Background and importance Current recommendations from the National Institute for Occupational Safety and Health (NIOSH) require hospitals to ensure the safety of hospital workers when handling hazardous drugs (HD).
Aim and objectives To design a circuit to prepare and condition oral HD in a pharmacy service (PS).
Material and methods The HD included in the hospital documented by the NIOSH were selected, as well as those that due to their structure, mechanism of action and toxicity were similar to some HD or that some dangerous characteristic reflected in their data sheet.
Using Farmatools (electronic PS prescription) and electronic medical record programmes, the HD were identified by adding HD or HD-RR (if reproductive risk) to their description, and recommendations for their preparation and administration were incorporated in the file for each HD (this information was integrated into the nursing pharmacological activity sheet where they register the medication administered to patients).
Labels were designed to identify HD boxes in the PS.
The following ‘observations on the dispensation’ were defined and included in Farmatools:
Solid drugs: repackaged in blister, fractionated and repackaged in blister, dosed in capsule and repackaged in blister. Solid drugs administered by tube or for patients with swallowing problems: tablet packaged in syringe, crushed tablet and repackaged in syringe, powder repackaged in syringe, dosed and powder repackaged in syringe.
Liquid drugs: solution/suspension repackaged in syringe.
A guide was prepared for the administration by tube or for patients with swallowing problems (possibility of disintegrating or diluting in water, volume and time required, need to crush, etc).
Results Identification and recommendations from the computer programmes have allowed the location of the HD treatments in the PS to dispense them prepared, and nurses can differentiate them when necessary. With the pharmaceutical validation of the prescription, the most appropriate pharmaceutical forms were adapted and the corresponding observation was selected for each prescribed HD. Generating a ‘treatment location list according to observations’, which facilitates Farmatools, has allowed PS personnel to determine the relationship, pharmaceutical form and conditioning of the prescribed HD that have to be prepared.
Conclusion and relevance Changes in computer programmes have allowed the design of a circuit to prepare and condition oral HD and improve the safety of hospital workers.
References and/or acknowledgements No conflict of interest.
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