP) product and are usually “piggybacked” through a primary IV line that contains the IV base solution


Topics2323

IVPB Solutions…/2

IVPB bag components are similar to those of an IV base solution bag

The IVPB medication is administered to the patient intermittently, based on the frequency ordered by the prescriber

Many intravenously administered antibiotics are delivered via an IVPB


Topics2424

Premixed Parenteral Products Some medications for

administration by IV or IVPB are supplied in the form of premixed, shelf-stable products IV bags that contain a standard

dose of potassium chlorideIVPB that contains a standard

dose of famotidineprefilled syringe provided for

IV push use2012 Paradigm Publishing

Topics2525

Premixed Parenteral Products…/2

Various IVPBs are supplied in packages of 12, 24, or 48 and are shipped from the wholesale supplier in a container packed in dry ice

Other products commonly used are systems such as ADD-Vantage, MINI-BAG Plus, and Add-A-Vial


Topics2626

Premixed Parenteral Products…/3

These products require sterile compounding personnel to screw or snap a specially built vial onto an IVPB designed for this type of attachmentperformed in the hood

One advantage of this type of IVPB is that it can be mixed just moments before the dose is requiredhelpful if the medication is not stable for long periods in its

mixed formreuse is possible because these systems are stable for up

to 30 days


Topics2727

Vials Vials are sealed, sterile containers with a rubber top

most often contain a sterile medication, in a liquid or powder form, or a liquid diluent

most commonly used diluents are sterile water and normal saline


Topics2828

Vials…/2

The two main types are single-dose vials (SDVs) that do not contain a preservative, and multiple-dose vials (MDVs) that do contain a preservative

Mix-O-Vial is used infrequently by IV technicians due to the limited number of immediate-use medications supplied in this type of containerdislocating the plug releases the liquid into the powder,

which dissolves and is then drawn up in solution by the IV technician for either an IV push or IVPB administration to a patient


Topics2929

Ampules

An ampule is a sterile, sealed container made entirely of glass with a tapered neckIV technicians break the glass at this tapered, scored neck

and aseptically remove the liquid with a needle and syringe

the ampule is an appropriate container for drugs that are not compatible with the rubber top or other components of a vial


Topics3030

IPA Swabs, Vented Dispensing Pins,IVA Seals, Sharps Containers

Sterile IPA swabs are wiped across most critical sites Vented dispensing pins are inserted into a vial or

glass bottle and then attached to a syringe


Topics3131

IPA Swabs, Vented Dispensing Pins,IVA Seals, Sharps Containers…/2

IVA seals are small foil stickers that sterile compounding personnel place over the injection port of the prepared IV, IVPB, and various other compounded products


Topics3232

IPA Swabs, Vented Dispensing Pins,IVA Seals, Sharps Containers…/3

The sharps container is a large bucket, usually red in color, made of thick plastic and used to safely dispose of used needles, syringes, and broken glasschemotherapy waste must

be disposed of in a special sharps container that is typically yellow in color


Topics3333

Sterile IV Tubing

Sterile IV tubing is a supply item frequently used throughout the hospital

Primary IV tubing is sterile IV tubing with multiple injection portsnurses use primary IV tubing to administer an IV base

solution to the patient Secondary IV tubing is short, sterile IV tubing that

may or may not have an injection portIV technicians use secondary IV tubing to transfer a solution

from a source container to another bag or bottle


Topics3434

Sterile IV Tubing…/2

Insert the universal spike adaptor into the tubing portobserve the drip

chamber to calculate the flow rate

the roll clamp is used to regulate the flow rate

the far end of the tubing is called the needle adaptor


Topics3535

Repeater Pumps

Some sterile compounding facilities use repeater pumps to rapidly transfer sterile fluids from large-volume or bulk containers into small-volume containers such as syringes or vialswhen personnel must prepare large batches of fluid-filled

syringes of the same volume, a repeater pump is an excellent alternative to drawing up the syringes from a bulk container by hand


Topics3636

Miscellaneous Sterile Compounding Supplies

Other supplies that are less frequently used but still important to the work of an IV technician include syringe caps, Luer-to-Luer connectors, membrane filters, and empty evacuated containers


Topics3737

Miscellaneous Sterile Compounding Supplies…/2

A syringe cap is a small, plastic cap that attaches to the tip of a filled syringe

A Luer-to-Luer connector is a plastic tube with Luer-lock hubs at both ends

Membrane filters (0.2 micron or smaller) are used to sterilize solutions that have been prepared using nonsterile ingredients

An empty evacuated container (EEC) is a sterile, empty vial or glass bottle whose volume ranges from 2 mL to 1000 mL


Topics38

Your Turn


3) The sharps container is usually this color.a. redb. yellowc. blued. black

4) Some sterile compounding facilities use these to rapidly transfer sterile fluids.a. drip chambersb. syringe capsc. membrane filtersd. repeater pumps

In Slide Show view, click here to see the answer to Question 3. Then click again to advance to Question 4.

In Slide Show view, click here to see the answer to Question 4.

Sterile Compounding Supplies

Health & Medicine

Transcript of Sterile Compounding Supplies