In summary, "Targeting Zero" contamination initiative has been created by the Association for Professionals in Infection Control (APIC) (http://http://www.apic.org/) to prevent the most common and fatal healthcare-associated infections (http://www.cdc.gov/).  Pharmacists and technicians can impact HAI reduction efforts in three ways:

• 1. Use proper aseptic technique when preparing CSPs
• 2. Work with health care professionals to establish proper aseptic technique for CSPs
• 3. Actively participate on the Infection Control Committee.

USP Chapter 797 (http://www.usp.org) emphasizes the important role that compounding personnel play through aseptic technique or how they use their hand in preventing contamination of CSPs during preparation.  Several studies have identified human-borne contamination as the greatest threat to the sterility of CSPs, making the most important factor to be controlled during aseptic processing. Trissel, et al, demonstrated that donning sterile gloves ad routinely disinfecting gloved hands with IPA reduced the rate of contamination of media fills from 5.2 % to .3%. In 2003, the ICU in Michigan has reported the implementation of a care team checklist of basic hygiene and sterilization practices which has resulted in Zero infection and lives saved.

A check list for pharmacists and technicians detailing the elements of performance of proper aseptic technique should include:

• Perform a time out and review of all orders and ingredients.
• Garb from dirtiest to cleanest (shoe covers, hair net, beard cover and mask. Wash hands.
• Understand the elements of "first air". HEPA filter, unidirectional air flow, working in unobstructed zone, antechamber.
• Disinfect the work surface before and after every CSP batch with IPA 70 %
• Disinfect all components with IPA 70 % prior to placement in the ISO class 5 primary engineering control such as the CAI (http://www.isotechdesign.com/en/products-pharmacies-rx/sterile-compounding-admixtures.php) or CAWS (http://www.isotechdesign.com/en/products-pharmacies-rx/laminar-flow-workstations.php)
• Routinely disinfect gloved hands with IPA 70 % and inspect gloves for holes or tears.
• Visually inspect the CSPs

Confirming that all of these steps occur during the preparation of each and every CSP can ensure that the patient will receive a sterile CSP. In conclusion, these basic elements of performance for aseptic technique can positively impact the effort to minimize or eliminate HAIs (http://www.cdc.gov/). 

This article was written by Eric S. Kastango, MBA, RPh, FASHP and published in the Pharmacy Purchasing & Products, Vol.6 No.4 (http://www.pppmag.com)