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Hospital Pharmacy 54(4)

Table 2. Preintervention and Postintervention Written Exam Scores, Including by Question Subsection.
Average percentage correct, % (95% CI)

Overall
Calculations
Compounding equipment and supplies
Facilities
Aseptic technique/compounding
Assignment of BUD

Pre (n = 236)

Post (n = 150)

P

65.2 (63.3-67.1)
73.7 (70.3-77.1)
71.6 (68.8-74.3)
56.7 (54.5-59.0)
68.8 (66.1-71.4)
55.2 (51.9-58.4)

74.8 (72.7-77.0)
84.9 (81.1-88.7)
79.3 (76.1-82.5)
63.6 (60.9-66.3)
76.1 (73.2-79.0)
79.8 (75.8-83.8)

<.0001
<.0001
.0004
.0001
.0004
<.0001

Note. CI = confidence interval; BUD = beyond-use dating.

Table 3. Preintervention and Postintervention Written Exam Pass Rates, Including by Question Subsection.
Pass rate (%)

Overall
Calculations
Compounding equipment and supplies
Facilities
Aseptic technique/compounding
Assignment of BUD

Pre (n = 236)

Post (n = 150)

P

19.6
55.7
46.8
6.0
38.7
11.9

45.3
80.0
65.3
10.7
51.3
52.0

<.0001
<.0001
.0005
.1182
.0157
<.0001

Note. BUD = beyond-use dating.

represented as percentage correct. A passing score was that
of 80% or greater. In addition, results were separated and
analyzed based on question-specific topics. Media-fill challenge test results were documented as either positive or negative based on evidence of microbial contamination after
incubation. To pass, the test had to be negative or clear of any
microbial contamination. The aseptic technique rubric utilized during the media-fill challenge test was marked with
pass, fail, or not applicable for each of the 14 competency
criteria listed. The rubric must have had a total of zero fail
marks to successfully pass. The media-fill results and aseptic
technique rubrics were collected with individual personnel
identification. If available, media-fill results were matched
accordingly with individual aseptic technique rubrics.

Statistical Analysis
A chi-square test was used to determine whether there was a
difference in the written exam pass rate preintervention and
postintervention for the overall exam, as well as within each
subsection of questions. In addition, the average percentage of
correct answers was examined preintervention and postintervention using the t test. Again, this was conducted for the overall exam and within each subsection of questions. For the 51
matched pairs, McNemar test was utilized to determine whether
there was a difference in the preintervention and postintervention pass rates for the media-fill challenge test and aseptic technique observation combined. Finally, the chi-square test was

used to determine whether there was a difference in pass rates
preintervention and postintervention for aseptic technique
observation, including those that were nonmatched. The priori
level of statistical significance for all comparisons and hypothesis tests was 0.05.

Results
A total of 236 written exams were collected and scored during the preintervention phase and 150 exams in the postintervention phase. The average percentage correct on the written
exams for the preintervention and postintervention phase
was 65.2% and 74.8%, respectively (P < .0001). The overall
exam scores, as well as scores in each question category,
showed a statistically significant improvement, demonstrating increased retention of sterile compounding knowledge
(Table 2). The number of personnel with passing scores in
the preintervention phase was 46 (19.6%) and in the postintervention phase was 68 (45.3%; P < .0001) (Table 3). A passing score was that of 80% or greater on the written exam.
The media-fill challenge test was completed by 144 sterile
compounding personnel in the preintervention phase and 70 in
the postintervention phase. There was 1 media-fill test result
from the preintervention phase and 3 results from the postintervention phase that had evidence of microbial contamination.
Along with these media-fill challenge tests, there was a total of
133 aseptic technique rubrics collected in the preintervention
phase and 64 in the postintervention phase. There was
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