PTCE · Patient Safety and Quality Assurance · 6 min read
Infection Prevention and Cleaning Standards
- Identify proper hand hygiene methods, nail care standards, and garbing sequences for sterile and non-sterile pharmacy environments.
- Distinguish between cleaning and disinfection processes while applying correct sanitation protocols to dispensing equipment and laminar airflow workbenches.
- Recognize personal protective equipment requirements for hazardous drug handling and standard procedures for preventing medication cross-contamination.
Hand Hygiene and Fingernail Standards
Hand hygiene is the single most effective practice in reducing the transmission of infectious agents in pharmacy settings. Whether working in community dispensing, non-sterile preparation, or cleanroom suites, pharmacy technicians perform all infection-control tasks under pharmacist supervision, in accordance with applicable law and pharmacy policy. It is vital to recognize that wearing gloves does not eliminate the requirement to perform thorough hand hygiene. Technicians must perform hand hygiene immediately before donning gloves and immediately after removing gloves.
For routine hand washing with soap and water, technicians must scrub all surfaces of the hands and wrists for at least 20 seconds. Hands must always be washed with soap and water whenever they are visibly soiled, rather than relying on an alcohol-based hand rub. Alcohol-based hand rubs are acceptable for routine hand antisepsis in non-sterile settings only when hands are not visibly dirty.
When preparing for sterile compounding, technicians must execute a much more comprehensive cleansing process. Hands and forearms must be washed with soap and water from the fingertips all the way up to the elbows. To prevent recontaminating hands during this process, hand washing sinks located in sterile compounding anterooms must have hands-free or foot-operated water controls. Additionally, personnel preparing sterile products must clean underneath their fingernails using a disposable nail pick under running warm water.
Fingernail maintenance is essential for infection control and barrier integrity. Natural fingernails must be kept neat, clean, and trimmed short to avoid puncturing gloves and harboring pathogens. For sterile compounding, artificial nails, nail extenders, and nail polish are strictly prohibited. Personnel performing nonsterile compounding must follow applicable standards and pharmacy policy regarding nail care. After completing the wash for sterile compounding, technicians must dry their hands and forearms completely with low-lint, disposable towels or wipes; electronic hand dryers are not permitted in these environments.
Common mistakes
- Using an alcohol-based hand rub instead of washing with soap and water when hands are visibly soiled.
- Assuming that sterile 70% isopropyl alcohol alone is sufficient to remove all types of drug residues from counting trays and spatulas.
- Using circular wiping motions or spraying solutions directly at the HEPA filter when sanitizing a laminar airflow workbench.
- Failing to allow counting trays and spatulas to air dry completely before counting the next oral solid medication.
Key points
- Hand hygiene is the single most effective practice in reducing infectious agent transmission and must be completed before donning gloves and after removing them.
- Routine hand washing requires scrubbing with soap and water for at least 20 seconds, while sterile compounding preparation requires washing from fingertips to elbows, using a nail pick, and drying with low-lint disposable wipes.
- Sterile compounding garbing moves from less-clean to cleaner areas, ending with powder-free sterile gloves, while hazardous drug compounding requires two pairs of ASTM D6978 chemotherapy-tested gloves.
- Cleaning physically removes particulates and soil, whereas disinfection inactivates or destroys microorganisms and requires a designated wet contact or dwell time.
- Laminar airflow hoods are cleaned using unidirectional, overlapping strokes from top to bottom and back to front, without spraying the HEPA filter.
- Counting trays and spatulas must be cleaned with approved agents and allowed to air dry completely to avoid drug residue cross-contamination, especially from beta-lactams and hazardous drugs.
- The pharmacist-in-charge or designated pharmacist oversees infection control compliance, while clinical evaluations, patient counseling, and final prescription verification remain the sole responsibility of the pharmacist.
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