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SELF ASSESSMENT - MM3 Admin

CCOONNFFIIDDEENNTTIIAALL self ASSESSMENT Qualitative Inspection Questionnaire for Services Provided in Community and Institutional Pharmacies PLEASE NOTE: The confidentiality of this document may be withdrawn should the information furnished lead to further investigation(s) Please refer this questionnaire for special attention: YES NO Encircle or mark applicable number/block with an Responsible Pharmacist or Pharmacist Initials/signature 2 self - ASSESSMENT QUESTIONNAIRE TABLE OF CONTENTS 1. DISPENSING PROCEDURES (CODE 0001) PHASE 1,2 & 3 2. COMPOUNDING OF AN EXTEMPORANEOUS ITEM (CODE 0002) .. 6 3. PREPARATION OF A STERILE PRODUCT .. 8 4. PREPARATION OF AN INTRAVENOUS ADMIXTURE OR PARENTERAL SOLUTION (CODE 0004) .. 10 5. PREPARATION OF TOTAL PARENTERAL NUTRITION (CODE 0005) .. 12 6. PREPARATION OF CYTOTOXIC MEDICINES (CODE 0006).

COONNFFI IDDEENNTTIAALL SELF ASSESSMENT Qualitative Inspection Questionnaire for Services Provided in Community and Institutional Pharmacies

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