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Expert
Posts: 1,142
Registered: ‎02-23-2010
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Re: Garbing in Ante Room

Linda,

 

Please don't get too hung up on the specific order when dealing with dirtiest to cleanest.  The language in the chapter was guidance and not intended to reflect every facility layout.  Many small IV rooms have the sink near the door so you need to treat your door threshold into the anteroom as your LOD.  If you have a SOP and you and your staff are consistent and are donning your head, face and feet (in any order that makes sense based on your anteroom size) PRIOR to washing your hands, you should be good.  Many State Board of Pharmacy inspectors have been to the CriticalPoint Boot Camp, where we teach the order in my first response.  We also teach them not to get too hung up on the precise order as long as a pharmacy is consistent. 

 

Articles that we write and of the content we teach, meet the standard but we do include best practices and may be more information that what is in the chapter. The issue where the application of the surgical scrub and donning of sterile gloves is one of those examples.  We have a problem with staff going into the buffer room barehanded to apply the scrub and gloves.   We have done studies where the sterile gloves are donned in the anteroom vs. buffer room and have not seen any difference in contamination rates.  The key activity is routine/frequent glove disinfection with sterile IPA.  The chapter language suggests that the surgical scrub and gloving activities occur in the buffer room.  It would be interesting what others are doing.  It is important that you have a copy of the chapter so you can review what it says and how the minor variations can be acceptable.  Hope this helps. 

Eric S. Kastango, MBA, RPh, FASHP

It's all about the patient.
Advisor
Posts: 28
Registered: ‎01-09-2017
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Re: Garbing in Ante Room

We have always donned PPE, then crossed the line of demarcation, performed hand hygiene, went into the buffer area where we applied the appropriate hand cleanser and sterile gloves.

 

Now that i am ever more confused, do we done all PPE, in whatever consistent order, prior to or after crossing the demarcation line?

 

Thanks

 

Art R.

Advisor
Posts: 12
Registered: ‎09-25-2017
0

Re: Garbing in Ante Room

Per USP 797  -Once inside the buffer area and prior to donning sterile gloves, antiseptic hand cleansing shall be performed and hands allowed to dry before donning sterile gloves.

 

So my somewhat obvious concern/question  is - Then I must assume that it is ok to have a hands free hand sanitizer dispenser and packages of gloves in the buffer room, correct?

 

Thank you

 


EricKastango wrote:

Linda,

 

Please don't get too hung up on the specific order when dealing with dirtiest to cleanest.  The language in the chapter was guidance and not intended to reflect every facility layout.  Many small IV rooms have the sink near the door so you need to treat your door threshold into the anteroom as your LOD.  If you have a SOP and you and your staff are consistent and are donning your head, face and feet (in any order that makes sense based on your anteroom size) PRIOR to washing your hands, you should be good.  Many State Board of Pharmacy inspectors have been to the CriticalPoint Boot Camp, where we teach the order in my first response.  We also teach them not to get too hung up on the precise order as long as a pharmacy is consistent. 

 

Articles that we write and of the content we teach, meet the standard but we do include best practices and may be more information that what is in the chapter. The issue where the application of the surgical scrub and donning of sterile gloves is one of those examples.  We have a problem with staff going into the buffer room barehanded to apply the scrub and gloves.   We have done studies where the sterile gloves are donned in the anteroom vs. buffer room and have not seen any difference in contamination rates.  The key activity is routine/frequent glove disinfection with sterile IPA.  The chapter language suggests that the surgical scrub and gloving activities occur in the buffer room.  It would be interesting what others are doing.  It is important that you have a copy of the chapter so you can review what it says and how the minor variations can be acceptable.  Hope this helps. 


 

Expert
Posts: 1,142
Registered: ‎02-23-2010
0

Re: Garbing in Ante Room

Linda,

 

Correct.  Application of the surgical scrub with persistent activity and the donning of sterile gloves occurs in the buffer room. 

Eric S. Kastango, MBA, RPh, FASHP

It's all about the patient.
Advisor
Posts: 12
Registered: ‎09-25-2017
0

Re: Garbing in Ante Room

Thank you!