Anticancer drug preparations: conformity of volume taken what size syringue?

M.Tissot1, A.Bendjama1, AL.Clairet1, M.Mairey1, H.Mockly-Postal1, S.Perrin-Bonnot1, C.Fagnoni-Legat1 et M.Kroemer1
1 : Pôle Pharmacie, CHU Jean Minjoz, 3 bd Fleming, 25030 Besançon

Introduction
The centralized reconstitution unit of university hospital of Besançon produces approximately 46,000 injectable anticancer preparations per year. The objective of this work was to assess the type of syringe used according to the volume of anticancer drug to take during their preparation.

Materials et method
An evaluation of professional practices in the form of an observational audit was conducted prospectively over a period of five mornings of production. Two auditors noted the volumes collected as well as the syringes used for the solvent samples required for powder reconstitution and for the levies of anticancer drug. A volume taken less than 30% of the total capacity of the syringe was difined not compliant. Indeed, below 30% of the capacity of the syringe, the volume cannot be taken with an acceptable error1, 2.

Results
Six different volume syringes (from 1 to 60 mL) were used for injectable anticancer preparations. Eight pharmacy technicians were observed during the study period and 591 samples were audited. The compliance rate was 95.4%. Lost of non-compliances were observed for samples of less than 20 mL prepared with 60 mL syringe. About 30% of non-compliances observed were low-volume samples intended for therapeutic lumbar punctures.

Discussion-Conclusion
This work allows identifying situations in which the volume taken was less than 30% of the capacity of the syringe. Some situations could be corrected and led to drafting a procedure for the good use of syringes. Situations corresponding to the volume samples intended for therapeutic lumbar punctures could not be corrected because syringes smaller than 1 mL are not commercially available.

1 De Giorgi Isabella et al. Justesse et précision des prélèvements de faibles volumes à l’aide de seringues. 2006
2 EN ISO 7886-1 :1997

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