Pharmacists' opinions about and compliance with recommendations for intravenous admixture practices

Hospital pharmacy departments nationwide were surveyed to determine compliance with and opinions on the importance of recommended practices for preparation of i.v. admixtures. Questionnaires that included 84 recommendations by the National Coordinating Committee on Large-Volume Parenterals, the American Society of Hospital Pharmacists, and the Joint Commission on Accreditation of Hospitals were mailed to 625 randomly selected acute-care hospitals. Questions covered the compounding area and recommended equipment; selection, education, and training of personnel; compounding procedures; quality assurance; labeling and record keeping; and reference materials and professional services. The response rate was 43% (198 usable replies). Responses indicated that 42 (50%) of the recommended practices were followed in fewer than 75% of the hospitals, 25 (30%) in fewer than 50% of the hospitals, and 17 (20%) in fewer than 25% of the hospitals. Twenty of the recommendations were considered marginal in importance. Adherence to published guidelines for i.v. admixture services varies among hospitals in the United States; compilation of a single set of guidelines should be considered.