Department of Pharmacy, Mount Auburn Hospital, Cambridge MA.
Am J Health Syst Pharm. 2020 Dec 4;77(24):2081-2088. doi: 10.1093/ajhp/zxaa320.
Healthcare facilities are obligated to implement strategies to protect healthcare workers from exposure to hazardous drugs, including any real or potential risk from contaminated surfaces. Guidelines are broad and lack sufficient detail for healthcare facilities to establish clear effectiveness targets for their decontamination procedures. Our goal in this analysis was to measure the effectiveness of a decontamination procedure in a pharmacy buffer room contaminated with 5 antineoplastic drugs.
Six rounds of contamination, decontamination, and wipe sampling were performed in a pharmacy buffer room designated for hazardous drug (HD) compounding. Ten locations in the buffer room were contaminated with 5-fluorouracil, carboplatin, cyclophosphamide, paclitaxel, and doxorubicin. Pharmacy staff were blinded to contamination sites. After contamination, 3 pharmacy technicians following the same decontamination procedure decontaminated the buffer room. To assess the impact of decontamination, residual hazardous drug levels were assessed after contamination and after decontamination using a commercially available wipe sampling product.
The mean (SD) residual contamination levels for the 239 wipe samples taken before and after decontamination were 63 (60) ng and 3.9 (8.2) ng, respectively, representing a 94% reduction in residual HD contamination. Residual contamination was not detectable (<5 ng) in 221 (~93%) of the samples after decontamination.
The employed decontamination procedures effectively reduced residual HD surface contamination.
医疗机构有义务实施策略，保护医护人员免受危险药物的暴露，包括受污染表面的任何实际或潜在风险。指南广泛而缺乏足够的细节，医疗机构无法为其消毒程序确立明确的有效性目标。我们在这项分析中的目标是测量在一个被 5 种抗肿瘤药物污染的药房缓冲区中消毒程序的有效性。
在指定用于危险药物（HD）配制的药房缓冲区中进行了 6 轮污染、消毒和擦拭取样。在缓冲区的 10 个位置污染了氟尿嘧啶、卡铂、环磷酰胺、紫杉醇和多柔比星。药房工作人员对污染地点不知情。污染后，3 名遵循相同消毒程序的药剂师对缓冲区进行了消毒。为了评估消毒的效果，在污染后和消毒后使用市售的擦拭取样产品评估残留危险药物水平。
消毒前后 239 个擦拭样本的平均（SD）残留污染水平分别为 63（60）ng 和 3.9（8.2）ng，分别代表残留 HD 污染减少了 94%。消毒后 221 个（约 93%）样本中的残留污染无法检测到（<5 ng）。
所采用的消毒程序有效地降低了残留 HD 表面污染。
