ASHP Guidelines on the Safe Use of Automated Compounding Devices for the Preparation of Parenteral Nutrition Admixtures
Benjamin Iredell, Hesham Mourad, Nancy A. Nickman, Hao Dieu, Gary Austin, Rani Goradia, Joseph Scott Wade, Justin Goette, Tanya O Ezekiel, Brendan R Begnoche, Andrew Liu, Stacey English
Abstract
Automated compounding devices (ACDs) are frequently used by pharmacists for the extemporaneous preparation of parenteral nutrition (PN) admixtures. This continuing shift from manual compounding procedures comes as a result of significant advances in automated technology, as well as in response to changing healthcare demands to provide admixture compounding in a safer, more efficient, and more accurate manner. As of 2019, approximately 29% of hospitals in the United States use ACDs. Larger teaching facilities are more likely to implement ACDs, with approximately 58% of hospitals with 400 beds or greater having an ACD in their workflow.1 Compounders are also used for other types of intravenous (IV) admixtures and in other settings, including home care and long-term care facilities; therefore, the overall magnitude of their use is substantial. As with other automated systems or devices, the benefits can be realized only when the technology is used appropriately. Significant patient harm may occur when safety and quality assurance measures are overlooked or circumvented.2