Background: The risk of medication errors related to drug preparation unit cannot be totally avoided because of human interference. The aim of this study is to investigate the background and knowledge of the pharmacy staff by replicating the cytotoxic preparation unit with potential errors. Methods: A 10-m 2 room was provided to duplicate the centralized chemotherapy unit with three areas reproducing virtually the equipment preparation bench, the isolator, and the dispensing bench. The 14 situations selected by experts were integrated to each corresponded area. For each participant, a form was given and answers were analyzed by two independent experts. Statistical processing data were performed using GraphPad Prism Õ software. Results: A total of 19 professionals participated in error simulation workshop over a one-month period. The overall rate of correct responses was 58 AE 19%. In five situations, correct responses rate was lower than 50%: wrong drug batch related to the preparation sheet (40%), inappropriate sterilizing conditions (15%), the time on the preparation sheet provides an expired expiry date for melphalan preparation (45%), a maximum drug dose exceeded (25%), the dispensing form not corresponds to the preparation sheet and final product label (30%). The rate of correct responses was 45 AE 25% for professionals not specifically dedicated to chemotherapy preparation. The overall satisfaction workshop rate was 8.7 AE 1.0 out of 10. Conclusion: This study showed the importance of training programs to sensitize personal staff to the risks of chemotherapy preparation and prevent errors.

Purpose: Musculoskeletal disorders (MSD) remain the most common occupational disease in the Western countries. Beside the effects on workers themselves, MSDs may lead to high costs to enterprises and the society as a whole. Among the painful or tiring positions encountered in healthcare settings, caregivers often cite the filling of portable infusion pumps (PIP). This context was conducive to achievement of the goal of the following project: the development of a motorized apparatus designed to minimize the risk of MSDs caused by repeated gestures of filling PIPs. Methods: The development of the tool followed eleven steps including: (a) a market analysis, (b) a SWOT analysis, (c) definition of the specifications of the apparatus, and (d) a concurrent engineering methodology. Results: In approximately 18 months, a dynamic project group supported by a concurrent engineering methodology has designed and developed a compact and lightweight motorized apparatus able to suppress the risk of MSDs caused by manual filling of PIPs. After a mandatory step of familiarization, all involved operators have unanimously endorsed the new tool. Conclusion: We believe that this new motorized apparatus may now simply and substantially alleviate occupational MSDs caused by the manually filling of PIPs. Another major benefit of this research program is the clear improvement of the intrinsically quality of therapeutic objects (TO) through the creation of a more accurate and reproducible method of PIP filling.

Objective:The global professional risk assessment applied to the central unit of antineoplastic agent preparations is part of a mandatory approach required by the European legislation for workers. This study identified the hazardous situations related to the staff activity and then enabled the preparation of a formal plan of occupational prevention.Methods:The nature of study approved by a working group constituted by experts was the global risk analysis. After identifying the hazardous situations, the global risk analysis estimated the risk level of each hazardous situation based on a criticality score, including severity and frequency. The global risk analysis highlighted the initial and residual risks after establishing a plan to reduce the high criticality risks.Results:Hence, 33 unacceptable hazardous situations were identified. The critical categories of professional risks were “Product, emissions, and waste risks” with 17 (55%) hazardous situations; “Psychosocial risk factors” with 8 (24%) hazardous situations; and “Risks related to work equipment” with 6 (18%) hazardous situations. Once the risk reduction plan was in place, all hazardous situations were considered under control. The corrective actions led to a reorganization of human resources, the update of protection protocols, and optimization of ergonomic work tools. Staff-specific medical monitoring and regular surface contamination tests have been scheduled annually. In addition, initial and continuous training, specific to product and waste risks, has been updated.Conclusion:The global professional risk assessment related to centralized antineoplastic agent preparation unit generated failure in our system and enabled corrective actions for staff safety.

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