When you receive an infusion, usually the IV bag of medication is ready and waiting for you. You may not know all of the steps taken behind the scenes to ensure the safety and accuracy of the treatment.
“Most medications start in powder or liquid form and need to be added to an IV bag in a sterile environment and checked for accuracy by a pharmacist,” says Elissa King, PharmD, MS, a UNC Health infusion services manager. “Mistakes in the preparation process could lead to serious safety events for our patients, so we’ve got to make sure they are prepared accurately.”
Infusion therapy—the process of giving medication directly into a vein in an outpatient setting—is often a part of regular treatment for people with cancer or those with chronic conditions, such as multiple sclerosis, rheumatoid arthritis and Crohn’s disease.
Dr. King shares questions that patients should ask to ensure they are receiving safe and high-quality infusion therapy.
1. How do I know my dose is safe from contamination?
Medications for IV therapy should be prepared by certified pharmacy technicians in a certified cleanroom. A cleanroom is a controlled environment in which temperature, pressure and humidity are regulated and contaminants are filtered out. Personal protective equipment is required to enter a cleanroom. They also follow strict safety guidelines, which are set by the nonprofit United States Pharmacopeia and enforced by state boards of pharmacy.
“If your medication is compounded outside of a sterile, regulated environment, such as on a table in a clinic, it doesn’t take much for the drug or the needle to come in contact with contaminants,” Dr. King says. “If it does become contaminated, it could make a patient very sick.”
Research shows that nearly 1 in 5 products made outside of a cleanroom were found to be contaminated. Ask your infusion team where your treatment was prepared.
2. How do I know I’m receiving the right dose of the correct medication?
The key to ensuring you are receiving the correct dose is having multiple checks in place.
At a minimum, different people should prepare and administer a drug so that someone can perform a safety check with fresh eyes. Ideally, there would be multiple checks throughout the medication use process.
“It’s best to have a certified pharmacy technician preparing the medications, a pharmacist checking them and a nurse confirming everything is correct before administration,” Dr. King says.
3. How do I know my infusion won’t cause a bad reaction?
While there is no guarantee that you won’t experience a reaction to a drug, drugs that would interfere with medication you are already taking or that you are allergic to should be avoided. To help prevent this, it’s best to receive your infusions within the same health system as your doctor. This will ensure that the team compounding and scheduling your infusions can see your entire medical record, not just the infusion prescription. They will know what allergies you have, the medications you take, any drugs you have taken in the past and whether they work for you.
Keeping your care information all in one place allows the infusion team to contact your physician to ask questions or get clarification.
“We often pick up the phone and call the patient’s doctor if we have questions or notice that something looks off with the prescribed infusion,” Dr. King says. “If you go to an infusion center that is separate from your doctor, they may not have a way to easily contact your medical team if there are questions.”
4. Can I get my laboratory tests and infusions done in the same place?
Some medications require certain laboratory tests, such as a blood or urine analysis, to be performed before the drug can be given.
To reduce wait times, it’s helpful if lab testing and infusion can be done in the same place.
“If we don’t have to send out labs, the coordination of care ends up being much more efficient for the patient,” Dr. King says. “At UNC Health, lab testing is usually done in the same building that the infusion is given, so it saves the patient from having to go to multiple visits in different locations. The pharmacists, nurses and physicians are all working together to make sure the patient gets the highest quality of care.”
If your treatment includes infusion therapy, talk to your provider about the best place to receive it.
Looking for a doctor? Find one near you.