Aseptic Skill Validation Checklist
Appendix
Validation of Staff on Cytotoxic Preparation Techniques
Name of Staff: ___________________________________ Date: ________
Name of Examiner: _____________________________________________
| SN | KNOWLEDGE AND SKILLS | YES | NO |
|
1. |
Demonstrates proper infection control (removes jewelry; ties long hair back; washes to elbow with bacteriocidal soap; re-washes or uses alcohol if contaminated) | ||
|
2. |
Demonstrates proper growing procedure (hair cover, mask, lab coat, gloves, shoe covers) | ||
| 3. | Demonstrates understanding that the most important part of preparation cabinet is the HEPA filter. | ||
| 4. | Demonstrates understanding that cabinet should be serviced and certified by a qualified technician every 6 months and when they are moved, repaired, or if the HEPA filter is contaminated by a spill. |
||
| 5. | Demonstrates understanding that cabinet must run for a specified period, depending on the type of cabinet, before it can be used. |
||
| 6. | Demonstrates understanding that cabinet must be cleaned after a spill with water and detergent, followed by a thorough rinsing. | ||
| 7. | Demonstrates proper cabinet cleaning (uses 70% isopropyl alcohol, cleans back to front; documents cleaning; cleans spills quickly). | ||
| 8. | Demonstrates understanding that cytotoxic and other hazardous medications must not be prepared in a cabinet utilised for preparation of other sterile products. | ||
| 9. | Correctly performs all calculations prior to admixture preparation. | ||
| 10. | Correct medications, solutions, and supplies placed in hood appropriately to prevent blocking air flow. Keep non-essential items outside hood. | ||
| 11. | Check labels both prior to and after compounding to ensure medications and solutions used agree. | ||
| 12. | Demonstrates understanding of air-flow in cabinet, maintains flow of clean air over objects in hood, does not interrupt air flow, works well within hood. | ||
| 13. | Places hands within the most effective work zone during preparation. | ||
| 14. | Performs all work on plastic-backed paper mat placed on the work surface. | ||
| 15. | Demonstrates proper technique in swabbing, entering, and withdrawing fluid from vials, ampoules, and bags. Does not touch or contaminate components that must remain sterile. | ||
| 16. | Minimises positive pressure in vials during reconstitution or withdrawal of medication. Does not aspirate at any time. | ||
| 17. | Demonstrates correct use of appropriate transfer devices (filter needles, vented needles, dispensing pins, and etc). | ||
| 18. | Demonstrates proper closure technique for syringes and infusion bag. | ||
| 19. | Uses correct amounts of solutions and additives in compounding. Verifies type and amount of each additive prior to injecting into container. | ||
| 20. | Inspects final admixture for incompatibilities and particulate matter. | ||
| 21. | Demonstrates proper labeling, initialing, etc. of bags /syringes /bottles. | ||
| 22. | Demonstrates proper knowledge of expiration dates and storage requirements, (or can show where to obtain data). | ||
| 23. | Affixes appropriate labels to medication container including auxiliary and chemotherapy hazard labels. | ||
| 24. | Seals preparation in zip-lock bag before leaving the pharmacy. | ||
| 25. | Disposes of all used equipment and waste in appropriate hazardous waste disposal containers. | ||
| 26. | Washes hand after completion of operations in clean room. |
