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Syringe, IV Bag Compounding/Filling Systems Fulfill ‘Mission’: Part I

Two automated IV compounding systems sterile-fill liquids and lyophilized products into IV syringes and bags for administration to Mission Health patients.

Two automated IV compounding systems sterile-fill liquids and lyophilized products into IV syringes and bags for administration to Mission Health patients.
Two automated IV compounding systems sterile-fill liquids and lyophilized products into IV syringes and bags for administration to Mission Health patients.

In 2018, for the sixth time in the past seven years, Asheville, NC-based Mission Health was named one of the U.S.’s Top 15 Health Systems by IBM Watson Health. Mission Health, which operates six hospitals, including Mission Hospital, was also recognized last year as one of the nation’s best hospitals by U.S. News & World Report, one of only 29 hospitals in the country to receive that status.

This level of excellence is achieved in part by employing advanced technology, which includes two RIVA™ automated IV compounding systems from ARxIUM that sterile-fill liquids and lyophilized products into IV syringes and bags for administration to Mission Health patients. Mission Health employs the RIVA systems in an 864 sq-ft cleanroom suite within its 10,000 sq-ft central distribution pharmacy located at Mission’s Materials Management Distribution Center. Built in 2010, the suite meets USP <797> guidelines for the sterile preparation and compounding by pharmacies of medications administered through injection.

The RIVA units run from 6 a.m. until 8:30 p.m., seven days/week, in total filling some 4,800 syringes and 1,200 bags/month, according to Josh Powell, PharmD, Mission Health’s PharmD Pharmacy Operations Manager at the distribution center.

Although technicians do manually prepare some medications, Powell says the RIVA systems are employed to automatically “manipulate” or fill meds for Mission Health patients.

For Mission Health, one RIVA is dedicated to filling syringes, another to IV bags. Powell explains the reasoning behind this decision: “If we dedicate one RIVA to do all syringes, then we can load a bunch of syringes in it and not worry about changing them out and replacing them with bags for the next batch. That provides us with greater consistency.” That same philosophy extends to the RIVA unit for IV bags.

IV bags

The first RIVA machine was added in 2010 when Mission Health opened the facility. This RIVA produces bags for three products; two in 500-mL sizes and a third in a 100-mL offering. These are all clear Viaflex-brand flexible PVC container bags supplied by Baxter.

The 500-mL bags are compounded with either phenylephrine to help control heart rate and blood pressure, or oxytocin, used to help induce labor. The 100-mL bags contain diltiazem, a calcium channel blocker used to treat hypertension, angina and certain heart rhythm disorders.

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