Audit

Employee Name ___________________________________________________________________________

Hazardous Compounding Training/Competency Documentation
Demonstrated Competency with Hand Hygiene, Gowning and Donning of Protective Garb for Hazardous Compounding
Select date

Demonstrated Sterile Compounding Competency with Completion of Media Fill and Gloved Finger Tip Samples
Select date

Demonstrated Competency of Manipulation of Hazardous Product with Completion of Fluorescein Chemo Test
Select date

Demonstrated Competency of Hazardous Compounding in Biological Safety Cabinet
Demonstrated Competency of Use with Closed System Transfer Devices

Understands Proper Use of Perdox RTU for Hazardous Drug Decontamination
Select date

Completion of HMTW Pharmacy Department Hazardous Sterile Preparation Exam
Select date

Evaluator Review: Name ______________________________________________________

Select date
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.