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Choice of items for compounding

S

U

IV Bag

____________ Vehicle ____________ Volume

Disinfect hands with sterile alcohol

S

U

Assembly of items in hood

S

U

Assembly of syringe/needle

S

U

Syringe size

____________ mL

Vial (diluent)

Swab

S

U

Air in (volume)

____________ mL

Liquid out (volume)

____________ mL

Vial (drug)

Swab

S

U

Liquid in (volume)

____________ mL

Air out (venting volume)

____________ mL

Agitate and dissolve

S

U

Discard syringe/needle

S

U N/A

Assembly of new syringe/needle

S

U N/A

Syringe size

____________ mL

Vial (dissolved drug + diluent)

Swab

S

U

Air in (volume)

____________ mL

Liquid out (volume)

____________ mL

IV Bag

Swab

S

U

Product Inspection

□ Mix/shake

(check all items completed)

□ Check for leaks/punctures

 

□ Check for haze/color changes/precipitates

Airflow

Airflow

S

U

Blocked

_________________________________

6” line

 

S

U

Crossed

_________________________________

Waste Disposal

Needle/Syringe

S

U

Vial

S

U

Bubbles

 

Other Comments

(venting, airflow, manipulation, other errors)

 

*Created by and used with permission from The Ohio State University College of Pharmacy Integrated Patient Care Laboratory.

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