Open Forum

Any advice pro and con appreciated. We have a busy musculoskeletal clinic, within our family practice setting. A busy provider that performs many joint injections has requested that we consider training and adding a  responsibility for the MA's that work in this clinic. This would include drawing up the steroid and local anesthetic. This would be a double check with the provider. I have seen MA's perform this task under the supervision of the provider in dermatology offices, but this is usually one medication, not the mixing. Where do I begin to look for guidelines?

Hi Joan, this has been a debate at several organizations that I have worked for, and I have seen this come up in the forums many times. It might make sense to consult with your pharmacy department on their policy on compounding, which is what you are describing. At my current organization, we do not allow our MA's to compound due to the complexity of the task and the risk associated with compounding incorrectly. I would think if your pharmacy department is OK with allowing them to compound, they should be involved with creating the teaching and competency demonstration for the staff who are doing the compounding. That is just my perspective from an education and risk standpoint. 

Hi 
We are too looking into this from a legal and pharmacy law perspective as it pertains to scope within our organization. What you are describing is USP 797 Compounding for immediate use. I agree with the other responder that you should involve pharmacy colleagues/leadership and also look at your state pharmacy law. We are examining this closely at this time and are probably going to move towards only licensed, competent clinical team members. USP 797 has a lot of requirements that need to be in place for Immediate Use Compounding (lean into pharmacy). 

interested to continue to learn what other organizations are doing ? Centralization (pharmacy tech under pharmacy over site, RNs only ? LPNs? Athletic trainers ? ) 

Thanks so much for posting 

Thank you Margaret. I found your advice helpful. We will be working with our pharmacy team.

Joan

Thank you Sharon. I appreciate the guidance and the forms.

Joan

I would love information regarding this work.  Our state does not allow compounding but we have had a consultant say we need to look at our staffing mix. Thank you.