Evaluation of Pharmacist and Nurses Practices of IV Admixture Preparation Outside Pharmacy in Saudi Arabia

Background: Compounding and dispensing sterile preparation is a major part of pharmacy practice and the responsibility of pharmacists. The intravenous admixtures are sterile products prepared by mixing a medication or a combination of medications with a different intravenous solution. Errors during IV preparations have been reported to ISMP national medication error reporting program and are regularly discussed. Methods: An online survey-based, descriptive, cross-sectional study was conducted among Pharmacists and nurses working in Eastern Province, Saudi Arabia. The questionnaire was distributed among pharmacists and nurses compounding IV admixtures in the hospitals. Results: Out of 206, 115 (55.8%) respondents reported preparing IV admixtures outside pharmacy out of which 79 (68.7%) prepared it daily. Maximum were IV infusions. 63 (54.8%) of them prepared more than one IV admixture at one time. Although there were a high number 93 (80.8%) of people who said that they were provided with the established guidelines for preparing IV admixtures outside pharmacy however there is enough number 16 (13.9%) who said that they were not aware of them. Antibiotics 93 (80.8%) were frequently prepared in the form of IV admixtures. 22(19.1%) respondents reported experiencing errors during preparing IV admixtures. Use of wrong dose, concentration, diluent, diluent volume 12 (54.54%) was the most frequent error reported. Rushing during an emergency was the main challenge 56 (48.7%) faced. Conclusion: Although great emphasis is made to prepare the most IV preparations inside the pharmacy still there are situations where many IV medications had to be prepared outside the pharmacy. Intravenous infusions, antibiotics were the most commonly prepared IV admixtures. The most common error reported was in preparing the dose which could be due to the rushing during emergencies. Our study suggests that proper IV admixture training during the course study and on job must be made mandatory and wherever possible ready to use IV injections must be used.