Home Infusion Pharmacy Flashcards

Question 1

What is home infusion pharmacy and where is therapy usually delivered?

Accepted Answer

Home infusion pharmacy is a pharmacy service that prepares and supplies sterile intravenous and other parenteral medications, along with related supplies, for patients who receive treatment in their own residence. The pharmacy coordinates ordering, compounding, delivery, caregiver training, and follow-up so that therapy can continue safely outside a hospital or clinic.

Question 2

What does the term parenteral mean in pharmacy practice?

Accepted Answer

Parenteral means administered by a route that bypasses the digestive tract, such as directly into a vein, under the skin, or into a muscle. In home infusion, the term usually describes intravenous and subcutaneous delivery. Because these routes avoid normal absorption through the gut, sterility and accurate dosing become important for every product prepared.

Question 3

What kinds of settings count as the home in home infusion practice?

Accepted Answer

The home in this context is any residence where the patient lives and receives care, including a private house, apartment, or assisted living setting. The defining feature is not the building type but that the patient or a caregiver, rather than a clinical staff member, carries out most of the administration.

Question 4

What role does the prescriber play in the home infusion workflow?

Accepted Answer

The prescriber is the licensed clinician who writes the order specifying the medication, concentration, rate, duration, and monitoring plan. The pharmacy verifies that order for appropriateness, completeness, and compatibility before preparing anything. Clarifying questions go back to the prescriber, and the pharmacist does not change the order without authorization from that prescriber.

Question 5

What does the term admixture mean in infusion pharmacy?

Accepted Answer

An admixture is a final infusion solution made by combining one or more medications with a compatible diluent or base solution, such as sodium chloride or dextrose in water, in a sterile container. Pharmacists must confirm stability and compatibility of every component before it is labeled and released for use.

Question 6

Why do home infusion patients often need caregiver involvement in daily care?

Accepted Answer

Therapies often require routine tasks such as connecting supplies, checking equipment, recording observations, and responding to alarms. Caregivers, who may be family members or the patient, must be trained and competent to perform these tasks. Clear teaching and written instructions reduce the chance of errors and help the patient follow the plan safely.

Question 7

What happens during intake in a home infusion referral?

Accepted Answer

Intake begins when a referral arrives from a hospital, clinic, or prescriber and the pharmacy gathers the patient's demographic details, payer information, documented reason for therapy, known allergies, and the ordered regimen. Staff confirm the home setting is appropriate and required nursing and equipment support can be arranged before accepting the patient for service.

Question 8

What does the term medication reconciliation mean in this setting?

Accepted Answer

Medication reconciliation is the process of comparing the patient's current medication list against new orders and records from other care settings to find and resolve discrepancies. In home infusion, it helps prevent duplicate therapies, omissions, or conflicting instructions. The pharmacist documents the review and communicates any unresolved questions to the prescriber.

Question 9

What does aseptic technique mean in sterile compounding?

Accepted Answer

Aseptic technique is a set of practices that keeps microorganisms and other contaminants out of a sterile product during preparation. It includes hand hygiene, gowning, disinfecting work surfaces, and handling ingredients in a way that avoids introducing particles or microbes. The goal is to maintain sterility throughout preparation.

Question 10

Why is a laminar airflow workspace used for sterile compounding?

Accepted Answer

A laminar airflow workspace moves filtered air across the work area in a steady, unidirectional pattern, which carries particles away from the product and the preparer. High efficiency particulate air filters remove most airborne particles before air reaches the work surface. The workspace supports sterility, and it does not replace proper technique.

Question 11

What is a beyond-use date on a compounded sterile preparation?

Accepted Answer

A beyond-use date is the date after which a compounded preparation should not be used, set by the pharmacy based on available stability data, the type of container, and the storage conditions. It is not the same as the expiration date printed by a manufacturer. Staff must label every compounded preparation with this date.

Question 12

What is a final check in compounding and why is it done?

Accepted Answer

A final check is a verification step performed after a preparation is complete and before it is released, confirming the correct product, strength, quantity, and labeling. A second trained person often reviews the label against the order. The check catches errors that may have occurred during preparation and reduces dispensing mistakes.

Question 13

What is a closed system transfer device and what is its general purpose?

Accepted Answer

A closed system transfer device is a container and connector arrangement that limits the escape of vapors, aerosols, and particles while a hazardous or sensitive substance is moved between containers. It supports worker protection during transfer steps but does not replace good technique.

Question 14

What is a hazardous drug and why do handling standards exist for it?

Accepted Answer

A hazardous drug is a medication with properties that can harm exposed workers, such as carcinogenicity, reproductive toxicity, or organ toxicity. Handling standards exist to protect staff, patients, and the environment from contamination during preparation, administration, and waste disposal. Pharmacies follow written procedures that apply these protections to every step.

Question 15

What is the role of a pharmacist in verifying a compounding order?

Accepted Answer

The pharmacist reviews the order for completeness, appropriate dose calculation, compatibility of components, and stability for the intended storage and use. The pharmacist also confirms that ingredients and calculations are documented before preparation. When a problem is found, the pharmacist contacts the prescriber and does not proceed until the issue is resolved.

Question 16

What does media fill testing measure in sterile compounding?

Accepted Answer

Media fill testing is a simulation in which staff prepare sterile products using a growth medium in place of the actual drug. The sealed containers are then incubated and examined for microbial growth. The results show whether an individual's technique and the workspace can maintain sterility, and they are repeated periodically for each preparer.

Question 17

What is an infusion pump and what does it do?

Accepted Answer

An infusion pump is a device that delivers fluid or medication at a programmed rate, volume, or schedule through an administration set. Pumps typically include alarms for air, occlusion, or a completed volume. Caregivers must understand the pump's settings and alarm responses before using it safely at home.

Question 18

What is the difference between gravity and pump-driven infusion?

Accepted Answer

Gravity infusion relies on the height of the fluid container to move solution through tubing at a rate that depends on that height and the tubing's flow characteristics. Pump-driven infusion uses a mechanism to push the fluid at a set rate regardless of container height. Pumps offer more precise control and alarm features.

Question 19

What is a central venous access device, in general terms?

Accepted Answer

A central venous access device is a catheter placed in a large vein near the heart, used to deliver fluids or medications and sometimes to draw samples. Placement is performed by trained clinicians, and home staff follow the written care plan for keeping the device working properly.

Question 20

What is an administration set, and what are its main parts?

Accepted Answer

An administration set is the sterile tubing assembly that connects a medication container to the patient's access point and controls the flow. Its main parts include a spike or connector for the container, a drip chamber, a roller clamp or flow control, filters where indicated, and a port for connection to the patient's line.

Question 21

Why must a pharmacy track equipment serial numbers and maintenance dates?

Accepted Answer

Tracking serial numbers and maintenance dates lets the pharmacy know which device a patient has, when it was last serviced, and whether it is due for inspection or retirement. This record supports recalls, safety notices, and timely repairs. It also creates an audit trail for quality management.

Question 22

Why does home infusion require a carefully planned delivery schedule?

Accepted Answer

Supplies must arrive before they are needed, so the pharmacy plans deliveries around the patient's dosing times, the stability of prepared products, and the amount of supply each household can safely store. Missed or late deliveries can interrupt therapy, while overly early deliveries can create storage concerns. Scheduling is a clinical and logistical task.

Question 23

What is the purpose of a clinician's home visit in infusion care?

Accepted Answer

A clinician's home visit allows assessment of the patient's condition, checking of equipment and access sites, review of caregiver technique, and confirmation that the written plan is being followed. Visits also let the team answer questions and adjust teaching. Findings are documented and reported to the prescriber when they affect the plan.

Question 24

What information should a home delivery label include?

Accepted Answer

A delivery label should identify the patient, the product name and strength, the total volume or quantity, the preparation or beyond-use date, the storage requirements, and any special handling instructions. Caregivers rely on this information to use the product correctly and recognize when it should not be used.

Question 25

What is a medication administration record in home infusion?

Accepted Answer

A medication administration record is a log that documents each dose or infusion given to the patient, including the date, time, product, rate or volume, and the person who gave it. In home infusion, caregivers usually complete this record for review at follow-up visits. Accurate entries support safe review by the care team.

Question 26

Why is documentation of patient education considered part of the record?

Accepted Answer

Teaching is a clinical service, and documentation shows what was taught, to whom, how understanding was checked, and what the learner was unable to do. This evidence supports safe home care and helps the team decide when more teaching or a different approach is needed.

Question 27

What is a standing order and how does it differ from a patient-specific order?

Accepted Answer

A standing order is a general instruction, written by a prescriber or protocol committee, that allows staff to perform a defined action under set conditions without a new order each time. A patient-specific order is written for one named patient and reflects that patient's individual regimen. Staff must confirm which type applies before acting.

Question 28

What is a discrepancy report and when is it created?

Accepted Answer

A discrepancy report documents a difference between what was ordered, what was prepared, what was delivered, or what was given. It is created when the difference is noticed, regardless of whether harm occurred. The report records the facts, the people involved, and the corrective step taken, so the team can learn from it.

Question 29

What does a plan of care document in home infusion?

Accepted Answer

A plan of care describes the goals of therapy, the medications and supplies to be used, the schedule, the monitoring to be done, the caregiver responsibilities, and the people to contact for questions or emergencies. It is updated whenever the regimen or the patient's situation changes.

Question 30

What is the purpose of a telephone triage log?

Accepted Answer

A telephone triage log records each call from a patient or caregiver, including the reported concern, the questions asked, the advice given or the escalation made, and the time of the contact. It creates an accurate history that supports continuity of care and shows whether urgent concerns were handled promptly.

Question 31

Why do pharmacies keep records of prescriber contact?

Accepted Answer

Records of prescriber contact show when a clarification was requested, who was contacted, what was decided, and whether the order changed as a result. These entries protect the patient, the prescriber, and the pharmacy by making decisions traceable. They also help the team see recurring order problems that may call for a process improvement.

Question 32

What should a pharmacist document when a delivery is refused by a patient?

Accepted Answer

The pharmacist should record the date and time of the refusal, the reason given if one was stated, the product involved, and the people contacted about it. Notes should describe the attempts made to reach the prescriber and caregiver and any plan for rescheduling. Clear documentation helps the team restore therapy promptly.

Question 33

What is a quality management system in a pharmacy?

Accepted Answer

A quality management system is a structured set of policies, procedures, training, and records that a pharmacy uses to plan, check, and improve its services consistently. It defines who is responsible for each task and how errors, complaints, and equipment problems are handled. Its purpose is to make safe, accurate service routine.

Question 34

What is root cause analysis and when is it used?

Accepted Answer

Root cause analysis is a structured review that looks beyond the immediate error to identify the underlying system factors that allowed it to happen. It is used after an event that caused harm or came close to causing it. The output is a set of corrective actions rather than blame for an individual.

Question 35

What is a near miss in medication safety?

Accepted Answer

A near miss is an error that was caught before it reached the patient, so no harm resulted. Near misses are valuable because they reveal weaknesses in a process without the cost of harm. Reporting them, and reviewing them without blame, lets a pharmacy strengthen its safeguards before a similar error causes injury.

Question 36

What is a medication error, as defined in general pharmacy practice?

Accepted Answer

A medication error is any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or caregiver. Errors can occur in ordering, transcribing, preparing, dispensing, delivering, administering, or monitoring.

Question 37

What is a recall and how does a pharmacy respond to one?

Accepted Answer

A recall is an action, usually initiated by a manufacturer or regulator, to remove a product from distribution because it may be defective, contaminated, or mislabeled. A pharmacy responds by checking inventory and prepared products against the recall notice, quarantining affected items, and documenting the actions taken.

Question 38

How do public health concepts apply to home infusion pharmacy?

Accepted Answer

Public health concepts such as infection prevention, surveillance, and population-level safety apply because home infusion involves many patients, caregivers, and supply chains. Pharmacies contribute by following hygiene and cleaning standards, reporting adverse events, and cooperating with product safety notices. Thinking at the population level helps teams spot patterns across many patients.

Question 39

What is a sentinel event in patient safety reporting?

Accepted Answer

A sentinel event is an unexpected occurrence involving death or serious harm that is not related to the natural course of a patient's illness or condition. The term signals that a serious event has happened and that an immediate review is needed. Reporting duties vary, so pharmacies follow their own policy and applicable requirements.

Question 40

How does general nutrition science relate to home parenteral nutrition?

Accepted Answer

General nutrition science explains that the body needs energy, protein, fluid, electrolytes, vitamins, and minerals in balanced amounts. Home parenteral nutrition is a formulation delivered intravenously, so the pharmacy must match its composition to the prescribed nutritional plan. Dietitians and prescribers set those targets, while the pharmacy ensures accurate, stable preparation.

Home Infusion Pharmacy Flashcards

1Foundations of Home Infusion

2Sterile Compounding Principles

3Delivery Equipment and Devices

4Records and Communication

5Quality, Safety and Public Health

Learning Resources