Background and importance According to the European Commission, every year more than 20 million workers in Europe are exposed to carcinogenic, mutagenic, reprotoxic hazardous drugs, including cytotoxic drugs.
Aim and objectives To review the safety of handling hazardous drugs in our paediatric referral hospital, according to the national guidelines included in the ‘technical document on hazardous medicines, preventive measures for their preparation and administration’(TDHM), published on 2016 by the Spanish National Institute for Safety and Hygiene at Work.
Material and methods Medicines included in our pharmacy formulary labelled as hazardous were identified, listed and classified into three groups according to the proposed model of the National Institute for Occupational Safety and Health (NIOSH). We categorised each group in two according to the route of administration (parenteral/oral). Those administrated orally were divided according to their need for reconstitution or manipulation before administration. Also, we noted if drugs were currently prepared in the pharmacy department (PD).
Results (Figure 1).
Conclusion and relevance After analysing our hazardous medicines handling protocols, we found that there is still room for improvement. We describe the actions planned for each drug group:
Requesting compounded intravenous products to be stored in vials instead of ampoules would allow preparing them using enclosed systems.
Regarding the five parenteral route group (three hazardous medicines currently prepared by nurses), three could be prepared in the PD and, for the remainder, an accurate handling protocol could be developed to ensure utilisation of the enclosed systems for their preparation.
Regarding the five oral route group (three hazardous medicines), reconstitution is required for three, which can be done in the PD. The other two are sold in sachets, so we plan to develop a handling protocol.
Directly proposed to prepare them in the PD.
Finally, we encourage implementing safe handling recommendations to achieve the goal of a safety plan for workers.
References and/or acknowledgements We acknowledge all pharmacy and nursing staff.
No conflict of interest.
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