The THRIV Coalition’s top 5 IV Workflow must-haves for patient safety

3. Volume verification

Ensuring the correct volume of medications is essential to patient safety. Inaccurate volumes of drugs or diluents used during compounding can place patients at risk through underdosing or overdosing. Compounded doses are more accurate and safer for patients when volume verification technologies are utilized, including any one or combination of the following:

In-process image capture (or live video):

Still image or live video capture documents each step in the compounding process. Images and video become part of the compounding record, allowing pharmacist verification to occur remotely. Remote verification reduces staff movement into the cleanroom, protecting the sterile compounding environment from increased bioburden. Still images and video that are part of the compounding record allow for pharmacist verification of all steps in the compounding process, including ingredient verification, lot numbers and expiration dates, preparation steps, and final products. Using this technology, pharmacists can know without a doubt if the preparation was compounded correctly or if it needs to be reworked.  

Gravimetric analysis:

Gravimetric analysis allows for precisely measuring the exact volumes of ingredients by analyzing the mass of the ingredients used during compounding. Because gravimetric analysis relies on measuring mass rather than volume, it is a valuable tool when dispensing high-potency medications, specialty medications, or medications for a highly susceptible patient population like pediatrics.  

Volumetrics:

Volumetric technologies that automatically draw, release, measure, and verify delivered volumes allow for highly accurate measurement of liquids, ensuring the correct volume of ingredients every time. Utilizing volumetric technologies reduces the potential for human error in calculations and measuring while increasing efficiency through faster compounding.

Optical volume recognition:

Optical volume recognition is an advanced technology that measures and verifies the volume of liquid measurements in the compounding process using high-resolution cameras and advanced software algorithms. This automated technology works with IVWMS to provide automatic documentation and traceability while minimizing the risk of human error associated with manual measurement techniques.  

4. Auto labeling

Labels applied to compounded preparations must be legible and have all the required information per USP <797> to prevent storage, dispensing, and administration errors. IVWMS, which incorporates auto labeling, utilizes advanced technologies to streamline the labeling process during compounding. IVWMS that use pre-defined templates for labels that comply with regulatory standards and organizational protocols and are automatically populated with real-time data from the electronic health record provide increased safety. Labels include a barcode that uniquely identifies the compounded preparation, allowing for tracking and verification. High-quality, colored labels ensure durability and legibility, alerting personnel handling or administering the preparation to the drug class and storage requirements.

5. Auto documentation

Documentation of the compounding process is an important step outlined in USP <797>. And must comply with all laws and regulations of the applicable jurisdiction. Auto documentation captures real-time data throughout the compounding process, ensuring all information is up to date and consistent every time. Every preparation step is recorded and time-stamped, reducing the need for manual logging, allowing the pharmacy staff to focus on patient care, and ensuring all documentation is completed accurately and completely for every preparation. Auto documentation can also capture errors intercepted by the technology during the compounding process to increase visibility and assist with quality improvement efforts. Comprehensive and organized documentation of the compounding process facilitates easier audits and inspections, as all documentation is readily available and complete.