[Standard doses applied to preparations of injectable drugs and their reconstitution in the hospital: methodology and implementation]. / Présentation d'une démarche d'aide et de réflexion pour la mise en place de doses standards appliquée aux préparations et reconstitution d'injectables en milieu hospitalier.

ABSTRACT

INTRODUCTION: Improvement of healthcare quality and safety are two main goals for hospitals. High risk preparations of injectable drugs is one of the possible areas for improvement. In this context the production of batches of standard doses is a practical solution in response to the increased demand. Some toolkits exists to facilitate the implementation of dose banding, but, to our knowledge, no complete strategy was available until today. AIM AND PURPOSE: To propose a rational approach to analyse the possibility of implementing standard doses and choose the most relevant drugs for dose standardization. METHOD: The method is based on the analysis of literature focusing on different themes safety, international guidelines, batch production regulation and stability studies. RESULTS: An approach on the strategies to develop is detailed for pharmacists willing to implement standard doses. All key stages are discussed the needs of care units, the analysis and risk assessment, the stability studies and the practical implementation of the standard doses preparation and quality control. CONCLUSION: The implementation of standard doses seems a rational and necessary evolution of hospital pharmacy in response to the increase of compounding activity and the requirements of quality preparation. A global and all-inclusive approach is needed for this purpose. All parameters have to be considered to avoid errors. A process and a decision aid are suggested to facilitate the development of standard doses.