Purpose Surface wipe sampling for various hazardous agents has been employed in many occupational settings over the years for various reasons such as evaluation of potential dermal exposure and health risk, source determination, quality or cleanliness, compliance, and others. Wipe sampling for surface residue of antineoplastic and other hazardous drugs in healthcare settings is currently the method of choice to determine surface contamination of the workplace with these drugs. The purpose of this article is to review published studies of wipe sampling for antineoplastic and other hazardous drugs, to summarize the methods in use by various organizations and researchers, and to provide some basic guidance for conducting surface wipe sampling for these drugs in healthcare settings. Methods Recommendations on wipe sampling methodology from several government agencies and organizations were reviewed. Published reports on wipe sampling for hazardous drugs in numerous studies were also examined. The critical elements of a wipe sampling program and related limitations were reviewed and summarized. Results Recommendations and guidance are presented concerning the purposes of wipe sampling for antineoplastic and other hazardous drugs in the healthcare setting, technical factors and variables, sampling strategy, materials required, and limitations. The reporting and interpretation of wipe sample results is also discussed. Conclusions It is recommended that all healthcare settings where antineoplastic and other hazardous drugs are handled consider wipe sampling as part of a comprehensive hazardous drug ‘safe handling’ program. Although no standards exist for acceptable or allowable surface concentrations for these drugs in the healthcare setting, wipe sampling may be used as a method to characterize potential occupational dermal exposure risk and to evaluate the effectiveness of implemented controls and the overall the safety program. A comprehensive safe-handling program for antineoplastic drugs may utilize wipe sampling as a screening tool to evaluate environmental contamination and strive to reduce contamination levels as much as possible, using the industrial hygiene hierarchy of controls.

111 Background: Cancer Care Ontario organizes and ensures quality cancer care for 13.5 million residents in Ontario, Canada and is systematically deploying a web-based tool, called Electronic Patient Reported Experience Measures (ePREM), through a touch-screen platform previously deployed within Regional Cancer Centres (RCCs). ePREM has been used to disseminate the first patient reported experience measure (PREM), called Your Voice Matters (YVM). YVM will be collected on all patients in Ontario undergoing cancer treatment in real time, creating the largest known, linkable patient experience dataset. Methods: Implementation feasibility and readiness was assessed across all 14 Regional Cancer Programs through a provincial assessment which informed the phased implementation. Implementation was rooted in a change management framework: clinical and administrative champions, available resources, existing technical environment and competing program priorities. In March 2016 a four-wave implementation was initiated controlling for readiness and centre volumes, with a focus on extensive stakeholder engagement, tool training, launch and operational support. To date, ePREM is fully operational in 10 of 15 RCCs. Results: Provincial deployment was 66% complete in October 2016. By March 2017 full provincial implementation will be complete. Successful implementation has been directly linked to an adaptive design within the implementation and change management framework as a four-wave roll out. Key factors included: multi-faceted communications with centre leadership, and implementation teams. During this initial data stabilization phase, there were 9,266 completed surveys submitted and 10,932 partial survey responses submitted. Conclusions: PREMs are appropriate quality improvement indicators for cancer patients within the treatment phase. ePREMs enables systematic, linkable collection of real time PREMs to improve the patient experience in Ontario and contribute to the planning of new initiatives. Upon full provincial implementation ePREMs will allow for the largest known dataset of PREMs. Successful implementation has been directly linked to an adaptive, four-wave approach.