PHARMACY COMPOUNDING CHECKLIST: SAFETY & ACCURACY

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--- INGREDIENT VERIFICATION ---
[ ] Prescription Received From (Physician, Dentist, Other Healthcare Provider)
[ ] Prescription Number
[ ] Patient Name
[ ] Drug Name
[ ] Quantity Ordered
[ ] Strength per Unit
[ ] Unit of Measure (mg, g, mL, Count)
[ ] Notes/Special Instructions (e.g., allergies, substitutions)

--- EQUIPMENT CALIBRATION & MAINTENANCE ---
[ ] Last Calibration Date
[ ] Calibration Result (e.g., % accuracy)
[ ] Calibration Notes (e.g., deviations, corrective actions)
[ ] Calibration Standard Used (USP <1079>, Manufacturer's Recommendation, Other (Specify))
[ ] Next Calibration Due Date
[ ] Equipment Status (In Service, Out of Service, Needs Repair)

--- ENVIRONMENTAL CONTROL ---
[ ] Room Temperature (°C)
[ ] Humidity Level (%)
[ ] Ventilation System Status (On, Off, Maintenance)
[ ] Air Filtration Status (HEPA Filtration Active, Standard Filtration Active, Filter Needs Replacement)
[ ] Notes on Environmental Conditions
[ ] Last Surface Cleaning Date

--- WEIGHING AND MEASURING ---
[ ] Ingredient Weight (grams)
[ ] Measured Volume (mL)
[ ] Measurement Unit Verified? (Yes, No)
[ ] Balance Calibration Date
[ ] Balance Readability (mg)
[ ] Notes/Observations during Weighing

--- MIXING AND PROCESSING ---
[ ] Mixing Procedure Followed (Detailed Description)
[ ] Mixing Time (Minutes)
[ ] Mixing Equipment Used (Mortar and Pestle, Automated Mixer, Propeller Mixer, Other (Specify))
[ ] Mixing Speed (RPM - if applicable)
[ ] Observed Deviations from Standard Procedure (if any)
[ ] Process Temperature Maintained? (Yes, No, Not Applicable)
[ ] Temperature During Mixing (°C)

--- DOCUMENTATION & LABELING ---
[ ] Prescription Details (Rx Number, Patient Name, Date)
[ ] Formulation Details (Ingredients, Quantities, Instructions)
[ ] Compounding Date
[ ] Compounding Time
[ ] Batch Number
[ ] Pharmacist Signature
[ ] Technician Signature
[ ] Label Type (Standard, Large Print, Braille)

--- QUALITY CONTROL TESTING ---
[ ] Test Performed (e.g., pH, Assay, Loss on Drying) (pH Measurement, Assay, Loss on Drying, Specific Gravity, Viscosity, Other (Specify in Long Text))
[ ] If 'Other' Selected Above, Please Specify Test:
[ ] Test Result Value:
[ ] Acceptable Range (Lower Limit):
[ ] Acceptable Range (Upper Limit):
[ ] Result Status: (Pass, Fail, Out of Range)
[ ] Date of Testing:
[ ] Time of Testing:
[ ] Quality Control Signature:

--- PERSONAL PROTECTIVE EQUIPMENT (PPE) ---
[ ] Gloves: Type & Intact? (Nitrile, Latex, Other (Specify), Yes - No Tears/Holes)
[ ] Gown Type (Standard, Fluid Resistant, Isolation, Other (Specify))
[ ] Mask/Respirator Type (Surgical Mask, N95 Respirator, Other (Specify))
[ ] N95 Fit Test Date (if applicable)
[ ] Notes on PPE Usage/Condition

--- WASTE DISPOSAL ---
[ ] Waste Category (Hazardous Pharmaceutical Waste, Non-Hazardous Pharmaceutical Waste, Sharps Waste, Chemical Waste)
[ ] Estimated Waste Volume (liters/gallons)
[ ] Description of Waste Materials
[ ] Date of Disposal
[ ] Time of Disposal
[ ] Signature of Person Disposing Waste
[ ] Disposal Site Location

--- STORAGE & STABILITY ---
[ ] Storage Temperature (°C)
[ ] Humidity Level (%)
[ ] Compounding Date
[ ] Expiration Date
[ ] Stability Testing Notes (if applicable)
[ ] Storage Container Type (Amber Glass, Light-Resistant Plastic, Other)
[ ] Light Sensitivity (Sensitive, Not Sensitive, Unknown)

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