3PC-016 Implementation of new recommendations for handling hazardous drugs

Background Some drugs can be considered hazardous because of their potential to cause irreversible effects. Purpose To describe the actions carried out in a pharmacy service after the publication of Spanish National Institute of Occupational Health and Safety (INSHT) recommendations about hazardous drugs (HD). Material and methods A list with the HD included in the pharmacotherapeutic guide was drawn up. HD were classified according to the requirements when handling them and actions about their storage, repackaging, preparation and dispensation needed. The pharmacotherapeutic guide and the guidelines for nasogastric drug administration were updated. The actions carried out were communicated to the Hospital’s management team and nursing staff. Results Of the 321 pharmaceutical forms included in the INSHT list, 134 were excluded (not included in the pharmacotherapeutic guide) and four were withdrawn from the guide because of the low level of consumption. The 183 drugs included were classified as: 101 from group 1, 44 from group 2 and 38 from group 3. The HD were classified according to the actions carried out in six groups: 64 parenteral antineoplastic drugs which are prepared in a class IIb Biological Safety Cabinet (IIb–BSC). 40 oral antineoplastic drugs for which the pharmacotherapeutic guide and the guidelines for nasogastric drug administration were modified to avoid splitting or crushing. Nursing staff should contact the pharmacy service to assess that the treatment is temporarily stopped, administered via another route or split in a IIb–BSC. 15 drugs that do not require any manipulation to compound them (pre–filled syringes, ointments, vaginal tablets and oral solutions). 47 oral drugs (groups 2 and 3) for which the pharmacotherapeutic guide and the guidelines for nasogastric drug administration were modified to avoid splitting or crushing. 10 drugs that must be reconstituted in a IIb–BSC. 7 parenteral drugs with recommendations only if the handler is at reproductive risk. Furthermore, the repackaging process of five drugs and the Standard Operating Procedures of five compounded medications were modified to be carried out inside the IIb-BSC. Conclusion The actions adopted have supposed a decrease in the risk of occupational exposure in nursing staff, minimising the handling of HD with a consequent increase in safety. These modifications have led to an increase in the workload of the pharmacy service. References and/or Acknowledgements INSHT recommendations about Hazardous Drugs. 2017. No conflict of interest