20Ways Winter Hospital 2025

WINTER 2025 I HEALTH SYSTEM • INFUSION

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ABBY ROTH, FOUNDER/MICROBIOLOGIST AT PURE MICROBOLOGY

QUESTION & ANSWER

Q. What’s the best starting point for aligning with

the current USP <797> (2024)?

Begin with a formal gap assessment against the current

<797> requirements. If your organization hasn’t done this

yet, it is way behind other sterile compounding pharmacies.

Be ruthlessly objective. Observe real work practices and

compare them to your SOPs; what’s on paper often diverges

from daily practice. Prioritize high-risk findings (e.g., personnel

practices, engineering controls, viable sampling trends) before

lower-risk issues.

Q. What personnel competency elements do

inspectors and surveyors expect for USP <797>?

Obviously, initial and ongoing didactic training and the

chapter defined hand hygiene and garbing competency and

aseptic manipulation competency are going to be of interest.

The table to the right highlights the required elements.

Inspectors and surveyors are increasingly focusing on training

and competency assessments for surface sampling and colony-

forming unit (CFU) enumeration. These are critical activities

that often benefit from outsourced training unless internal staff

have been formally trained by a subject matter expert (SME)

using a train-the-trainer model. Competency assessments may

be obtained from external vendors or developed internally.

Q. For USP <800>, where do organizations most

often struggle?

One of the most common areas of noncompliance is

developing a compounding workflow that fully aligns with USP

<800> requirements. Sterile HD compounding is inherently

deliberate and must be approached with patience and respect

for the process. While patient care is always a priority, staff

safety must not be compromised.

When evaluating your HD sterile compounding process,

ensure the following:

• A new pair of outer sterile gloves is donned at the start of

each preparation.

• Hands remain inside the containment primary engineering

control (C-PEC) until the compounded sterile preparation

(CSP) is complete and decontaminated.

• Each CSP is decontaminated before being removed from

the C-PEC.

USP <797> &

RESOURCES, COMPLIANCE,

INITIAL COMPETENCY

REQUIREMENTS

Garbing & Hand Hygiene Competency

• Three Times

• Must Pass Consecutively

Includes:

• Visual Observation

• GFT

Aseptic Manipulation Competency

Replicates Not Specified

Includes:

• Media-Fill

• GFT

• Surface Sampling

ONGOING COMPETENCY

REQUIREMENTS

Garbing & Hand Hygiene Competency

• One Time

Includes:

• Visual Observation

• GFT

Aseptic Manipulation Competency

Replicates Not Specified

Includes:

• Media-Fill

• GFT

• Surface Sampling