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Archive February 2020 XXI, No. 2

Avoid Compounding in the OR

Start small to stop drug preparations that can lead to errors and sterility issues.

Jared Bilski


A BETTER WAY Sanford Medical Center Fargo (N.D.) standardized its irrigation protocol to reduce compounding and the number of solutions surgeons could request.

Doing away with compounding in the OR will improve patient safety and case efficiencies. It will also make sure your facility complies with USP 797, which governs a wide range of factors that ensure compounded drugs are prepared in a dedicated space by specially trained pharmacists who follow strict quality controls and do all their mixing under a laminar air flow hood.

Perhaps you're looking to stop compounding in the OR, but feel overwhelmed at the prospect of overhauling a practice that's become a cornerstone of your day-to-day procedures. Sure, you can outsource anything you mix in-house to a compounding pharmacy (see "5 Questions to Ask Your Compounding Pharmacist"). But if your facility has safety or cost concerns, or simply doesn't have the time or resources to properly vet an outside compounder, there's another option. You can start small by focusing on a specific medication or solution you want to stop mixing in the OR and break down the process step by step until you find a better way.

That's what Sanford Medical Center Fargo (N.D.) did recently. The facility used to rely on a variety of irrigation solutions, which were often compounded or mixed by a circulator right in its ORs. When the Joint Commission raised concerns about the safety of such an approach, Sanford took the following steps to do away with its irrigation compounding practices, according to Laci R. Soper, BSN, RN, the facility's operating room educator.

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