Preparation efficiency and operational risk of two dosage forms of fluorouracil in PIVAS workflow: A retrospective comparative study.

ObjectiveTo compare the efficiency and operational risks of preparing two forms of fluorouracil (solution and powder) for injection in the Pharmacy Intravenous Admixture Service (PIVAS).MethodsA retrospective analysis was conducted to assess a total of 100 preparation records of two forms (solution and powder; 50 records each) of fluorouracil at a tertiary hospital from May 2024 to December 2025. The configuration efficiency was assessed by the time spent and the number of configuration steps; the operational risks were evaluated by operational abnormalities and adverse events recorded in the PIVAS management system.ResultsThe average preparation time for solution-form fluorouracil was significantly shorter than that of the powder-form counterpart [(673.58 ± 279.74) seconds vs. (1049.34 ± 540.48) seconds, P < 0.05], with a reduction of over 42.86% in preparation steps (≤4 steps vs. ≥ 7 steps). Two adverse events occurred with powder-form fluorouracil during the analysis period: one involved the formation of insoluble particles after drug reconstitution, and the other was due to operational error leading to liquid leakage. No adverse events were reported in relation to solution-form fluorouracil.ConclusionIn scenarios of limited resources or high workloads in the PIVAS, it is advisable to prioritize the use of solution-form fluorouracil under certain conditions to enhance efficiency and reduce operational risks. The findings may provide some clinical evidence for optimizing clinical dosage form and risk management.