This scenario presents a professional challenge due to the need to balance public health imperatives with individual patient autonomy and the practicalities of vaccine administration within a community setting. The pharmacist must navigate potential barriers to immunization uptake, ensure equitable access, and maintain the integrity of the immunization program while adhering to public health directives and professional ethical standards. Careful judgment is required to select the most effective and compliant strategy. The best approach involves a proactive, multi-faceted community outreach program that leverages existing public health data and partnerships. This strategy directly addresses identified gaps in immunization coverage by targeting specific demographics and locations where uptake is low. It aligns with public health pharmacy principles by aiming to improve population health outcomes through increased vaccination rates. This approach is ethically sound as it promotes the common good and fulfills the pharmacist’s role in disease prevention. It is also regulatorily compliant by adhering to public health guidelines for immunization campaigns and ensuring appropriate patient education and consent processes are integrated into outreach activities. An incorrect approach would be to solely rely on in-pharmacy vaccination clinics without actively seeking out underserved populations. This fails to address the identified disparities in immunization rates and limits the pharmacist’s impact on population health. It neglects the proactive role public health pharmacy should play in reaching those who may face barriers to accessing traditional healthcare settings. Another incorrect approach would be to prioritize convenience for existing pharmacy customers over addressing community-wide immunization deficits. While customer service is important, the core mandate of public health pharmacy in this context is to improve overall community immunity, not just serve those who already frequent the pharmacy. This approach would likely exacerbate existing health inequities. A further incorrect approach would be to implement a blanket marketing campaign without considering the specific needs and barriers of different demographic groups. While broad awareness is useful, a targeted strategy based on public health data is more effective in achieving equitable immunization coverage and maximizing the population health impact. This approach lacks the strategic focus necessary for a successful public health intervention. Professionals should employ a decision-making framework that begins with analyzing public health data to identify specific needs and disparities. This should be followed by an assessment of available resources and potential partnerships. Ethical considerations, including equity, autonomy, and beneficence, must guide the selection of strategies. Finally, regulatory compliance must be ensured at every step of planning and implementation.

The evaluation methodology shows that assessing proficiency in advanced Mediterranean home infusion pharmacy requires a comprehensive understanding of its specific regulatory landscape, particularly concerning patient safety, medication management, and the unique challenges of delivering care outside a traditional hospital setting. This scenario is professionally challenging because it demands not only clinical expertise but also a deep awareness of the eligibility criteria and purpose of the Advanced Mediterranean Home Infusion Pharmacy Proficiency Verification. Misinterpreting these foundational aspects can lead to inappropriate application for verification, potentially compromising patient care standards and regulatory compliance. The correct approach involves a thorough review of the Advanced Mediterranean Home Infusion Pharmacy Proficiency Verification framework to ascertain if the applicant’s practice setting and scope of services align with the stated purposes and eligibility requirements. This includes verifying that the applicant is actively engaged in providing home infusion services within the Mediterranean region, adheres to all relevant local and regional regulations governing such practices, and demonstrates a commitment to patient safety and quality outcomes as defined by the verification standards. This approach is correct because it directly addresses the core intent of the verification process, which is to ensure that only qualified and appropriately situated practitioners undergo this specialized assessment, thereby upholding the integrity of the certification and protecting patient welfare. An incorrect approach would be to assume that any pharmacy providing infusion services, regardless of geographical location or specific regulatory adherence within the Mediterranean context, is automatically eligible. This fails to acknowledge the specialized nature of the “Advanced Mediterranean” designation and its associated regulatory framework. Another incorrect approach would be to focus solely on the technical aspects of infusion therapy without considering the overarching purpose of the verification, which is to confirm proficiency within a specific, regulated environment. This overlooks the critical requirement that the practice must be situated and compliant within the defined Mediterranean jurisdiction. Finally, an incorrect approach would be to prioritize the applicant’s desire for verification over the established eligibility criteria, potentially leading to the inclusion of unqualified entities, which undermines the credibility of the proficiency verification and poses a risk to patients. Professionals should employ a decision-making process that begins with a clear understanding of the verification’s purpose and scope. This involves consulting the official documentation outlining the eligibility criteria and the specific regulatory requirements of the Mediterranean region for home infusion pharmacy. The next step is to objectively assess the applicant’s practice against these defined standards, focusing on alignment with the geographical, regulatory, and service-specific requirements. If any discrepancies exist, further clarification or denial of eligibility should be considered, always prioritizing patient safety and regulatory compliance.

The evaluation methodology shows that assessing the proficiency of home infusion pharmacy professionals requires a nuanced understanding of both clinical practice and regulatory adherence within the specific context of Mediterranean healthcare systems. This scenario is professionally challenging because it demands the evaluator to balance the direct patient care aspects of infusion therapy with the stringent legal and ethical obligations governing pharmaceutical practice, particularly in a cross-border or multi-regional context implied by “Mediterranean.” Ensuring patient safety, medication efficacy, and compliance with diverse, potentially evolving, regulatory frameworks are paramount. Careful judgment is required to differentiate between acceptable variations in practice and deviations that compromise patient well-being or legal standing. The best approach involves a comprehensive review of the professional’s documented patient care records, including medication administration logs, patient assessment notes, and communication with prescribing physicians and other healthcare providers. This review should be cross-referenced with the professional’s adherence to established national and regional guidelines for home infusion therapy, including sterile compounding practices, aseptic technique, and patient education protocols. Furthermore, it must assess the professional’s understanding and application of pharmacovigilance principles relevant to home-administered medications and their ability to manage adverse events. This approach is correct because it directly evaluates the practical application of knowledge and skills in a real-world setting, grounded in verifiable documentation and aligned with established standards of care and regulatory mandates. It demonstrates a commitment to evidence-based practice and patient safety, which are core tenets of pharmaceutical proficiency verification. An incorrect approach would be to solely rely on the professional’s self-reported knowledge or a brief interview without corroborating evidence. This fails to provide objective verification of skills and adherence to protocols, potentially overlooking critical deficiencies that could impact patient safety. It also neglects the regulatory requirement for demonstrable competence. Another incorrect approach would be to focus exclusively on the theoretical knowledge of drug mechanisms and indications without assessing the practical aspects of safe and effective home infusion delivery, sterile technique, or patient management. This overlooks the essential hands-on and patient-interaction components of home infusion pharmacy. Finally, an approach that prioritizes speed of verification over thoroughness, perhaps by only reviewing a limited sample of cases or skipping key documentation checks, would be professionally unacceptable. This risks missing significant errors or non-compliance issues, thereby failing in the primary duty to protect patients and uphold regulatory standards. Professionals should employ a decision-making framework that begins with clearly defining the scope of proficiency being assessed, referencing the specific regulatory requirements of the relevant Mediterranean jurisdiction. This framework should then incorporate a multi-faceted evaluation strategy, combining objective documentation review, practical skill assessment (where feasible and appropriate), and verification of adherence to ethical and legal standards. Continuous professional development and a commitment to staying abreast of evolving guidelines and regulations are also crucial components of maintaining and demonstrating proficiency.

The audit findings indicate a potential breakdown in the quality control system for sterile product compounding, specifically concerning the handling of a recently received batch of a critical raw material. This scenario is professionally challenging because it directly impacts patient safety, requires immediate and decisive action based on incomplete information, and necessitates a thorough understanding of both pharmaceutics and regulatory compliance. The pharmacist must balance the urgency of patient treatment with the imperative of ensuring product integrity and adherence to established quality standards. The best approach involves immediately quarantining the suspect raw material batch and initiating a comprehensive investigation. This includes reviewing the supplier’s Certificate of Analysis (CoA), performing in-house quality control testing on retained samples (if available) or on a sample from the quarantined batch, and cross-referencing the material’s specifications with the compounding formulary and established protocols. This methodical approach ensures that any potential contamination or deviation from quality standards is identified and addressed before the material is used in compounding, thereby safeguarding patient health and upholding the principles of Good Pharmacy Practice (GPP) and sterile product quality control as mandated by relevant pharmaceutical regulations. An incorrect approach would be to proceed with compounding using the suspect raw material while awaiting further information. This action poses an unacceptable risk to patients, as the material could be contaminated or substandard, leading to compromised sterile products and potential adverse events. This directly violates the fundamental ethical and regulatory obligation to ensure the safety and efficacy of dispensed medications. Another incorrect approach would be to discard the entire batch of raw material without conducting any investigation or testing. While this might seem like a precautionary measure, it is wasteful and does not address the root cause of the potential issue. It also fails to fulfill the responsibility to investigate deviations and gather data that could inform future supplier quality assessments or process improvements. Furthermore, it bypasses the established quality control procedures designed to identify and rectify specific problems. Finally, an incorrect approach would be to rely solely on the supplier’s assurance that the material is acceptable without independent verification. While supplier CoAs are important, they are not a substitute for a robust internal quality control system that includes verification of critical raw materials, especially when there are audit findings suggesting a potential issue. This reliance undermines the pharmacy’s own quality assurance responsibilities and could lead to the use of compromised materials. Professionals should employ a systematic decision-making process when faced with such challenges. This involves: 1) immediate risk assessment and containment (quarantine), 2) thorough investigation and data gathering (reviewing documentation, performing testing), 3) consultation with relevant internal policies and external regulations, 4) clear communication with the team and potentially the supplier, and 5) making an informed decision based on evidence to ensure patient safety and regulatory compliance.

Scenario Analysis: This scenario presents a common yet critical challenge in home infusion pharmacy: ensuring medication safety and regulatory compliance when dealing with a patient’s complex medication regimen and potential for adverse events. The professional challenge lies in balancing timely intervention with accurate information gathering, adherence to strict dispensing protocols, and the legal and ethical obligations to protect patient well-being. The pharmacist must navigate potential data integrity issues, communication breakdowns, and the inherent risks associated with potent medications administered outside a controlled hospital setting. Careful judgment is required to prioritize patient safety while respecting physician orders and maintaining efficient workflow. Correct Approach Analysis: The best professional practice involves immediately verifying the reported adverse event with the prescribing physician and the patient’s primary caregiver. This approach directly addresses the core of the issue by seeking to confirm the validity and severity of the reported event from the most authoritative sources. It aligns with regulatory expectations for patient safety and medication error reporting, which mandate prompt investigation and communication. Ethically, it prioritizes the patient’s immediate well-being by initiating a collaborative problem-solving process. This proactive verification ensures that any subsequent actions are based on accurate, up-to-date information, preventing unnecessary interventions or delays in appropriate care. It also upholds the pharmacist’s role as a crucial member of the healthcare team, fostering interdisciplinary communication essential for safe patient management. Incorrect Approaches Analysis: One incorrect approach involves immediately contacting the medication manufacturer to report a potential adverse drug reaction without first confirming the event with the prescribing physician. This fails to acknowledge the pharmacist’s primary responsibility to investigate and manage patient care in collaboration with the prescriber. Regulatory frameworks emphasize that pharmacists are the frontline in identifying and addressing medication-related issues, and bypassing the physician hinders effective patient management and potentially leads to misdirected reporting or unnecessary alarm. Another unacceptable approach is to assume the reported issue is a medication error and immediately adjust the patient’s prescription without any independent verification or consultation. This demonstrates a lack of critical thinking and a failure to adhere to established protocols for medication error investigation. Regulatory compliance requires a systematic approach to error analysis, not unilateral decision-making that could compromise patient safety or contradict physician orders. A further incorrect approach is to document the reported event as a medication error and wait for the physician to follow up at their next scheduled contact. This passive stance neglects the urgency often associated with adverse events and the pharmacist’s ethical duty to act promptly when patient safety is potentially compromised. Regulatory expectations for adverse event reporting and patient monitoring demand a more proactive and timely response. Professional Reasoning: Professionals should employ a systematic decision-making process that begins with patient assessment and information gathering. When an adverse event is reported, the first step is to gather all relevant details from the patient and caregiver. This is followed by immediate communication with the prescribing physician to confirm the event, understand the clinical context, and discuss potential causes and solutions. Simultaneously, pharmacists must consult relevant drug information resources and internal protocols for medication error management. Documentation should be thorough and accurate, reflecting all communications and actions taken. This collaborative and evidence-based approach ensures patient safety, regulatory compliance, and the maintenance of professional standards of care.

The evaluation methodology shows a complex scenario involving a patient receiving home infusion therapy for a chronic condition, requiring careful integration of clinical pharmacology, pharmacokinetics, and medicinal chemistry principles. The professional challenge lies in ensuring the safe and effective management of the patient’s medication regimen, which involves understanding drug absorption, distribution, metabolism, and excretion (ADME) in the context of their specific physiological state and potential drug interactions, all while adhering to the strict regulatory framework governing home infusion pharmacy practice in the UK. This requires a nuanced approach that goes beyond simple dose calculation and delves into the underlying scientific principles to anticipate and mitigate potential adverse events or therapeutic failures. The best professional approach involves a comprehensive review of the patient’s current medication regimen, including the prescribed home infusion therapy and any concomitant oral or other parenteral medications. This review must critically assess the pharmacokinetic profiles of all drugs, considering potential drug-drug interactions that could alter absorption, metabolism (e.g., via cytochrome P450 enzymes), or excretion, thereby impacting plasma concentrations and therapeutic efficacy or toxicity. Furthermore, an understanding of the medicinal chemistry of the infused drug is crucial to identify potential incompatibilities with infusion materials or other medications, and to predict stability under storage and administration conditions. This integrated approach, grounded in evidence-based practice and regulatory guidelines such as those from the General Pharmaceutical Council (GPhC) regarding safe and effective medicines management and the provision of pharmaceutical services, ensures patient safety and optimal therapeutic outcomes. An incorrect approach would be to solely focus on the prescribed infusion rate and duration without considering the broader pharmacokinetic implications of the patient’s overall medication profile. This oversight could lead to sub-therapeutic drug levels or toxic accumulation if interactions are not identified and managed. Another professionally unacceptable approach is to rely on generic guidelines for drug compatibility without a specific assessment of the patient’s individual infusion setup and the potential for chemical degradation or precipitation of the infused medication, which could compromise its integrity and efficacy. Lastly, failing to document and communicate any identified risks or necessary adjustments to the prescribing clinician and the patient, based on the integrated pharmacological assessment, represents a significant breach of professional duty and regulatory compliance, potentially jeopardizing patient care. Professionals should employ a systematic decision-making process that begins with a thorough patient assessment, followed by a detailed review of all prescribed and administered medications. This review should integrate knowledge of clinical pharmacology, pharmacokinetics, and medicinal chemistry to identify potential risks and optimize therapy. Collaboration with the prescribing physician and other healthcare professionals is paramount, supported by clear and concise communication of findings and recommendations. Adherence to professional standards and regulatory requirements, such as those set by the GPhC, forms the bedrock of safe and effective practice in home infusion pharmacy.

The evaluation methodology shows that managing medication therapy across different care settings, particularly transitioning a patient from hospital to home infusion, presents significant professional challenges. These challenges stem from the need to ensure continuity of care, prevent medication errors, and maintain patient safety during a vulnerable period. The complexity arises from coordinating information between multiple healthcare providers, potential gaps in communication, and the patient’s own capacity to manage their therapy at home. Careful judgment is required to anticipate potential issues and implement proactive strategies. The approach that represents best professional practice involves a comprehensive, interdisciplinary medication reconciliation process initiated prior to hospital discharge. This includes a thorough review of the patient’s current medication regimen, identification of any discrepancies between inpatient and outpatient orders, and clear communication of the home infusion plan to the patient, their caregiver, and the home infusion pharmacy. This approach is correct because it directly addresses the core risks of medication errors and continuity gaps during transitions of care. Regulatory frameworks, such as those governing pharmacy practice and patient safety, emphasize the pharmacist’s role in medication reconciliation and ensuring that patients understand their medications. Ethically, this proactive approach upholds the principle of beneficence by prioritizing patient well-being and minimizing harm. An incorrect approach involves relying solely on the discharge summary provided by the hospital physician without independent verification by the home infusion pharmacist. This fails to account for potential transcription errors, outdated information, or omissions in the discharge documentation. It represents a significant regulatory failure by not adhering to professional standards that mandate thorough medication reconciliation and a breakdown in ethical responsibility by not actively ensuring the accuracy of the patient’s medication regimen. Another incorrect approach is to assume the patient or their caregiver will proactively identify and report any medication-related issues upon returning home. While patient engagement is important, placing the entire burden of error detection on the patient during a vulnerable transition is professionally unacceptable. This approach neglects the pharmacist’s duty to provide comprehensive medication management and support, potentially leading to delayed intervention and adverse events, which is a failure in both regulatory compliance and ethical patient care. A further incorrect approach is to only provide the home infusion pharmacy with the prescription for the new infusion medication, without a comprehensive review of the patient’s entire medication profile. This overlooks potential drug-drug interactions, duplicative therapies, or contraindications with existing home medications, thereby failing to provide holistic medication therapy management. This constitutes a significant regulatory oversight and an ethical lapse in ensuring the patient’s overall safety and therapeutic outcomes. Professionals should employ a systematic decision-making framework that prioritizes patient safety and regulatory compliance. This involves: 1) Proactive engagement: initiating medication reconciliation early in the patient’s hospital stay. 2) Interdisciplinary collaboration: actively communicating with physicians, nurses, and the home infusion team. 3) Thorough verification: independently reviewing all prescribed medications, including over-the-counter drugs and supplements. 4) Patient education: ensuring the patient and caregiver understand the medication regimen, administration, potential side effects, and who to contact with concerns. 5) Documentation: meticulously recording all reconciliation activities and communications.

The evaluation methodology shows a critical juncture for a home infusion pharmacy professional seeking to maintain their proficiency. This scenario is professionally challenging because it requires a nuanced understanding of the Advanced Mediterranean Home Infusion Pharmacy Proficiency Verification’s blueprint, specifically concerning its weighting, scoring, and retake policies. Misinterpreting these policies can lead to significant professional setbacks, including extended periods of non-compliance or the need for extensive, unplanned retraining. Careful judgment is required to navigate these policies effectively and ensure continued practice. The best approach involves meticulously reviewing the official Advanced Mediterranean Home Infusion Pharmacy Proficiency Verification handbook, paying close attention to the sections detailing the blueprint’s weighting of different knowledge domains, the precise scoring thresholds for passing, and the established retake policy, including any limitations on the number of attempts or required waiting periods between attempts. This approach is correct because it directly adheres to the established procedural framework of the verification process. Relying on the official documentation ensures that all decisions are based on the most accurate and current information, thereby minimizing the risk of error and demonstrating a commitment to professional standards and regulatory compliance. This proactive and diligent review aligns with ethical obligations to maintain competence and uphold the integrity of the verification process. An incorrect approach would be to rely on anecdotal information or the experiences of colleagues regarding the blueprint, scoring, or retake policies. This is professionally unacceptable because it introduces a high risk of misinformation. Policies can change, and individual interpretations may be flawed. Basing decisions on such information could lead to incorrect assumptions about passing scores or eligibility for retakes, potentially resulting in wasted time and resources, and ultimately, failure to meet verification requirements. Another incorrect approach is to assume that the retake policy is lenient and allows for immediate retesting without understanding specific conditions or limitations. This is professionally unacceptable as it disregards the structured nature of proficiency verification. Many such programs have defined waiting periods or require demonstration of remediation before a retake is permitted. Ignoring these stipulations can lead to disqualification from retaking the assessment or necessitate a full reapplication process, undermining the professional’s ability to continue practicing. Finally, an incorrect approach would be to focus solely on the weighting of specific blueprint sections without understanding how they contribute to the overall score and the passing threshold. This is professionally unacceptable because it suggests a superficial engagement with the evaluation. While understanding weighting is important, it is the aggregate score and meeting the defined passing criteria that determine proficiency. A fragmented understanding can lead to misallocation of study efforts and a failure to grasp the holistic requirements for successful verification. Professionals should employ a decision-making framework that prioritizes direct engagement with official policy documents. This involves actively seeking out and thoroughly understanding the rules and guidelines governing their professional certifications. When faced with uncertainty, the first step should always be to consult the primary source of information. If clarification is still needed, seeking guidance from the official administering body or a designated representative is the next appropriate step, rather than relying on informal channels.

The evaluation methodology shows a scenario that is professionally challenging due to the inherent complexity of managing a patient requiring home infusion therapy, particularly when dealing with potential medication errors. The pharmacist must balance patient safety, therapeutic efficacy, and adherence to professional standards and regulatory requirements. The need for swift, accurate decision-making under pressure, while maintaining clear communication with the patient and healthcare team, is paramount. The best approach involves a systematic and evidence-based review of the medication order, cross-referencing it with the patient’s clinical profile and current treatment plan. This includes verifying the prescribed medication, dosage, route, frequency, and duration against established clinical guidelines and the patient’s specific needs and history. The pharmacist should then proactively communicate any discrepancies or concerns to the prescribing physician, documenting all interactions and resolutions. This aligns with the core principles of patient safety and professional responsibility mandated by pharmacy practice standards, emphasizing the pharmacist’s role as a medication expert and patient advocate. An incorrect approach would be to proceed with dispensing the medication without thoroughly verifying the order against the patient’s clinical data, especially if there are any ambiguities or deviations from standard practice. This bypasses critical safety checks and could lead to dispensing an inappropriate or potentially harmful medication, violating the pharmacist’s duty of care and regulatory obligations to ensure medication safety. Another incorrect approach involves relying solely on the patient’s verbal confirmation of the medication without independent verification. While patient input is valuable, it cannot replace the pharmacist’s professional responsibility to ensure the accuracy and appropriateness of the prescription through established verification processes. This could lead to dispensing errors if the patient misunderstands or misremembers the prescribed regimen. Finally, an incorrect approach would be to delay dispensing due to minor, easily resolvable issues without initiating communication with the prescriber. While caution is necessary, an undue delay in providing essential therapy without clear justification can negatively impact patient outcomes and contravenes the principle of timely and effective patient care. Professionals should employ a decision-making framework that prioritizes patient safety, clinical appropriateness, and regulatory compliance. This involves a thorough review of all available information, critical thinking to identify potential risks, proactive communication with the healthcare team, and meticulous documentation of all actions and decisions.

The evaluation methodology shows that successful candidates for the Advanced Mediterranean Home Infusion Pharmacy Proficiency Verification must demonstrate a comprehensive understanding of preparation resources and realistic timeline recommendations. This scenario is professionally challenging because it requires balancing the immediate needs of patients requiring home infusion therapy with the practical realities of resource availability, regulatory compliance, and the need for thorough, evidence-based preparation. A rushed or inadequate preparation process can lead to medication errors, patient harm, and regulatory non-compliance, all of which have severe consequences in a healthcare setting. Careful judgment is required to ensure that preparation is both efficient and effective, meeting the high standards expected of advanced practitioners. The approach that represents best professional practice involves a structured, proactive, and evidence-informed strategy. This includes identifying all necessary components for successful patient care, such as specialized equipment, medications, and patient education materials, well in advance. It also necessitates consulting current clinical guidelines, regulatory requirements (e.g., those pertaining to home infusion therapy in the Mediterranean region, if applicable, or general best practices for pharmaceutical care), and manufacturer instructions for all involved products. Developing a realistic timeline that accounts for procurement, training, patient assessment, and potential delays is crucial. This approach is correct because it prioritizes patient safety and regulatory adherence by ensuring all aspects of care are meticulously planned and executed. It aligns with ethical principles of beneficence and non-maleficence, as well as professional standards that demand thoroughness and diligence in pharmaceutical practice. An approach that focuses solely on acquiring the minimum required equipment without considering the full spectrum of patient needs or potential complications is professionally unacceptable. This fails to account for the complexities of home infusion therapy, where unforeseen issues can arise, and a lack of readily available or appropriate resources can compromise patient care. It also neglects the importance of comprehensive patient assessment and education, which are vital for successful home management. Another professionally unacceptable approach is to rely on outdated or anecdotal information for preparation. This disregards the dynamic nature of medical knowledge and pharmaceutical advancements. Clinical guidelines and best practices evolve, and using outdated information can lead to suboptimal or even harmful therapeutic interventions. It also risks non-compliance with current regulatory standards, which are designed to ensure patient safety and quality of care. Finally, an approach that prioritizes speed over thoroughness, assuming that standard pharmacy practices are sufficient for specialized home infusion, is also professionally unsound. Home infusion therapy requires specific expertise, equipment, and protocols that differ significantly from traditional inpatient or outpatient pharmacy settings. A failure to recognize and address these unique requirements can lead to critical errors in medication preparation, administration, or patient monitoring. The professional decision-making process for similar situations should involve a systematic risk assessment. Professionals should identify potential hazards and challenges associated with the specific therapy and patient population. They should then consult authoritative sources, including regulatory bodies, professional organizations, and peer-reviewed literature, to inform their preparation strategy. Collaboration with other healthcare professionals, such as physicians, nurses, and pharmacists specializing in home infusion, is also essential to ensure a holistic and well-coordinated approach. Finally, a commitment to continuous learning and adaptation is paramount, as the field of home infusion therapy is constantly evolving.