Massoomi Firouzan Fred, Neff Bill, Pick Amy, Danekas Paula
Department of Pharmacy Services, Nebraska Methodist Hospital, Omaha, NE 68141, USA.
Am J Health Syst Pharm. 2008 May 1;65(9):861-5. doi: 10.2146/ajhp070443.
The implementation of a safety program for handling hazardous drugs in a community hospital is described.
A committee of representatives of the departments of pharmacy, nursing, human resources, safety, radiology, performance improvement, employee health, and environmental services and members of the hospital administration was formed to formally address the management of hazardous drugs in a community, not-for-profit, adult hospital in Omaha, Nebraska. Published guidelines and regulations were reviewed to determine the hospital's compliance with the handling of hazardous drugs. A knowledge deficit regarding the risk and severity of occupational exposure to hazardous drugs was identified. A formal education plan was immediately implemented providing inservice education to all staff who may come into contact with hazardous drugs. Each drug was electronically tagged in the hospital computer system. The nitrile gloves used in the pharmacy were switched to a brand tested for resistance to chemotherapy drug permeation. The use of personal protective equipment for all health care workers who may come into contact with hazardous drugs was also instituted. Waste stream management was addressed, and a new waste stream was identifed and implemented to address chemicals regulated by the Resource Conservation Recovery Act. Nursing, pharmacy, and housekeeping personnel were extensively educated on the different waste streams and the importance of segregating waste at the point of use. All gloves for housekeeping and laundry service staff were replaced with hazardous-drug-rated nitrile gloves.
A gap analysis allowed a multidisciplinary team to establish a safety program for managing hazardous drugs in a community hospital.
描述在一家社区医院实施的危险药物处理安全计划。
成立了一个由药学、护理、人力资源、安全、放射学、绩效改进、员工健康和环境服务部门的代表以及医院行政管理人员组成的委员会，以正式解决内布拉斯加州奥马哈市一家社区非营利性成人医院中危险药物的管理问题。审查了已发布的指南和法规，以确定医院在危险药物处理方面的合规情况。发现了有关职业接触危险药物的风险和严重性方面的知识欠缺。立即实施了一项正式的教育计划，为所有可能接触危险药物的工作人员提供在职教育。每种药物在医院计算机系统中进行了电子标记。药房使用的腈手套换成了经过化疗药物渗透抗性测试的品牌。还规定了所有可能接触危险药物的医护人员使用个人防护设备。解决了废物流管理问题，并确定并实施了一种新的废物流，以处理《资源保护与回收法》规定的化学品。对护理、药学和家政人员进行了广泛的不同废物流教育以及在使用点进行垃圾分类的重要性教育。家政和洗衣服务人员的所有手套都换成了具有危险药物防护等级的腈手套。
差距分析使一个多学科团队能够在一家社区医院建立一个管理危险药物的安全计划。
