Baxter | 20Ways Summer Hospital 2024 Case Study

Welcome to interactive presentation, created with Publuu. Enjoy the reading!

CASE STUDY

www.baxter.com

6. MICROBIOLOGICAL AIR AND

SURFACE MONITORING

6.2.3 Viable air sampling data

evaluation and action levels

Viable airborne particle counts

by ISO classification must not

exceed actionable levels:

ISO 5 > 1 cfu/m3

ISO 7 > 10 cfu/m3

6.3.3 Surface sampling data

evaluation and action levels:

ISO 5 > 1 cfu/media device

ISO 7 > 10 cfu/media device

The decrease in

staff needing to

enter the cleanroom

associated with

remote verification

can also be used as

a control mechanism

to decrease viable

air and surface

contaminants.

11. MASTER FORMULATION AND

COMPOUNDING RECORDS

11.1 Creating Master Formulation

Records (MFR)

An MFR is a detailed record of procedures

that describes how the CSP is to be

prepared. An MFR must be created for all

CSPs prepared from nonsterile ingredient(s)

or CSPs prepared for more than one patient.

11.2 Creating Compounding Records (CR)

CR documents the compounding of

each CSP. A CR must be created for all

Category 1, Category 2, and Category

3 CSPs. A CR must also be created for

immediate-use CSPs prepared for more

than one patient. The CR must be created

to document the compounding process.

A prescription or medication order or

label may serve as the CR. If an ACD,

workflow management system, or other

similar equipment is used, the required

information in the CR may be stored

electronically as long as it is retrievable

and retains the required information.

The following

DoseEdge

functionality can be

used in aggregate to

support most/all the

requirements for the

contents of an MFR

and CR, and help

ensure that the MFRs

and CRs are followed:

• Customizable

Drug Formulary

• Customizable

Product Formulary

• Customizable

Actions

• Customizable

Procedures

• Customizable

Scan Events

• Storage

capabilities

• Customizable

product-specific

information fields

12. RELEASE INSPECTIONS AND TESTING

12.2 Sterility Testing

For Category 2 CSPs assigned a BUD

that requires sterility testing (see

Table 13) and all Category 3 CSPs,

the testing must be performed.

12.3 Bacterial Endotoxins Testing

Category 2 injectable CSPs compounded

from one or more nonsterile component(s)

and assigned a BUD that requires

sterility testing and Category 3 injectable

CSPs compounded from one or more

nonsterile component(s) must be tested

to ensure that they do not contain

excessive bacterial endotoxins.

Customizable Actions

and/or Procedures

can be used to

remind compounders

when sterility and/or

bacterial endotoxin

testing (or other

requirements) needs

to be completed.

14. ESTABLISHING BEYOND-USE DATES

Each CSP label must state the date, or

the hour and date, beyond which the

preparation must not be used and must

be discarded (i.e., the BUD). The BUD is

determined from the date and time that

preparation of the CSP is initiated.

14.2 Parameters to Consider

in Establishing a BUD

When establishing a BUD for a

CSP, compounders must consider

parameters that may affect quality.

The BUDs for CSPs are based primarily

on factors that affect the achievement

and maintenance of sterility, which

include, but are not limited to:

• Conditions of the environment

in which the CSP is prepared

• Aseptic processing and

sterilization method

• Starting components (e.g., sterile

or nonsterile ingredients)

• Whether or not sterility

testing is performed

• Storage conditions (e.g.,

packaging and temperature)

14.3 Establishing a BUD for a CSP

The BUD must not exceed the

shortest remaining expiration

date of any of the commercially

available starting components.

14.5 Multiple-Dose Containers

The use of preservatives must be

appropriate for the CSP formulation

and the route of administration. For

example, the preservative must not be

inactivated by any ingredients in the

CSP, and some preservatives are not

always appropriate for the patient (e.g.,

neonates) or route of administration (e.g.,

intrathecal or ophthalmic injection).

After a multiple-dose CSP container

is initially entered or punctured, the

multiple-dose container must not be

used for longer than the assigned BUD

or 28 days if supported by antimicrobial

effectiveness testing results on

the CSP, whichever is shorter.

BUDs are

automatically

calculated from the

time the compounding

process is initiated.

They can be

customized and

automated to

account for the many

options that are

available between

and within the three

Compounding

Categories

BUDs can be

customized at the

dose level based on:

• Starting

components

used in the dose

• Location of

preparation

(environmental

conditions such

ISO classified

vs SCA/RABS)

• Storage conditions

• Processes used

during preparation

(including

sterility testing)

The BUD of individual

doses are compared

to the BUDs or

expiration dates of the

components used in

dose to ensure they

are appropriate.

With ‘Preservative-

free” and “Route

of Administration”

designations in the

Product Formulary,

inappropriate

component use

can be prevented.

“Work in Progress”

products and labels

can automate BUDs

for components used

during preparation

Made with Publuu - flipbook maker