Development and Implementation of a Regional Program for the Safe Handling of Hazardous Drugs by Hospital Pharmacies
Notice bibliographique
Résumé
Providing a safe work environment is an important goal for any hospital pharmacy department. Historically, great care has been exercised in the receipt, storage, preparation, distribution, administration, and disposal of cytotoxic drugs. Although other drugs have been acknowledged as potentially hazardous, most facilities do not have processes to identify and ensure their safe and consistent handling. Existing medication and chemical safety programs have limitations in their applicability to hospital pharmacy practice. For example, the Workplace Hazardous Material Information System excludes prescription drugs. The US National Institute for Occupational Safety and Health (NIOSH) recommends full handling precautions for all hazardous drugs. However, in a busy, diverse hospital pharmacy practice, application of such procedures may be impractical. The Canadian Society of Hospital Pharmacists (CSHP), in its “Hazardous Pharmaceuticals (Including Cytotoxic Drugs): Guidelines for Handling and Disposal”, provides information about general issues related to handling hazardous products, but greater detail (for example, a list of specific drugs considered hazardous) was required to develop procedures for use by front-line staff. The Winnipeg Regional Health Authority (WRHA) is a publicly funded organization that delivers acute, long-term, and community health services in Winnipeg, Manitoba (population catchment 800 000). The WRHA Pharmacy Program has a staff of approximately 150 full-time equivalent pharmacists and 150 full-time equivalent pharmacy technicians. Staff members of the WRHA Pharmacy Program deliver and manage pharmacy care at 8 facilities totalling about 2000 beds and provide selected pharmacy services for WRHA-affiliated clinics, personal care homes, and community health agencies. The WRHA has a single formulary for all acute care facilities. This article describes the development and implementation of the Safe Handling of Hazardous Drugs Program within the WRHA Pharmacy Program. The purpose of this project was to develop practical guidelines for the safe handling of all potentially hazardous drugs. In 2007, the WRHA introduced a new policy for handling parenteral cytotoxic drugs, which was applicable to all regional staff. However, information was lacking about the safe handling of cytotoxic drugs administered by other routes and handling of potentially hazardous non-cytotoxic drugs; therefore, the WRHA Pharmacy Program struck a Hazardous Drugs Task Force. The regional Nursing Leadership Council was invited to participate in this task force, to help in developing safe handling processes for hazardous drugs that would also be applicable to nursing staff, but the Council chose not to participate; instead, they focused on implementation and education related to the new policy for cytotoxic drugs. Therefore, the task force worked on processes for the safe handling of hazardous drugs within the pharmacy, with the understanding that other health care disciplines would be included later, at a time of their choosing.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».