Exposure to hazardous drugs in Healthcare: An issue that will not go away

Davis, Jill; McLauchlan, Robert; Connor, Thomas H.

doi:10.1177/1078155210388462

Cited by 34 publications

(27 citation statements)

References 8 publications

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“…Other means of penetration into the body can be regarded as incidental events, such as eye contamination by spurts, or hand-to-mouth contact causing absorption of ANPD via the gastrointestinal tract (Turci et al 2003;Turci and Minoia 2006). The chemical and physical properties of the drug, the quantity administered, the availability of personal protection devices and/or collective protective equipment, and the worker's skill all contribute to determining the level of ANPD contamination (Davis et al 2011).…”

Section: Introductionmentioning

confidence: 99%

Micronuclei and chromosome aberrations in subjects occupationally exposed to antineoplastic drugs: a multicentric approach

Moretti

Grollino

Pavanello

et al. 2014

Int Arch Occup Environ Health

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Section: Introductionmentioning

confidence: 99%

Micronuclei and chromosome aberrations in subjects occupationally exposed to antineoplastic drugs: a multicentric approach

Moretti

Grollino

Pavanello

et al. 2014

Int Arch Occup Environ Health

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“…However, and despite the investment made in personal protective equipment, biological safety cabinets and workers training, occupational exposure of health care workers is still being reported (Fransman et al 2007;Hedmer et al 2008;. It may be impossible to eliminate all risk; however, it is imperious to reduce risk to the lowest level (Davis et al 2011).…”

Section: Introductionmentioning

confidence: 99%

Antineoplastic drugs contamination of workplace surfaces in two Portuguese hospitals

Viegas

Pádua

Veiga

et al. 2014

Environ Monit Assess

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Despite the classification as known or suspected human carcinogens, by the International Agency for Research on Cancer, the antineoplastic drugs are extensively used in cancer treatment due to their specificity and efficacy. As human carcinogens, these drugs represent a serious threat to the healthcare workers involved in their preparation and administration. This work aims to contribute to better characterize the occupational exposure of healthcare professionals to antineoplastic drugs, by assessing workplace surfaces contamination of pharmacy and administration units of two Portuguese hospitals. Surface contamination was assessed by the determination of cyclophosphamide, 5-fluorouracil, and paclitaxel. These three drugs were used as surrogate markers for surfaces contamination by cytotoxic drugs. Wipe samples were taken and analyzed by HPLC-DAD. From the total of 327 analyzed samples, in 121 (37 %) was possible to detect and quantify at least one drug. Additionally, 28 samples (8.6 %) indicate contamination by more than one antineoplastic drug, mainly in the administration unit, in both hospitals. Considering the findings in both hospitals, specific measures should be taken, particularly those related with the promotion of good practices and safety procedures and also routine monitoring of surfaces contamination in order to guarantee the appliance of safety measures.

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“…[1][2][3][4] In addition to patient safety concerns, antineoplastic preparation and administration create significant staff risks. [5][6][7][8][9] The medication use system includes several stages that are vulnerable to opportunities for potentially harmful medication errors (MEs), such as incorrect drug, dose, concentration, or storage. 10 Recent efforts to improve medication safety have predominantly addressed the ordering, transcription, and administration stages of the system.…”

Section: Introductionmentioning

confidence: 99%

Impact of Robotic Antineoplastic Preparation on Safety, Workflow, and Costs

Seger

Churchill

Keohane

et al. 2012

JOP

103

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Purpose: Antineoplastic preparation presents unique safety concerns and consumes significant pharmacy staff time and costs. Robotic antineoplastic and adjuvant medication compounding may provide incremental safety and efficiency advantages compared with standard pharmacy practices. Methods:We conducted a direct observation trial in an academic medical center pharmacy to compare the effects of usual/ manual antineoplastic and adjuvant drug preparation (baseline period) with robotic preparation (intervention period). The primary outcomes were serious medication errors and staff safety events with the potential for harm of patients and staff, respectively. Secondary outcomes included medication accuracy determined by gravimetric techniques, medication preparation time, and the costs of both ancillary materials used during drug preparation and personnel time.Results: Among 1,421 and 972 observed medication preparations, we found nine (0.7%) and seven (0.7%) serious medication errors (P ϭ .8) and 73 (5.1%) and 28 (2.9%) staff safety events (P ϭ .007) in the baseline and intervention periods, respectively. Drugs failed accuracy measurements in 12.5% (23 of 184) and 0.9% (one of 110) of preparations in the baseline and intervention periods, respectively (P Ͻ .001). Mean drug preparation time increased by 47% when using the robot (P ϭ .009). Labor costs were similar in both study periods, although the ancillary material costs decreased by 56% in the intervention period (P Ͻ .001). Conclusion:Although robotically prepared antineoplastic and adjuvant medications did not reduce serious medication errors, both staff safety and accuracy of medication preparation were improved significantly. Future studies are necessary to address the overall cost effectiveness of these robotic implementations.

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Exposure to hazardous drugs in Healthcare: An issue that will not go away

Cited by 34 publications

References 8 publications

Micronuclei and chromosome aberrations in subjects occupationally exposed to antineoplastic drugs: a multicentric approach

Micronuclei and chromosome aberrations in subjects occupationally exposed to antineoplastic drugs: a multicentric approach

Antineoplastic drugs contamination of workplace surfaces in two Portuguese hospitals

Impact of Robotic Antineoplastic Preparation on Safety, Workflow, and Costs

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