Medication - Sterile Compounding - Nurse Competency Requirements (USP 797 2008 Version Only)
Are we required to do Finger Tip Testing and Media Fill Testing on nurses who compound emergent-use items outside of the pharmacy ?
Any examples are for illustrative purposes only.
No, immediate-use compounding is reserved for situations where an immediate/urgent need for medications is present and a delay in waiting for the pharmacy to compound items could delay care, as well as items with limited stability, once compounded. Therefore, The Joint Commission will not require fingertip or media fill competencies for nurses performing immediate-use compounding outside of the pharmacy.
No, immediate-use compounding is reserved for situations where an immediate/urgent need for medications is present and a delay in waiting for the pharmacy to compound items could delay care, as well as items with limited stability, once compounded. Therefore, The Joint Commission will not require fingertip or media fill competencies for nurses performing immediate-use compounding outside of the pharmacy.
Manual:
Critical Access Hospital
Chapter:
Human Resources HR
Last reviewed by Standards Interpretation: April 19, 2022
Represents the most recent date that the FAQ was reviewed (e.g. annual review).
First published date: January 23, 2018
This Standards FAQ was first published on this date.
This page was last updated on November 05, 2024
with update notes of: Editorial changes only
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