Insourcing IV Robotics: A Better Standard of Practice for Sterile Compounding

Post Date: Apr 18th 2016

Author: Dave Webster

Human error and contamination are the most common patient safety risks for any pharmacy compounding operation – and often the most serious. It then follows that best practices for compounding focus on two primary goals: accuracy and sterility.

The healthcare industry at large recognizes that higher standards of practice stem from minimizing the potential for human error. Which begs the question: How can a hospital align with best practices when manual processes are the norm for sterile compounding?

Complex manual compounding is plagued by the possibility of missteps at every turn. For instance, USP<1116> Microbiologic Evaluation of Clean Rooms and Other Controlled Environments acknowledges the problem—microbial contamination is unavoidable in any environment where humans are present.

In fact, one organization found that it fell short of patient safety targets even when using USP standards and highly skilled technicians ─ with contamination rates still greater than five percent.

Progressive healthcare organizations like the University of Rochester Medical Center (URMC) are leveraging automation to enhance compounding sterility and accuracy. URMC moved to a fully automated in-house compounding model for many products after determining that enhanced environmental conditions, coupled with IV robotics, would improve product sterility and patient safety.

Multiple industry studies underscore the opportunity for IV robotics to drastically reduce the probability of adverse drug events—by as much as four times, according to one study. Automated IV compounding workflows also substantially improve the outlook on IV dispensing errors.

Today, IV robotics forms the backbone of URMC’s in-house sterile compounding operation, allowing the organization to drastically reduce potential for IV compounding errors to elevate patient safety and advance extended beyond use dating initiatives. URMC is producing 30 percent of in-sourced standard preparations using robotics, also improving workflow efficiency.

At URMC, robotics produced 40,000 doses of IV products over an 18-month period and was partially responsible for an additional 15,000 doses. The robotics platform also paved the way for more than 50 separate sterility tests for extended beyond use dating with no evidence of contamination – enhancing inventory and days on hand capabilities.

“Although there are facilities, such as URMC, taking steps to minimize safety risks, in general, the IV room is still often an overlooked area for basic automated safety technology. Through our partnership, we are working toward a better standard of practice by leveraging comprehensive solutions for:

  • barcode verification
  • digital imagery (to provide visual confirmation of steps taken to prepare an IV compound)
  • gravimetrics (the industry gold standard for ensuring accuracy)
  • fully automated compounding within an isolated ISO 5 environment

For more information about medication management solutions to support sterile compounding, visit

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