In the study Improving the Safety of Ambulatory Intravenous Chemotherapy in Canada, a serious safety concern emerged relating to the organization of materials and work processes during pharmacy admixture. The study report included a recommendation that only one mix at a time enter the biological safety cabinet (BSC). The response to this recommendation from the pharmacy community in Canada has been positive and there is an interest in implementing this change across the country. However, there has been a concern that this approach to mixing will increase preparation times and that additional staffing may be required. This potential impact had not yet been validated or quantified.
Objectives for this project were to:
At two community sites, current practices were observed and analyzed. Staff then performed pre-determined mixes of real chemotherapy regimens for simulated patients, while their actions and timing were documented. HumanEra then worked with local staff to make workflow changes, and after a month, returned for more observations and a repetition of the mixing simulation.
Results showed that when sites performed one mix at a time, their practice was at least as efficient, or more efficient. The study also helped better define the concept of “one mix at a time” and identified some additional safety improvements that could be made to practice in oncology pharmacies.
CancerCare Manitoba Foundation
White, R. (2012, Oct). Improving chemotherapy preparation safety through process changes: Workload and workflow implications. Presented at the National Oncology Pharmacy Symposium 2012, Saskatoon, Saskatchewan.