Non-sterile compounding in hospital pharmacy: batch first, dispense second
Oral liquids made from tablets, mouthwashes, creams and capsules are compounded in almost every hospital pharmacy. Making them one order at a time is slow and hard to control. A batch-first workflow — make ahead, check, release, then dispense per order — is faster and safer.
1. Start with a master formulation record
Every formula needs one controlled record: ingredients and quantities per unit, the method, the container, storage, the beyond-use date and its basis (see USP <795> BUDs), and the auxiliary labels such as “Shake well” or “For external use only”. Staff should compound from the record, not from memory.
2. Plan the batch
Choose the formula and the number of units. The software should calculate the ingredient quantities — including fractions of a stock bottle or jar — and assign a lot number and beyond-use date to the batch.
3. Prepare and record
When preparation starts, ingredients are deducted from stock by lot, earliest expiry first, exactly once. The compounder records the actual amounts used.
4. Independent check and release
A second person checks the batch before it is released into stock. The checker should never be the person who made it. Only released batches can be dispensed; a rejected batch is written off with its ingredients reversed.
5. Dispense per order
When a patient order arrives — for example for a magic mouthwash — the pharmacist picks a released batch, earliest expiry first, and dispenses it. The patient label prints with directions, the batch lot and the beyond-use date. If a unit comes back unused, it returns to the same batch.
Why it works
- Checks happen once per batch instead of once per bottle.
- Every dispensed unit traces back to a batch, its ingredients and the people who made and checked it.
- Expired stock is never dispensed, because the earliest batch is always offered first.
- Formulas with no released batch are flagged, so the pharmacy can plan ahead.