Patterns and characteristics associated with the surface contamination of hazardous drugs in hospital pharmacies

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  • February 26, 2019
Creator
  • Salch, Stephanie
    • Affiliation: Eshelman School of Pharmacy
Abstract
  • Purpose: To summarize the surface contamination levels of five commonly used hazardous drugs in hospital pharmacies, identifying practice patterns associated with contamination. Methods: Contamination testing data was compiled to evaluate surface contaminants of five hazardous drugs (docetaxel, paclitaxel, cyclophosphamide, ifosfamide, and 5-fluorourcil). Data from 799 wipe events over 6 years was collected from 338 hospital pharmacies. The contamination level for each drug was categorized as non-detectable (ND; ≤ 10 ng/ft2), low (between 10 and ≤ 100ng/ft2), medium (between 100 and ≤ 1,000ng/ft2) or high (> 1,000ng/ft2). Surface exposures for each drug were summarized based on location, contamination at first and subsequent wipe events, and the use of a closed system transfer device (CSTD). Results: The majority of contamination results corresponded to locations at or near hazardous drug preparation, but also occurred in areas were hazardous drug was not prepared. There was a higher incidence of contamination levels (high, medium, and low, respectively) at first wipe event (10.2%, 17.4%, and 17.7%) compared to subsequent wipe events (5.8%, 12.2%, and 13.6%) (P<0.0001). There was a lower incidence of contamination levels at institutions that used CSTDs (6.3%, 12.8%, and 14.4%) compared to institutions that did not use CSTDs (14.2%, 17.9%, and 17.3%) (P<0.0001).Conclusions: The majority of highest contamination levels corresponded to locations where hazardous drugs were prepared. While the incidence of contamination was lower at subsequent wipe events and at institutions that used CSTDs, contamination was not completely eliminated in either scenario, suggesting that routine contamination testing is beneficial in recognizing and correcting practices that lead to surface exposures.
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Rights statement
  • In Copyright
Advisor
  • Eckel, Stephen
Degree
  • Doctor of Pharmacy
Academic concentration
  • Pharmacy
Honors level
  • Honors
Degree granting institution
  • University of North Carolina at Chapel Hill
Graduation year
  • 2018
Language
  • English

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