Research indicates that poor technique or failure to follow up-to-date standards and protocols can lead to injury or even death to patients requiring compound medications.
Despite the fact that pharmacy assistants perform most aseptic compounding practices, the loss of aseptic techniques and knowledge over time can lead to unsafe, non-sterile compounding, according to a study published in the Journal of Pharmacy Technology. Next, the study authors call for continuing education efforts to address sterile compounding of pharmacy assistants.
Several previous studies have shown that poor technique or failure to follow up-to-date standards and protocols can lead to patient injury or even death. Between 2001 and 2013, researchers identified 19 outbreaks of infections associated with compound sterile products. At least 1,000 patients were affected in these outbreaks, with some cases resulting in death.
The researchers also noted that Texas is currently the only state to require sterile compounding training or continuing education hours for technicians making prepared sterile products in the state. In addition, according to the survey, there are currently no uniform conditions for hiring pharmacy technicians.
In the study, the authors looked at the links between knowledge of sterile compounding and years in the field, while controlling for formal training in sterile compounding techniques. They distributed an assessment tool to members of pharmacy organizations in the Southeastern United States that are sterile compounding pharmacies and performed a multiple regression to predict sterile compounding knowledge based on years in the field and previous years of training.
Seventy assessments were attempted and 2 were disqualified for failing to complete or submit. The majority of the participants were women and the most common level of education among the participants was a diploma of education. The number of training hours ranged from 0 to 240 hours, the number of years in the field ranged from 1 to 28 years, and the assessment scores ranged from 18 to 30 points.
According to the study, participants with a bachelor’s degree scored higher on average, closely followed by participants with an associate degree. Those with a program degree and high school graduates scored lower.
The researchers also found that length of experience is a statistically significant predictor of knowledge retention. For each additional year of work experience, they found that the knowledge test score decreased by 0.18 points. However, the number of formal training hours was not found to be significant for the prediction.
A possible explanation could be a loss of knowledge due to modeling actions observed in other pharmacy staff. The researchers explained that employees replicate behaviors seen in their environment and that newer pharmacy technicians may be particularly susceptible to this. Over time, failure to correct when performing a task incorrectly leads to loss of skills and knowledge.
“Failing to correct unsatisfactory processes encourages the continuation of such practices and creates a sense of expected acceptance of all composite products,” the authors explained.
To avoid this loss of knowledge, the authors said mandatory continuing education at predetermined intervals may be necessary. Implementing knowledge retention strategies in the workplace can also improve knowledge loss, and providing incentives to stay informed about sterile compounding practices can be effective.
This can be access to continuing education credits or monetary bonuses. In addition, the researchers said appointing a person to oversee knowledge retention activities may be necessary, including identifying employees who show a decline in job performance.
“Even a minor loss of competence is a major concern when preparing sterile medications, as every aspect of the sterile compounding process is critical to patient safety,” the study authors wrote. “The findings of this study should be of interest to all pharmacy professionals.”
David J. and Ayars C. Preservation of sterile compound knowledge in pharmacy technicians. J Pharm Technology. 2021 Oct; 37(5): 219-224. July 20, 2021. Accessed September 13, 2022. doi: 10.1177/87551225211032395