Does anyone have a policy or SOP for your IV batching process? I'm particularly interested to know how much RPh supervision you require when batching high risk meds. We are currently having to batch heparin 1000 unit/500mL bags.

When batching 200 of these bags, which of these methods would you find acceptable?

1. Tech draws up 200 x 1mL syringes containing 1000 unit/mL heparin each. RPh checks syringes. RPh witnesses the tech injecting the 200 syringes into 200 bags of 500mL NS.
2. Tech draws up 200 x 1mL syringes containing 1000 unit/mL heparin each. RPh checks syringes. Tech independently injects the 200 syringes into 200 bags of 500mL NS.
3. Tech draws up 10 x 20mL syringes containing 20,000 units/20mL heparin each. RPh witnesses the tech injecting 1mL from the syringes into 200 bags of 500mL NS.
4. Tech draws up 10 x 20mL syringes containing 20,000 units/20mL heparin each. Tech independently injects 1mL from the syringes into 200 bags of 500mL NS.
5. Tech reverse pumps heparin 1,000 unit/mL vials into a 200mL empty bag. Tech calibrates the repeater pump to 1mL of heparin 1000 unit/mL. RPh checks the vials and confirms repeater pump settings/calibration. RPh witnesses the tech using the repeater pump to inject 1mL into each of the 500mL bags.
6. Tech reverse pumps heparin 1,000 unit/mL vials into a 200mL empty bag. Tech calibrates the repeater pump to 1mL of heparin 1000 unit/mL. RPh checks the vials and confirms repeater pump settings/calibration. Tech independently uses the repeater pump to inject 1mL into each of the 500mL bags.

Bonus question: Would your answer change if the tech were not compounding a high risk med?

I appreciate you taking the time to respond!