Implementation of a safety program for handling hazardous drugs in a community hospital

Massoomi, Firouzan; Neff, Bill; Pick, Amy M.; Danekas, Paula L.

doi:10.2146/ajhp070443

Cited by 16 publications

(8 citation statements)

References 14 publications

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“…Across the set of publications, 5 major strategies were identified: engineering controls, 1,7,12-32 personal protective equipment (PPE), * medical and environmental monitoring, † hazard identification, 1,7,12,15,[20][21][22][23][24][25][26][27][28][29][30][31][32]36,37 and the need for a comprehensive hazardous drug control program that includes education and training for health care workers. 26,27,31,32,36 …”

Section: Description Of Publications In Reviewmentioning

confidence: 99%

“…26,27,31,32,36 The prospective intervention study by Keat et al 15 was found to demonstrate the difference in environmental or worker contamination with one type of BSC compared with another, specifically for class 2 type A2 versus class 2 type B2. This differentiation is important, as primary engineering controls such as BSCs are expensive to obtain and upgrade.…”

Section: Comprehensive Hazardous Drug Control Programmentioning

confidence: 99%

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Systematic Review of Control Measures to Reduce Hazardous Drug Exposure for Health Care Workers

Crickman

Finnell

2016

Journal of Nursing Care Quality

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Because of their involvement in the transport, handling, preparation, administration, or disposal of hazardous medications, health care workers across multiple settings are at risk for adverse health consequences from exposure to these drugs. This review presents evidence-based strategies to mitigate the harmful exposures. These include engineering controls, full use of personal protective equipment, medical and environmental monitoring, hazard identification, and the need for a comprehensive hazardous drug control program that includes education and training for health care workers.

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Section: Description Of Publications In Reviewmentioning

confidence: 99%

Section: Comprehensive Hazardous Drug Control Programmentioning

confidence: 99%

Systematic Review of Control Measures to Reduce Hazardous Drug Exposure for Health Care Workers

Crickman

Finnell

2016

Journal of Nursing Care Quality

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“…A total of 12 studies were included (figure 1)10 11 18–27: 10 original articles, one thesis and one poster presentation. Studies were conducted in six countries: USA (n=4), Spain (n=3), France (n=2), Malaysia (n=1), Hungary (n=1) and Turkey (n=1).…”

Section: Resultsmentioning

confidence: 99%

Review of economic data on closed system transfer drug for preparation and administration of hazardous drugs

et al. 2019

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ObjectivesThe objectives of this study were to review economic data on the use of closed system drug transfer devices (CSTDs) for preparing and administering hazardous drugs, and to evaluate the quality of data reporting as defined by the Consolidated Health Economic Evaluation Reporting Standards (CHEERS).MethodsAll references from a recent Cochrane review about CSTDs were evaluated for inclusion. A literature review was also conducted. Articles containing economic data about the use of CSTDs were retained for analysis. Two researchers independently graded the articles according to the 24-item CHEERS checklist.ResultsOf the 138 articles identified initially, 12 were retained for analysis. Nine of these studies did not report acquisition costs or did not detail acquisition costs. Six studies reported economic benefits associated with the used of CSTDs, all related to extending the beyond-use date. The mean number of CHEERS criteria fulfilled by the included articles was 9.2 (SD 2.4).ConclusionsCSTDs are costly to acquire. However, few studies have examined the economic impact of these devices, and the existing studies are incomplete. As a result, hospitals planning to implement these devices will be unable to make a sound economic evaluation. Robust economic evaluation of CSTDs is needed.

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“…They used the NIOSH list as a reference and did not describe a standard way to evaluate drug toxicity in specific contexts. 20 The drug formulation, route of exposure and standard drug preparation practices all mitigate the risk of occupational exposure. The UHC consensus statement also gives recommendations that consider healthcare employees' potential exposure to hazardous drugs which institutions may view as practical and reasonable.…”

Section: Discussionmentioning

confidence: 99%

Development of a standardised method to recommend protective measures to handle hazardous drugs in hospitals

et al. 2012

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Purpose Healthcare professionals frequently have to handle hazardous drugs in the hospital setting. Data on the inherent toxicity of drugs cannot be directly applied to occupational exposure. We developed a standardised method to evaluate occupational risks and to recommend protective measures. Methods Step 1: evaluation of chronic and acute toxicities and toxicity for reproduction. Step 2: toxicity weighting according to risk of exposure related to drug formulations. Step 3: definition of protective measures. Step 4: toxicity assessment of drugs used in our institution and comparison with hazardous drug lists published in the literature. Results The whole process resulted in a standardised evaluation algorithm. Risks of exposure were determined by a panel of experts to balance intrinsic toxicity of each drug formulation or administration route. Protective measures were recommended. 80 substances (109 drug formulations) were screened for toxicity. Centralisation of compounding in the pharmacy was recommended for 12/24 (50%) of intravenous liquids, 19/32 (60%) of intravenous powders and 7/26 (27%) tablets (crushing). We found a slightly different estimation of risk for only two products (prednisone and mycophenolate mofetil) compared with the literature lists (National Institute for Occupational and Safety in Health Alert and University Health System Consortium Consensus). Conclusions We developed a simple standardised method to generate a list of hazardous drugs in our hospital according to the risk of exposure. We determined reasonable protective measures that could be easily introduced into practice to protect healthcare workers.

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Implementation of a safety program for handling hazardous drugs in a community hospital

Abstract: A gap analysis allowed a multidisciplinary team to establish a safety program for managing hazardous drugs in a community hospital.

Cited by 16 publications

References 14 publications

Systematic Review of Control Measures to Reduce Hazardous Drug Exposure for Health Care Workers

Systematic Review of Control Measures to Reduce Hazardous Drug Exposure for Health Care Workers

Review of economic data on closed system transfer drug for preparation and administration of hazardous drugs

Development of a standardised method to recommend protective measures to handle hazardous drugs in hospitals

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