Recently, several questions have come up during discussions with Pharmacy staff regarding appropriate workflow to maintain sterility. I was hoping someone knows the answers to the below questions:

1. Can a pharmacist make an IV in a BSC and step out of the buffer room into the anteroom with the needle along with the syringe still inserted into the IV bag, to show a pharmacist in the anteroom the medication they are preparing?
a. Is this procedure considered a break in sterility?
b. Would we consider the medication contaminated?
c. If we sent the prepared medication to the floor, how long is the bag good for?
d. Where would we find a reference that this practice is not acceptable?

2. When a nurse spikes an IV bag and administers it to a patient, is this the same as making an IV in dirty air? Are there references that this can be done and how often does the line have to be changed?

3. What is the difference between making an IM product in dirty air (for example, reconstituting and administering a Vaccine) vs. an Intravenous product in clean air? What is the bacterial growth rate for a dirty IV vs IM?

Thank You.