Continuing Education for Pharmacy Technicians Essential for Safe, Sterile Compounding


Research indicates that poor technique or failure to follow up-to-date standards and protocols could lead to injury or even death of patients who need compounded medications.

Despite the fact that pharmacy technicians perform the majority of aseptic compounding practices, the loss of aseptic technique and knowledge over time can result in unsafe, non-sterile compounding, according to a study published in the Journal of Pharmacy Technology. Subsequently, the study authors are advocating for continuing education efforts to address pharmacy technician sterile compounders.

Several prior studies have found that poor technique or failure to follow up-to-date standards and protocols could lead to injury or even death of patients. Between 2001 and 2013, researchers identified 19 outbreaks of infections that were linked to compounded sterile products. At least 1000 patients were affected in these outbreaks, with some cases resulting in death.

The investigators also noted that Texas is currently the only state requiring sterile compounding training or continuing education hours for technicians making compounded sterile products in the state. Furthermore, uniform prerequisites for employing pharmacy technicians are currently nonexistent, according to the study.

In the study, the authors looked at the links between sterile compounding knowledge and years in the field, while controlling for formal training in sterile compounding techniques. They distributed an assessment tool to members of pharmacy organizations in the southeastern United States who are sterile compounding pharmacy technicians and conducted a multiple regression to predict sterile compounding knowledge from the number of years in the field and prior years of training.

Seventy assessments were attempted and 2 were excluded due to failure of completion or submission. The majority of participants were female and the most common education level among participants was a program diploma. The number of training hours ranged from 0 to 240 hours, the number of years in the field ranged from 1 to 28 years, and assessment scores ranged from 18 to 30 points.

According to the study, participants with bachelor’s degrees averaged higher scores, followed closely by participants with associate degrees. Those with program diplomas and high school graduates scored lower.

The investigators also found that length of experience is a statistically significant predictor of knowledge retention. For every additional year of work experience, they found that the knowledge test score decreased by 0.18 points. However, the number of formal training hours was found to be nonsignificant to the prediction.

One potential explanation could be knowledge loss due to the modeling of actions seen in other pharmacy staff. The researchers explained that employees replicate behaviors seen in their surroundings and newer pharmacy technicians may be particularly prone to this. Over time, failure to be corrected when incorrectly performing a task results in loss of skills and knowledge.

“Failure to be corrected about unsatisfactory processes encourages the continuation of such practices and creates a sense of expected acceptance of all compounded products,” the authors explained.

In order to avoid this loss of knowledge, the authors said mandatory continued education at predetermined intervals may be necessary. Implementing knowledge retention strategies in the workplace may also improve knowledge loss and providing incentives for staying current with sterile compounding practices could be effective.

This could include access to continuing education credits or monetary bonuses. In addition, the researchers said appointing a person to oversee knowledge retention activities may be necessary, including identifying employees exhibiting a decline in work performance.

“Even a slight loss of competency is a significant concern in sterile medication compounding because every aspect of the sterile compounding process is critical to patient safety,” the study authors wrote. “The findings of this study should be of interest to all pharmacy staff.”


David J., and Ayars C. Retention of Sterile Compounding Knowledge Among Pharmacy Technicians. J Pharm Technol. 2021 Oct; 37(5): 219-224. July 20, 2021. Accessed September 13, 2022. doi:10.1177/87551225211032395

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