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A Virtual Clean Room to Teach USP 797 Regulations for Intravenous Medications

Sheetal Patel, PharmD, Ashley H. Vincent, PharmD, Steven R. Abel, PharmD, Carolyn M. Jacobs, PharmD, Steven R. Dunlop, MBA, and Megan Seibert, PharmD

Objective. To provide a virtual environment for pharmacy students to learn United States Pharmacopeia Chapter 797 (USP 797) requirements, while recognizing the role of pharmacists in the safe use of intravenous (IV) medications.

Design. A virtual laboratory was created that included stations for IV medications, product verification, medication safety, and patient cases pertaining to high-alert medications. Pharmacy students used 3-D glasses and a wireless controller to navigate through the session and identify violations of USP 797 regulations.

Assessment. Preassessments and postassessments were administered to students who completed the session in each of the 2 years it was offered. In the first year, 88% of students strongly agreed or agreed that the sessions met their expectation. Following their APPE clerkship, 92% of these students felt the virtual IV room prepared them for the IV clean room experience. In the second year, 88% of students felt the experience enhanced their understanding of clean room procedures. After session completion, 75% of participants perceived medication errors to be more significant. Written examinations also were administered and students’ mean scores improved significantly compared to those of students’ prior to implementation of the session (89.6% in year 0; 91.2% in year 1; and 96.1% in year 2).

Conclusion. The immersive virtual environment is a contemporary and effective way to teach USP 797 requirements and enhance the awareness of medication errors.

 

INTRODUCTION

Since the publication in 2000 of the Institutes of Medicine report ‘‘To Err is Human: Building a Safer Health System,’’ medication safety awareness has increased. Pharmacists serve a vital role in ensuring that the correct patient receives the correct medication as often only 1 step separates the pharmacist’s verification of the product and administration of the medication to the patient. Pharmacists involved in sterile compounding have an error rate of approximately 10%. Therefore, providing pharmacy trainees with adequate instruction to prevent medication errors is critical, including hands-on training within an IV room setting, which is not always feasible for pharmacy students before they embark on APPEs. Although the use of virtual reality is not common for teaching pharmacy concepts, its use in health care is not new. Surgeons have demonstrated that using virtual reality in training residents can improve operating room performance significantly, resulting in fewer errors and injuries. In April 2004, a Food and Drug Administration (FDA) panel voted to accept a proposal that virtual reality should be an important part of the training for carotid stenting. Virtual reality is also being used to train nonpharmacy personnel in the virtual platform Pulse!! (Texas A&M University/United States Navy, Corpus Christi, TX) developed to help train and educate military health care providers prior to the occurrence of a catastrophic event. Due to the significance of patient safety, this virtual pharmacy laboratory focused on aseptic procedures and USP 797 regulations to cultivate student confidence in preparing IV medications appropriately. This session fostered the use of best practices and advancement of pharmacy education within an IV room environment.

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