Sample_Log_Pharmacy_IV_Room_Agar_Plate.docx

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Biological Safety Cabinets Inspect/Test Base Plus Four Opt Years for VA Medical Center Oklahoma City OK 73104
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36C25919Q0105
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36C25919Q0105 Sample Log Pharmacy IV Room Agar Plate.docx

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Pharmacy IV Room Agar Plate Sample Log:

Sample collection (30 samples) for the following areas in Pharmacy on a Semi-annual basis.

Additional 5 samples for re-testing for any positive test results.

Pharmacy (119) IV Room Agar Plate Sample Log

Attn: Matt ClarkDate/Time: ______________
Sample
Date Prepared
Date of Results
Negative for Growth
Positive for Growth
CFU per Plate
Comments

Agar Contact Plates

ISO-5 Environment

IV Hood #1 (left)

IV Hood #1 (right)

IV Hood #2 (left)

IV Hood #2 (right)

IV Hood #3 (Chemo) (left)

IV Hood #3 (Chemo) (right)

IV Hood #4 (Chemo) (left)

IV Hood #4 (Chemo) (right)

Chemo Barrier Isolator (left)

Chemo Barrier Isolator (right)

Non-Hazardous Barrier Isolator (left)

Non-Hazardous Barrier Isolator (right)

ISO-7 Environment

IV room Counter-top

IV room clean-cart

IV room Storage cart

IV room Supply cart

IV room floor

IV room wall

Chemo room counter-top

Chemo room supply cart

Chemo room chemo storage cart

Chemo room floor

Chemo room wall

Chemo ante-room cart

Chemo ante-room supply cart

Chemo ante-room wall

Chemo ante-room floor

ISO-8 Environment

IV Ante-room cart

IV Ante-room wall

IV Ante-room floor

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