Maintain the Focus on Hazardous Drugs

October 2018 - Vol.15 No. 10 - Page #1
Hazardous drug (HD) contamination is a risk in health care settings, and wipe testing has certainly demonstrated the magnitude of this problem. Thus, the goal of USP General Chapter <800> Hazardous Drugs – Handling in Healthcare Settings is to develop effective handling strategies and ensure they are consistently employed. Testing the environment via wipe sampling serves to confirm the effectiveness of your practice.

However, while the regulation begins and ends in the hospital, the risk for HD exposure does not. When HDs arrive at the hospital, contamination may already be present on the packaging. Ideally, HDs would arrive with a contamination-free guarantee; instead, the burden of safe handling falls to the pharmacy.

One method some facilities have taken to mitigate the risk posed by contaminated products in receiving areas is to set up two separate accounts with their wholesaler: One for non-hazardous drugs and one for HDs. All purchase orders for HDs are submitted through this designated account and are then shipped separately from non-HDs. By naming the HD account “Oncology Pharmacy,” those HDs will arrive at the facility clearly marked as such, and receiving staff can be trained to identify and handle these products in a specific and safe way. This segregation will help minimize cross contamination of products and simplify handling issues at the dock and during unpacking.

Nonetheless, keep in mind that this strategy is simply a workaround; it does not provide complete protection. A comprehensive program of safe handling is necessary throughout the facility. In this month’s issue, safe-handling expert Fred Massoomi details a systematic approach to spill management (see page 8), and this month’s supplement—Cleanrooms & Compounding—explores the proposed changes to USP General Chapter <797> with Patti Kienle, a leading authority on medication compounding safety. In addition, Tom Connor, renowned expert on hazardous drugs, delves deeper into the evaluation of closed system drug-transfer devices (CSTDs).

We urge all pharmacy leaders to remain proactive when it comes to the handling, use, and disposal of hazardous products. It is clear that prolonged exposure to HDs by health care workers can be hazardous to their health and this is anathema to the fundamental mission of medical care. We hope you will continue to look to Pharmacy Purchasing & Products as a voice for your questions and a source for the answers.

All the best,

R. Mitchell Halvorsen


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