ABSTRACT
Objective: The importance of occupational exposure control in cancer therapy is widely recognized, and measurement of anti-cancer drug exposure during preparation, as well as comprehensive measures, including administrative control, patients’ excrements, and environmental pollution, among others, are becoming important. The Osaka Women’s and Children’s Hospital introduced the closed system drug transfer device (CSTD) for administering anticancer drugs, and conducted consistent exposure measures from preparation to disposal. We simultaneously conducted an awareness survey on anti-cancer drug exposure measures for health care workers,observed the changes in their awareness and behavior, and examined the issues that constantly challenge anti-cancer drug exposure measures.Method: We surveyed doctors, nurses, and pharmacists who handle anticancer drugs belonging to the Osaka Women’s and Children’s Hospital from March 2018 to October 2018. The questionnaire was anonymous and was collected within one week after distribution. In the questionnaire survey, we obtained permission to present the contents on paper and orally.Results: The questionnaire response rate was approximately 70%. Following the training and introduction sessions, the participants had an improved understanding of Hazardous Drugs and CSTD. The introduction of the workshops on anti-cancer drug exposure measures and CSTD encouraged the nurses to reflect on the exposure measures and revisit the manuals on in-hospital treatment with anti-cancer drugs; however, there was little or no change in the behavior of the pharmacists.Discussion: Since nurses work primarily in the field of patient care, their awareness of anti-cancer drugs has gradually declined, and it was observed that procedures for exposure control were not being followed. In order to ensure that anti-cancer drug exposure measures are properly observed, pharmacists need to take initiatives and conduct in-hospital workshops once every six months. It is also necessary to educate the medical staff about electronic devices in order to ensure their easy participation in workshops and encourage e-learning.
ABSTRACT
OBJECTIVE：To understand the situation of healthcar e workers’occupational exposure of hazardous drugs （chemotherapeutic drugs and antiviral drug ）and relative cognition level ，and to provide reference for improving the level of occupational protection. METHODS ：During Oct. 2018 to Mar. 2019，healthcare workers from 12 hospitals of different levels and different departments in Shaanxi province were selected as respondents to conduct a self-designed questionnaire survey. Information we surveyed contained baseline characteristics ，hazardous drugs exposure ，physical health status ，and occupational protection. Valid questionnaires were collected and analyzed statistically. RESULTS ：A totally of 1 848 questionnaires were sent out ，and 1 767 questionnaires were collected ，including 95 were pharmacists ，100 were physicians ，and 1 572 were nurses. The frequency of diarrhea and menstrual disorders in healthcare workers with long-term exposure to antiviral drugs （antiviral drug exposure group ） and cross-exposure to antiviral drugs and chemotherapeutic drugs （cross-exposure group ）were significantly higher than unexposed group （P＜0.05）. The incidence of routine blood abnormalities in cross-exposure group ，antiviral drug exposure group and healthcare workers with long-term exposure to chemotherapy drugs （chemotherapy drug exposure group ） was higher than unexposed group by 9.13％，5.50％ and 12.34％，respectively. 84.7％ of the respondents had little knowledge of hazardous drugs ， and 8.15％ of the respondents had never received occupational protection training. Additionally ，the ratio of healthcare workers receiving occupational protection training in the cross-exposure group was significantly higher than unexposed group （P＜0.05）， and the ratio of healthcare workers receiving occupational protection training in antiviral drug exposure group were significantly lower than unexposed group （P＜0.05）. CONCLUSIONS ：Long-term exposure to hazardous drugs will cause certain occupational hazards to healthcare workers. It is necessary to improve healthcare workers ’awareness of self-protection ，increase the input of hospitals in occupational protection training and establish occupational protection standards in order to improve the current situation of occupational protection of healthcare workers.
ABSTRACT
OBJECTIVE:To strengthen the management and risk control of 4 kinds of special drugs in pharmacy intravenous admixture service(PIVAS),and promote the drug use safety. METHODS:The 4 kinds of special drugs(high-alert drugs,hazard-ous drugs,important drugs/costly drugs and drugs needed for skin allergy test)in PIVAS were precisely managed by classification. The effect evaluation was carried out by tracer methodology. RESULTS:The 4 kinds of drugs were classified and managed by de-veloping specified directory,mading special logo,fixing position storage,strengthening medical order review,establishing emer-gency plan,daily inventory,batch number management,etc. It had standardized the management and use process of high-alert drugs,ensured the operational safety for hazardous drug and occupational protection,made the compliance rate reached 100% of important drugs/costly drugs,and ensured the consistency of preparation and use batch number of drug for skin allergy test basical-ly. Compared with before management(2015),the items ratio achieving good level(class B)and above in 18 evaluation indicators had increased from 22.23% to 94.44% after management (2016). CONCLUSIONS:The precise management by classification in PIVAS of our hospital has better controlled the management and risk of 4 kinds of special drugs in clinical use,and ensured the safe operation of PIVAS.