Pharmacy OneSource Blog

Self-efficacy and its Role in Compounding Sterile Preparations

Posted on 01/20/16


I was intrigued by reading the latest article in AJIC published electronically recently¹ that utilized Bandura’s social cognitive theory to address the problem of hand hygiene compliance education among HCWs.

I thought to myself, if I substitute “compounding of sterile preparations” for references to “hand hygiene,” how would the shoe fit? Interestingly, in my opinion, it is a very good fit indeed. I have taken the opportunity to substitute “hand hygiene” and inserting instead “compounding of sterile preparations” in a paraphrased section from this article. I will let you be the judge if the shoe fits.

Bandura's social cognitive theory may serve as the foundation to address the problem of educating pharmacists about compounding sterile preparations safely. The purpose of the theory is to understand and predict individual and group behaviors, identify methods where behavior can be modified or changed, and test interventions aimed at personality development, behavior pathology, and health/safety promotion.

The theory states individuals learn by direct experiences, human dialogue and interaction, and observation. The theory also stresses the importance of an individual being actively involved with the environment and how people actively select their own role models and regulate their own attitudes and actions regarding learning.

An important concept of Bandura's theory is self-efficacy. Self-efficacy promotes learning and productive human function. Behavioral determinants, such as attitude, social influence, and self-efficacy, play a large role in compounding sterile preparations. Bandura's social cognitive theory is potentially ideal for this educational strategy and target population because the theory deals with behavioral modification and how individuals decide to act and learn.

The pharmacist’s behavioral issues and beliefs associated with the compounding of sterile preparations can affect compliance and how the individual accepts behavioral modification strategies. Awareness of the effects of poor compliance with USP Chapter 797 standards in contributing to contaminated medications and patient harm by those charged with compounding sterile preparations may help to produce effective and sustained behavior changes (self-efficacy), leading to full compliance with USP 797 standards.

¹Role of a multimodal educational strategy on health care workers' handwashing, Jo Andrea Watson, AJIC, published online: December 28, 2015.

Topics: Sterile Compounding

About the Author

Keith H. St. John, MT(ASCP), MS, CIC has served as an Infection Preventionist for the past 30 years, including over 17 years of managing Infection Prevention and Control programs and personnel at major tertiary teaching institutions that include pediatric as well as adult hospital settings. Keith is a clinical microbiologist by training and is certified in Infection Control & Epidemiology (CIC). Keith’s rich professional experience includes: Past President of the Certification board of Infection Control & Epidemiology (CBIC); publications in medical and infection control journals; presentation at national and regional conferences; and former faculty associate at Temple Dental and Medical School. Mr. St. John is also a former member of APIC’s Governmental Affairs Committee, Education Committee, Practice Guidance Council and Research Foundation. He has served APIC as Chapter President & Board member, Editorial Board and reviewer for AJIC, APIC Text Revision Task Force (x2) and Pharmacy chapter co-author. Keith has been a volunteer member of the United States Pharmacopeia Convention Expert Compounding Committee since 2005, sharing his expertise on the revision of USP Chapter <797>, Pharmaceutical Compounding – Sterile Preparations. In addition to APIC, he is an active member of the Healthcare Infection Society (UK) and the Society for Health Epidemiology of America (SHEA). Keith received his Master’s of Science degree in Clinical Microbiology from Thomas Jefferson University in Philadelphia and his Bachelor of Science degree in Medical Technology from the University of Delaware.