I. Intravenous medication dispensing center (room) workflow
Clinical physician issued a prescription for intravenous infusion therapy or medication doctor's orders → medication doctor's orders information transfer → pharmacist audit → printing labels → labeling drug → verification → mixing and blending → infusion product verification → infusion product packaging → placed in closed containers by disease area, lock or seal → sent to the disease area by the worker → disease area pharmacy nurse to unlock (or unseal) checking and signing acceptance → before giving the patient medication, the nurse should be again with the medical record to check and acceptance (or open the seal) checking and signing → to the patient's medication before the nurse should once again check with the medical record medication prescription → to the patient's intravenous infusion of medication.
Second, the clinician issued a prescription or medication doctor's orders
Physicians based on the patient's diagnosis or therapeutic needs, in accordance with the principle of safe, effective, economical and rational use of drugs, prescriptions or medication doctor's orders, the information should be complete and clear.
The patient's long-term medical prescription for the next day's intravenous infusion will be transmitted to the intravenous medication dispensing center (room) according to the specified time. Temporary intravenous drug prescription deployment mode by the medical institutions in accordance with the actual situation of their own regulations.
Three, audit the prescription or medication doctor's orders operating procedures
Pharmacists responsible for the prescription or medication doctor's orders audit of the patient's intravenous infusion prescription or doctor's orders one by one, to confirm its correctness, reasonableness and completeness. The main content includes the following.
(a) Formal review: the content of the prescription or medication order should be in line with the "prescription management measures", "basic norms for case writing" of the relevant provisions of the writing is correct, complete, clear, no missing information.
(2) Analyze and identify the compatibility of clinical diagnosis with the selected drugs.
(3) Confirm the correctness and appropriateness of the selected drug varieties, specifications, routes of administration, usage, and dosage, and prevent duplicate administration.
(d) Confirm the appropriateness of intravenous drug compounding and analyze the compatibility and stability of drugs.
(e) Confirm the appropriateness of the solvent used.
(6) Confirmation of the suitability of intravenous drugs and packaging materials.
(G) confirm the results of drug skin test and drug serious or special adverse reactions and other important information.
(viii) Any doubts or undetermined elements that require further verification with the physician.
Errors in prescriptions or medication orders should be promptly communicated to the prescribing physician for adjustment and signature. Due to the condition of the need for overdose and other special medication, the physician should sign again to confirm. The medication error or can not guarantee the quality of the finished infusion of prescription or medical advice should be refused to deploy.
Four, print labels and labeling management procedures
(a) by the pharmacist suitability review of prescriptions or medication orders, after summarizing the data in order to ward as a unit, the physician's medication orders will be printed into the infusion prescription labels (referred to as: infusion labels). Verify the patient's name, ward, bed number, medical record number, date, date, time and expiration date on the infusion label, and place the infusion labels in the order of the nature of the prescription and the time of the medication in containers of different colors (to differentiate between batches) to facilitate the operation of dispensing.
(ii) infusion labels automatically generated by the computer system numbering, numbering method determined by the medical institutions themselves.
(c) print infusion labels, should be in accordance with the "centralized dispensing of intravenous drugs," the relevant provisions of the electronic prescribing system operation or the use of simultaneous printing of backup infusion labels. Infusion labels are attached to the infusion bag (bottle), backup infusion labels should be with the blending process, and signed by the operators of the positions or stamped with a signature, save 1 year for inspection.
(D) infusion labeling content in addition to the relevant provisions should be in line with the following matters should also indicate the need for special tips:
1. According to the regulations should be allergy testing or some special nature of the drug infusion labeling, there should be obvious signs;
2. pharmacists in the preparation or dispensing of drugs need special attention and suggestive notes, such as drug concentration Conversion, the actual dosage of non-vial (branch) use of drugs, etc.;
3. Matters needing special attention in the process of clinical use of medication, such as special drip rate, drip to avoid light, special medication monitoring.
V. Labeling and verification of operating procedures
(a) before the pharmacist should carefully read and verify the infusion label is accurate and complete, if there is an error or incomplete, should be informed to the prescribing pharmacist proofreading correction.
(2) The drugs shall be placed in the order listed on the infusion label, and placed in batches in containers of different colors according to their nature and time of administration; and in different mixing and blending areas according to the ward and the nature of the drugs.
(3) When placing medicines, it is necessary to check whether the name, dosage and specification of medicines are in accordance with the label content, and at the same time, it should pay attention to the intactness and expiration date of medicines, and sign or stamp the signature.
(d) set up the drug notes:
1. set up the drug, confirm that the same patient with the same drug lot number;
2. set up the drug should be wiped clean before being passed into the clean room, but should not be the cap of powdered syringes removed;
3. daily should be used in accordance with the provisions of the container for the organization of scrubbing and disinfection for the next time to be used. next use.
(E) Supplemental medicines in the preparation room:
1. After the completion of the daily preparation of medicines, the shortages of medicines in the preparation room should be supplemented in a timely manner and should be proofread;
2. Supplemental medicines should be dismantled from the outer packaging in a special area, and at the same time the expiration date and batch number of the medicines should be checked to prevent any misplacement, and the medicines need to be wiped and cleaned if there is any dust before they are placed on the shelves;
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3. When replenishing medicines, attention should be paid to the expiration date of medicines, according to the principle of first-in-first-out and first-in-recently-used;
4. High-risk medicines, such as potassium chloride injections, should have a special marking and a fixed position.
(F) the drug set up to check the operating procedures:
1. the infusion labels are neatly attached to the infusion bags (bottles), but the original label shall not be covered;
2. the pharmacist set up the drug should be double-checked and signed or stamped with a signature;
3. containers with injections and labeled infusion bags (bottles) will be sent into the operation room of the clean area through the transfer window and placed in the drug shelves (bottles) by patient area. The containers with injections and labeled infusion bags (bottles) are sent into the clean area operation room through the transfer window and placed on the medicine rack (cart) according to the disease area.
Six, intravenous drug mixing and blending procedures
(a) preparation for blending operations:
1. 30 minutes before the blending operation, according to the operating procedures to start the clean room and laminar flow bench purification system, and confirm that it is in a normal working condition, the operating room room temperature control at 18 ℃ ~ 26 ℃, humidity of 40% ~ 65%, the indoor and outdoor differential pressure in accordance with the provisions of the operating room temperature control at 18 ℃ ~ 26 ℃, humidity 40% ~ 65%, indoor and outdoor differential pressure in accordance with the provisions of the record and sign;
2. Operator records and signatures;
2. Shift staff should first read the records of the shift handover, the problem should be dealt with in a timely manner;
3. According to the dressing operation procedures, enter the clean area of the operating room, the first with a nonwoven cloth dipped in 75% ethanol to wipe the laminar flow of the internal parts of the clean table from top to bottom, from the inside to the outside.
(ii) Push the medicine trolley with medicine containers to the corresponding position near the laminar flow clean operation table.
(c) proofreading before dispensing: dispensing pharmacy technicians should check the name of the drug, specification, quantity, expiration date, etc., according to the infusion label for accuracy and drug intactness, and after confirming that there is no error, enter into the drug mixing and dispensing operation procedures.
(D) mixing operation procedures:
1. Select the appropriate disposable syringe, remove the outer packaging, rotate the needle to connect the syringe to ensure that the tip of the needle bevel and syringe scale in the same direction, the syringe will be vertically placed on the inner laminar flow clean table;
2. 75% ethanol disinfection of infusion bags (bottles) of the addition of medication, placed in the middle of the laminar flow clean table Remove the cap of the vial, sterilize the neck of the ampoule or the stopper of the vial with 75% ethanol, and open the ampoule on the side wall of the laminar flow clean table, avoiding opening it in the direction of the high-efficiency filter to prevent the liquid from splashing onto the high-efficiency filter;
4. When extracting the liquid, the beveled surface of the needle tip of the syringe should be facing upwards, and the liquid should be extracted immediately against the neck of the ampoule, and injected into the infusion bag (vial), gently shaking well;
5. Dissolve the powder injection, use a syringe to extract the appropriate amount of intravenous solvent, injected into the powder injection of the vial, if necessary, can be gently shaken (or placed on the shaker) to help dissolve, all dissolved and mixed, with the same syringe to draw out the liquid, injected into the infusion bag (vial), gently shaken;
6. After the end of the mixing, once again to verify the labeling of the infusion with the name of the drug, specifications, dosage, and the amount of the drug. Drug name, specifications, dosage, accurate and correct, the blending operator in the infusion label signature or stamp, labeling the time of blending, and blend the finished infusion and empty vials, ampoules and back-up infusion labels and other relevant information into a basket for the inspector to check;
7. Through the transfer window of the finished product infusion to the finished product checking area, into the finished product checking and packaging procedures;
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8. After completing each infusion mixing operation, the table should be cleared immediately, and the table surface should be wiped with a non-woven cloth dipped in 75% ethanol to remove residual liquid, and there should be no drugs, residual liquids, used syringes, and other items that are not related to the next batch of infusion mixing.
(e) After the daily dispensing work, clean and disinfect the table according to the cleaning and disinfecting operation procedures of this specification and operation procedures.
(F) Intravenous drug mixing and blending precautions:
1. The cross-blending process shall not be used;
2. If the drug used for intravenous drug blending is not a whole vial (bottle) of dosage, the actual dosage used must be clearly marked on the infusion label for proofreading;
3. If there are more than two kinds of powdered needles or injections to be added to the same If there are two or more powdered injections or injectable solutions to be added to the same infusion, they should be added in strict accordance with the requirements of the drug specification and the order of the nature of the drug; for parenteral nutritional solutions, high-risk medicines and the dispensing of certain special medicines, the relevant operating procedures for the order of addition should be formulated;
4. In the process of dispensing, there is an abnormality in the infusion or there is a doubt in the compounding of the drug and the operating procedures, the dispensing should be stopped, and report to the pharmacist in charge on duty to ascertain the reasons, or consult with the prescriber Adjustment of medication orders; blending errors should be corrected in a timely manner, re-blending and record;
5. Blending operation hazardous drugs precautions:
(1) Hazardous drugs should be blended to pay attention to the operator's occupational protection, blending should be pulled down the biosafety cabinet protection glass, the front window glass can not be higher than the safety cordon to ensure negative pressure;
(2) Hazardous drugs (2) hazardous drugs, must be left after the blending of vials, ampoules and other hazardous drugs in a separate appropriate packaging, and finished infusion and backup infusion labels and sent out for verification;
(3) blending of hazardous drugs used disposable syringes, gloves, masks, and inspection of the vials, ampoules and other wastes, in accordance with the provisions of the unified treatment of this health care organization;
(4) hazardous drugs Drug spillage disposal in accordance with relevant regulations.
VII. Operational procedures for verification, packaging and distribution of finished infusion solution
(1) Operational procedures for inspection and verification of finished infusion solution:
1. Check the infusion bag (bottle) for cracks, and the infusion solution should be free of sedimentation, discoloration, foreign matter, etc.
2. Perform the squeeze test, and observe whether there is any leakage from the infusion bag, especially at the place of addition of medicine;
3. ...Check whether the drug name, specification, dosage, etc. of the used infusion solution and empty vials and ampoules are consistent with each item according to the contents of the label of the infusion solution;
4...Verify whether the dosage of the patient who is not a whole vial (branch) of the dosage is consistent with the logo;
5...Whether the signature of the operator of each position is complete, and the checker should sign or stamp the seal of the verification after confirming that there is no error;
6...After verification is completed, the Empty ampoules and other wastes are disposed of according to regulations.
(ii) the finished infusion solution after verification, packaged in suitable plastic bags, neatly placed in closed containers with ward markings according to the ward, and the time and quantity of drug delivery recorded in the drug delivery register. In the hazardous drugs on the outer packaging to have a conspicuous mark.
(3) The airtight containers are locked or sealed, the keys are kept by the dispensing center and the ward, and the delivery workers deliver them to each ward in time, and the ward pharmacy nurses unlock or unseal the containers and check them one by one after counting and noting the time of handover, and then sign in the delivery register after there is no error.
Eight, intravenous drug dispensing drugs and materials required for the receipt of management procedures
(a) Drugs and materials should be requested, storage and maintenance should be a person responsible for.
(2) The requisition of drugs:
1. The requisition of drugs in the intravenous drug dispensing center (room) shall be based on the daily consumption, fill in the drug requisition form, and regularly requisition from the pharmacy, and the drug requisition form shall be signed by the person in charge or the designated personnel;
2. The intravenous drug dispensing center (room) shall not dispense the prescriptions other than those dispensed by the intravenous drug dispensing;
3. Intravenous drug dispensing center (room) shall not directly purchase drugs from outside, and all the required drugs shall be purchased and supplied by the drug section (library) of the pharmacy department.
(3) Acceptance of medicines:
1. The pharmacist in charge of the management of the second-level pharmacy shall check the medicines one by one according to the quality standard, requisition form, and voucher for issuing medicines with the real thing, including whether the name, specification, quantity, and expiration date are correct, and whether the medicine labels and packages are neat and intact, and then, after checking and passing, place the medicines into the corresponding fixed spaces and sign the vouchers for issuing medicines;
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2. Whenever the quality of drugs is questioned, the quantity of drugs does not match the specifications, or the drugs are out of date or damaged, they should communicate with the drug section (library) in time to return or replace the drugs, and make a record of it.
(D) storage management and maintenance of drugs:
1. The drugstore should be clean, neat, flat and dry ground, the width of the door and channel should be easy to handle the drugs and meet the requirements of fire safety; drug storage should be according to the "classification of the district, the number of the goods" method of positioning storage, according to the nature of the drugs Classification of centralized storage; high-risk drugs should be set up a prominent warning signs; and should do a good job of temperature and humidity monitoring and recording of the drugstore;
2. The drugstore has to ensure that the storage of medicines and materials required temperature and humidity conditions: room temperature area of 10 ℃ ~ 30 ℃, the cool area is not higher than 20 ℃, refrigerated area of 2 ℃ ~ 8 ℃, relative humidity of the warehouse 40% ~ 65%;
3. Stacking and cooling or heating facilities at a distance of not less than 30 centimeters, not less than 20 centimeters from the wall, from the roof and the ground at a distance of not less than 10 centimeters;
4. Standardize the stacking and handling of medicines, drugs to comply with the requirements of the outer packaging of the graphic symbols, shall not be inverted for storage;
5. Each type of medicine should be according to the lot number and expiration date of the proximity of the sequential or separate stacking and a clear sign, follow the "first", and the "first", and "first", and "second", and "second", and "third", and "third". Obvious signs, follow the "first production first use", "first in first use", "recent first use" and according to the batch number of the principle of drug use;
6, There should be a standardized system and records for the identification, reporting and destruction of substandard drugs.
(E) has established a hospital information system of medical institutions, should establish an electronic drug information management system, the drug stock should be established with the first level of the library electronic network transmission links to strengthen the costing of drugs and account management system.
(F) intravenous drug dispensing center (room) should be used to do a monthly inventory of drugs, the account matches, if any discrepancies should be identified in a timely manner.
(VII) syringes and needles and other materials should be used, management should be in accordance with the relevant provisions of these norms and reference to the drug requisition, acceptance of the management of the implementation, and should be stored separately from the drugs.
Nine, electronic information systems for intravenous drug dispensing procedures
(a) electronic information systems for intravenous drug dispensing process:
1. The physician in accordance with the "Prescription Management" and "Electronic Medical Record (Trial)" the relevant provisions of the basic norms, responsible for the patient's prescription or medication orders grouped into the computer;
2. Intravenous infusion of the medical orders directly to the Intravenous medication dispensing center (room);
3. After the pharmacist review of the appropriateness of the prescription or medication orders, the automatic generation of infusion labels and back-up infusion labels or the use of electronic prescription information system records, the above labels or records should have the information of the operators of the various processes.
(ii) the establishment of electronic drug information management system. Prescription or medication doctor's orders printed into infusion labels, and after the completion of the dispensing operation process, automatically subtract the prescription composed of drugs in the second level of the number of drugs stored in the library, so that the account is consistent with the goods and automatically form a monthly income and expenditure balance of the drug statement.
Ten, intravenous drug dispensing center (room) personnel changing procedures
(a) in and out of intravenous drug dispensing center (room) changing procedures. In and out of intravenous drug preparation center (room) should be replaced by the center (room) work clothes, work shoes and wear a hair cap. Non-center (room) personnel without the consent of the center (room), may not enter.
(2) into the 100,000 clean area procedures (a more):
1. Change out of ordinary work clothes and shoes, according to the six-step hand cleaning and disinfection method to disinfect the hands and dry;
2. Wear the designated clothing and wear a good hair cap, mask.
(3) Entering the 10,000-level clean area procedures (second shift):
1. Change the clean area of special shoes, clean isolation clothing;
2. Hand disinfection, wearing disposable gloves.
(D) leave the clean area procedures:
1. temporary out: in the second shift room off clean isolation clothing and hats, masks neatly placed, disposable gloves thrown into the bucket of dirt; in the first shift room should be replaced with overalls and shoes;
2. re-entry into the clean area, you must be in accordance with the above procedures for changing into the clean area;
3. the day of redeployment At the end of the day, take off the clean area shoes, clean isolation clothing for routine disinfection, at least 2 times a week cleaning; disposable masks, gloves and thrown into the dirt bucket.
Eleven, intravenous drug preparation center (room) cleaning, disinfection procedures
(a) the choice of ground disinfectant and preparation:
1. Sodium hypochlorite, 5% strong alkaline solution for ground disinfection as a 1% solution, the solution must be freshly prepared before use, handling/dispensing high concentration 5% sodium hypochlorite solution, must wear a thick mask and protective gloves.
2. quaternary ammonium cationic surfactants, corrosive; prohibited and soapy water and anionic surfactants used in conjunction, should be freshly prepared before use;
3. cresyl soap solution, corrosive, used for disinfection of the ground for 5% solution, should be freshly prepared before use.
(2) Intravenous medication preparation center (room) cleanliness and hygiene management of other provisions:
1. Each operating room shall not store items unrelated to the nature of the work of the room, are not allowed to eat or place food in the intravenous medication preparation center (room);
2. The end of the daily work should be cleared in a timely manner after the end of the day, a variety of wastes must be dealt with in a timely manner every day.
(3) Cleaning and disinfection operation procedure of non-clean area:
1. After daily work, scrub the floor with special mop, wipe the worktable, stools and chairs, door frames and door knobs, plastic baskets, etc. with normal water;
2. Disinfection of the floor and the bucket of dirt once a week: first, clean it with normal water, and then scrub the floor and the inside and outside of the bucket with disinfectant after it dries, for 15 minutes. Later, wipe off the disinfectant solution with normal water;
3. Once a week, disinfecting workbenches, closed containers for conveying finished products, medicine carts, stainless steel equipment, stools and chairs, door frames and door handles are wiped with 75% ethanol.
(4) 10,000 clean area cleaning, disinfection procedures:
1. Daily cleaning, disinfection: after the end of the deployment, with normal water to clean the stainless steel equipment, laminar flow operating table and both sides of the wall, the top of the transfer window, both sides of the wall, handles and countertops, benches and chairs, lighting switches, etc., to be dry, with 75% ethanol wipe disinfection;
2. Daily in accordance with the provisions of the The floor is cleaned and disinfected daily according to the specified operation procedures;
3. The walls and ceiling are cleaned and disinfected once a month, and the operation procedures are the same as above.
(E) cleaning, disinfection precautions:
1. disinfectant should be regularly rotated;
2. clean area and general auxiliary work areas must be strictly separated from the cleaning tools, no mixing;
3. cleaning and disinfection process, no water or disinfectant spray to the high-efficiency filters;
4. cleaning, disinfection
4. When cleaning and disinfecting, the filter should be wiped according to the procedure from top to bottom and from inside to outside, and no dead corner should be left;
5. When cleaning with normal water, the filter should be wiped with disinfectant only after it has dried up to ensure the cleaning and disinfecting effect.
Twelve, biological safety cabinet operating procedures
Biological safety cabinet belongs to the vertical laminar flow table, through the laminar flow table on top of the high-efficiency filters, can filter 99.99% of the particles above 0.3μm, so that the operation of the table space to form a local 100 clean environment, and through the work surface around the dispersion of holes back to the formation of a relative negative pressure, therefore, there should not be any object Therefore, there should not be any objects blocking the diffusion holes, including arms. Biological safety cabinets for the preparation of hazardous drugs, should be added to the activated carbon filter for filtration of harmful gases discharged.
(I) cleaning and disinfection:
1. Every day before the start of the operation, should use 75% ethanol to wipe the top of the work area, both sides and the countertop, the order should be from top to bottom, from the inside to the outside;
2. In the process of mixing, after each finished infusion mixing, should be cleaned up on the operating table waste, and wiped with normal water, and then 75% ethanol disinfection of the countertop if necessary;
4. Ethanol disinfection of the table;
3. At the end of each day's operation, the site should be thoroughly cleaned, cleaned with normal water, and then wiped with 75% ethanol disinfection;
4. At the end of each day's operation should be opened back to the outer cover of the air duct, cleaned with distilled water back to the air duct, and then 75% ethanol wipe disinfection.
(2) the operation of the biological safety cabinet and the precautions:
1. There are 1 to 2 deploying personnel half an hour in advance to start the biological cabinet circulating fan and ultraviolet light, close the front window to the safety line, after 30 minutes to turn off the ultraviolet light, and then wipe the top of the biological safety cabinet, both sides and the table with 75% ethanol in the order of disinfection from the top to the bottom and from the inside to the outside, and then turn on the Lighting before the deployment;
2. Ultraviolet lamp start period, no deployment, the staff should leave the operating room;
3. Ultraviolet lamps should be regularly tested, such as the sterilization effect can not be achieved, it should be replaced in a timely manner;
4. All intravenous drug deployment must be in the area of at least 10 centimeters away from the outer edge of the table 20 cm, the inner edge of the inner edge of the 8 ~ 10 cm, and away from the table surface. At least 10 cm from the table surface area;
5. The front window of the mixing can not be higher than the safety cordon, otherwise, the operation area can not ensure negative pressure, may cause the drug aerosol dispersion, causing injury to the staff or contamination of the clean room;
6. Biosafety cabinets should be regularly wiped with distilled water to clean the return air ducts, and then disinfected with 75% ethanol;
7. biological safety cabinet should be done once a month to monitor the settlement bacteria, method: the petri dish will be opened, placed on the operating table for half an hour, after sealing the lid of the bacterial culture, colony counting;
8. biological safety cabinets should be based on the automatic monitoring instructions, timely replacement of the filter's activated carbon.
(c) each year should be a biological safety cabinet for the parameters of the test to ensure that the quality of the operation of biological safety cabinets, and save the test report.
Thirteen, horizontal laminar flow clean table operating procedures
(a) the correct placement of items in the horizontal laminar flow clean table and operation is to ensure the quality of the work of the clean table is an important factor. The air blown from the horizontal laminar flow clean table is filtered by high efficiency filter, which can remove 99.99% of the particles with a diameter of 0.3mm or more, and ensure the air flow direction and flow rate. Horizontal laminar flow benches used for intravenous drug dispensing operations should have the air inlet at the top of the bench, which ensures that the cleanest air enters the bench first, and the lower support portion of the bench ensures that the air flows through. This kind of laminar flow clean table can only be used for the preparation of staff without harm to the drug, such as electrolyte drugs, parenteral nutrition drugs.
(2) Cleaning and disinfection:
1. Every day before the operation starts, one or two dispensers start the circulating fan and ultraviolet lamp of the horizontal laminar flow table in advance, turn off the ultraviolet lamp after 30 minutes, and then wipe the top, both sides and the surface of the laminar flow table with 75% ethanol in the sequence of disinfection from the top to the bottom and from the inside to the outside; and then turn on the illumination lamps before the dispensing;
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2. In the process of mixing, after each finished infusion mixing, should clean up the operating table waste, and cleaned with normal water, and then use 75% ethanol to disinfect the table surface if necessary;
3. Every day after the end of the mixing, should be thoroughly cleaned up, cleaned with normal water, and then wiped with 75% ethanol to disinfect.
(C) the operation of the horizontal laminar flow clean table and precautions:
1. the horizontal laminar flow clean table start half an hour before the intravenous drug mixing;
2. should try to avoid placing too many items on the operating table, the placement of larger items between the distance of about 15 centimeters; placed between the small items of about 5 centimeters distance;
3. The sterile items on the clean bench should ensure that the first time clean air flows through them, i.e., there should be no obstruction between the items and the high-efficiency filter, also known as the "open window";
4. Avoid splashing any liquid substances into the high-efficiency filter, once the high-efficiency filter is wet, it is easy to produce damage and mold growth;
5. Avoid placing objects too close to the high-efficiency filter, all operations should be carried out in the work area, do not place your wrist or elbow on the clean worktable, and keep the "open window" at all times;
6. Avoid strenuous movements in the clean room, avoid making loud noise, and strictly observe the rules of sterile operation;
7. Strictly abide by the rules of aseptic operation;
7. Horizontal laminar flow clean table can be divided into three areas:
(1) the inner area, closest to the high-efficiency filters in the region, 10-15 cm from the high-efficiency filters, suitable for placing the ampoule has been opened and other sterile objects that have been unpacked;
(2) the work area, that is, the center of the workbench, 10-15 cm from the edge of the clean table, all the work area, that is, the center of the table, is 10-15 cm from the edge of the table. (2) the work area, the central part of the table, 10 to 15 cm from the edge of the clean table, all the mixing should be done in this area;
(3) the outer area, from the edge of the table to the 15-20 cm distance between the area, can be used to place the outer packaging of syringes and other objects with the external packaging (should be as far as possible not to put or put less).
8. Ampoules cut with an abrasive wheel and the injection hole cap of the syringe vial opened, should be carefully wiped with 75% ethanol to disinfect and remove particles, the direction of opening the ampoule should be away from the high-efficiency filters;
9. Horizontal laminar flow clean table should be done once a week for dynamic bacterial monitoring of planktonic bacteria, the method: open the petri dish and place it on the operating table for half an hour, close the lid and then carry out a bacterial culture, the Colony counting.
(d) annual horizontal laminar flow clean table should be tested for various parameters to ensure the quality of clean table operation, and save the test report.
XIV, other
Medical institutions to carry out other centralized or decentralized clinical intravenous drug dispensing, with reference to the above operating procedures, the specific implementation of the procedures developed by the medical institutions responsible for.