This was a quick week (4 days only), with a great introduction to the sterile room. At BCCH the sterile room is responsible for:
- Making and checking CIVA orders and CIVA products
- Writing, making and checking TPN orders
- Preparing and checking chemo orders, chemo products and accurately ordering chemo.
- Preparing infliximab/rituximab orders and checking the final product
I was fortunate to be trained by several pharmacist, which was great as it allowed me to learn how each one does a particular task and see the process from a variety of perspectives. This was especially helpful when we were taught TPN as the math and the intricacies behind it can be complex, and learning it several ways was beneficial to solidify the thought processes behind it.
I was also fortunate to shadow a few of the sterile room technicians, and even scrub up. This really provided me with an appreciation for how much work a single CIVA order might entail. And really puts into perspective that step-down to PO is beneficial beyond just for the patient, but also in terms of workflow and workload!
Below are the tidbits I learned during my sterile room rotation:
- For chemo orders it is best to follow the road map on the protocol (to find the protocol go to the team site under onc studies under one of the left headers [e.g. 6, 7a, or 7b])
- For infliximab orders: check the core bag (serial # from abacis should match the bag serial #), total vol’ needed matches, expiry is good; check the volume of the syringe to match (there are more detailed instructions on the infliximab manufacturing sheet)
- Can tube chemo orders <100 mL, and CIVA <1 L. NEVER tube biologics (e.g. rituximab) or proteins (e.g. asparaginase)
- For TPN orders: see the attached doc (so many tidbits to know!) tpn-how-to