Personnel Cleansing and Garbing. In: The United States pharmacopeia, 37th rev., and The national formulary, 32nd ed. Rockville, MD: The United States Pharmacopeial Convention; 2014:57-58.
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PPE - Osha.gov,. 'Personal Protective Equipment'. N.p., 2015. Web. 2 Mar. 2015.
Pharmacy CSP Preparation: Personnel Garbing and Gloving
Personnel Garbing and Gloving
for the Cleanroom
Of the many potential sources of
contamination in cleanrooms and
other clean manufacturing
environments, none is more
persistent, pervasive or pernicious
than the human beings who
occupy them. ~Jan Eudy
a sterile drug product that has been prepared by compounding by a qualified individual in a sterile environment.
CSPs are not explicitly defined in USP <797>. However, USP <797> does state that certain dosage forms must be
sterile when administered to patients.
Ante-Area An ISO Class 8 or better area where personnel hand hygiene and garbing procedures, staging of components,
order entry, CSP labeling, and other high-particulate-generating activities are performed. It is also a transition
area that (1) provides assurance that pressure relationships are constantly maintained so that air flows from
clean to dirty areas and (2) reduces the need for the heating, ventilating, and air-conditioning (HVAC) control
system to respond to large disturbances.
Buffer Area An area where the primary engineering control (PEC) is physically located. Activities that occur in this area
include the preparation and staging of components and supplies used when compounding CSPs.
Cleanroom A room in which the concentration of airborne particles is controlled to meet a specified airborne particulate
cleanliness class. Microorganisms in the environment are monitored so that a microbial level for air, surface, and
personnel gear are not exceeded for a specified cleanliness class.
Equipment worn to minimize exposure to a variety of hazards. Examples of PPE include such items as gloves,
foot and eye protection, protective hearing devices (earplugs, muffs) hard hats, respirators and full body suits.
Particles shed from compounding personnel pose
an increased risk of microbial contamination of
critical sites of CSPs.
Squamous cells are normally shed from the
human body at a rate of 106 or more per hour,
and those skin particles are laden with
Individuals with rashes, sunburn, weeping sores,
conjunctivitis, active respiratory infection shed
particles at even higher rates. Compounding
personnel with these conditions shall be excluded
from working in ISO Class 5 and ISO Class 7
compounding areas until their conditions are
Before entering the buffer area or segregated
compounding area, compounding personnel shall
remove personal outer garments*; all cosmetics;
and all hand, wrist, and other visible jewelry or
piercings+ that can interfere with the effectiveness
of PPE (e.g., fit of gloves and cuffs of sleeves)
*bandannas, coats, hats, jackets, scarves, sweaters, vests +earrings, lip or eyebrow piercings
The wearing of artificial nails or extenders is
prohibited while working in the sterile
compounding environment. Natural nails shall be
kept neat and trimmed.
Personnel shall don PPE in an order considered
dirtiest to cleanest:
head and facial hair covers (i.e. beard covers)
face masks/eye shields*
dedicated shoes or shoe covers
* Eye shields are option unless working with irritants such as germicidal disinfecting agents or when preparing hazardous drugs
1 32 4
After donning dedicated shoes or shoe covers,
head and facial hair covers, and face masks,
perform hand hygiene.
2 31 4
Remove debris from underneath fingernails using a nail cleaner under
running warm water followed by vigorous hand washing.
Hands and forearms shall be washed to the elbows for at least 30
seconds with soap (either nonantimicrobial or antimicrobial) and water
while in the ante-area.*
Hands and forearms to the elbows will be completely dried using either
lint-free disposable towels or an electronic hand dryer.+
* The use of antimicrobial scrub brushes is not recommended because they can cause skin irritation and skin damage.
+ The use of hand dryers in the cleanroom is a topic of discussion as studies have shown that hand dryers may spread bacteria from hands into the air
2 31 4Hand hygiene:
After completion of hand washing, a nonshedding
gown with sleeves that fit snugly around the wrists
and enclosed at the neck is donned. Gowns
designated for buffer area use shall be worn, and
preferably they should be disposable. If reusable
gowns are worn, they should be laundered
appropriately for buffer area use.
You may now enter the buffer area or
segregated compounding area
Once inside the buffer area or segregated
compounding area, and prior to donning
sterile powder-free gloves, antiseptic hand
cleansing must be performed using a
waterless alcohol-based surgical hand scrub
with persistent activity following
Allow hands to dry thoroughly following
application of alcohol-based surgical hand
Don sterile powder-free gloves.
You are now ready to begin sterile
compounding using strict aseptic technique
Routinely disinfect gloves with sterile 70% Isopropyl
alcohol (IPA) throughout the compounding process and
after contacting nonsterile objects
Only use gloves that have been tested for compatibility
with alcohol disinfection by the manufacturer
Inspect gloves for holes and replace when breaches are
Compounding personnel exiting compounding area during a work shift
may remove and retain exterior gown in compounding area, if not
visibly soiled, to be re-donned during the same work shift. Shoe covers,
hair and facial hair covers, face masks/eye shields, and gloves must be
replaced with new ones before re-entering compounding area.
Compounding personnel exposed to air quality known or suspected to
be worse than ISO Class 7 must re-garb PPE along with perform hand
hygiene, including antiseptic hand cleansing with waterless alcohol-
based surgical hand scrub, and don sterile gloves upon reentering
When CAIs and CACIs are the source of the ISO
Class 5 environment, the garbing and gloving
requirements for compounding personnel should
be as described, unless the isolator manufacturer
can provide written documentation based on
validated environmental testing that any
component(s) of PPE or personnel cleansing are