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Background and Importance Paediatric chemotherapy compounding requires precision due to patient vulnerability. Manual workflows like pull-back syringe verification risk errors and poor documentation. IV workflow technology improves safety, compliance, and traceability. This study evaluates its impact on paediatric oncology compounding, where data remain limited.Aim and Objectives This study evaluated IV workflow technology’s impact on safety, compliance, and efficiency in paediatric chemotherapy compounding. It compared barcode scanning and image capture to manual pull-back verification and assessed remote pharmacist verification’s role in optimising workflows and meeting USP <797> and <800> standards.Material and Methods This prospective evaluation was conducted in a paediatric hospital pharmacy following the implementation of intravenous (IV) workflow technology for chemotherapy compounding. The intervention included barcode scanning for drug and diluent verification and image capture of each preparation step. Pharmacists performed in-line verification remotely, outside the cleanroom, using a secure interface that allowed real-time review of scanned data and preparation images. Outcome measures included the number and type of scan alerts, pharmacist interventions based on image review, preparation throughput, and adherence to USP <797> and <800> documentation standards.Results Over 180 days, 150 paediatric chemotherapy doses were compounded using IV workflow technology. Barcode scanning prevented 25% drug/diluent errors. Image-supported verification reduced waste by 98%, catching errors before completion. Remote pharmacist review increased clinical time by 35% by eliminating cleanroom entry. Automated documentation ensured consistent USP <797>/<800> compliance. No adverse events occurred. The technology significantly enhanced safety, efficiency, and regulatory adherence in a high-risk paediatric oncology setting.Conclusion and Relevance This study demonstrated that implementing IV workflow technology in paediatric chemotherapy compounding significantly improved safety, compliance, and operational efficiency. Real-time barcode scanning and image capture enabled early identification of drug and diluent errors, while in-line verification reduced waste of high-cost medications. Remote pharmacist verification contributed to improved workflow and increased time for clinical activities. These findings support broader adoption of IV workflow systems in high-risk compounding environments and highlight their potential to enhance patient safety and pharmacy practice.References and/or Acknowledgements 1. Batson S, Mitchell SA, Lau D, Canobbio M, de Goede A, Singh I. Automated compounding technology and workflow solutions for the preparation of chemotherapy: a systematic review. Eur J Hosp Pharm. 2020;27(6):330–336. https://ejhp.bmj.com/content/27/6/330Conflict of Interest No conflict of interest