Options for the Provision of Ready to Administer IVs to Support Clinical Areas – COVID-19

Ian Allen, Pharmacy Quality Assurance Regional Specialist (NW), North West Pharmaceutical Quality AssurancePublished

The Covid-19 crisis has generated an unprecedented demand for injectable medicines in ICU’s. These medicines are routinely prepared and administered by nursing staff, but the increased demand has placed huge pressure on available nursing time.

Pharmacy is taking a leading role in supporting nursing staff by providing injectable medicines in a ready to administer (RTA) presentation to the ICU clinical areas.

Wherever possible, the supply of RTA injectable medicines should be from a licensed (MS) or unlicensed (S10) pharmacy aseptic compounding unit to provide assurance of product quality.

In some situations there is insufficient capacity to meet demand from these supply routes and Chief Pharmacists may need to consider other options such as deploying pharmacy staff to prepare medicines in clinical areas.

There is no regulatory framework that applies to this situation and therefore it is recommended that any decision to exercise these options should be subject to scrutiny and approval by Trust Medical and Nursing Directors before submission for final governance approval by the Trust Board.

These documents have been developed by the Pharmaceutical QA Committee as resources to support Chief Pharmacists evaluate each option available to them and the associated risks. They should be read in conjunction with:

Chart A provides a clear visual overview of options available to Chief Pharmacists for provision of RTA injectable medicines to allow consideration of best use of the pharmacy team’s technical skills.

Chart B provides more detail with a risk matrix outlining the risks associated with pharmacy preparation in various settings.