OBSERVATIONAL STUDY OF ACCURACY IN COMPOUNDING IV ADMIXTURES AT 5 HOSPITALS

Rates of errors in i.v. admixture compounding at five U.S. hospital ph armacies were studied. Pharmacy staff members at five hospitals repres enting each U.S. geographic region were observed as they compounded st erile products in order to record the medication, dose, base solution, and other details. Intravenous admixtures, antineoplastic preparation s, parenteral nutrient solutions, and ready-to-use products were inclu ded. Observations took place for five days at each pharmacy. The obser vers' notes were checked against the labels used to prepare the doses; any deviation was considered an error. The clinical importance of eac h error was assessed for its potential to affect a patient adversely. The mean error rate far the five hospitals combined was 9% (145 errors for 1679 doses), excluding ready-to-use products. Mean error rates fo r individual pharmacies ranged from 6% to 10%. Wrong-dose errors were the most common type of error. Parenteral nutrient solutions had the h ighest error rates-37% for manual preparation and 22% for preparation that was partly automated. Of every 100 errors, 2 were judged to be po tentially clinically important. In five U.S. hospital pharmacies, the observed error rate for compounding i.v. admixtures was 9%.