Design of a self-assessment questionnaire on safe handling practices for hazardous drugs in Quebec

C. Delafoy1, J-F. Bussières1, 2, C. Tanguay1
1 Unité de Recherche en Pratique Pharmaceutique, Département de pharmacie, Centre hospitalier universitaire Sainte-Justine, Montréal, Québec, Canada;
2 Faculté de pharmacie, Université de Montréal, Montréal, Québec, Canada.


Context
The safe handling of hazardous drugs Prevention Guide from the Quebec health and safety association ASSTSAS was updated in 2021.

Objective
To describe the process for designing a self-assessment questionnaire on safe handling practices for hazardous drugs.

Methods
The ASSTSAS Guide is composed of 202 pages and 9 chapters each addressing a distinct theme. A selection of criteria was made to obtain a realistic tool to use. A member of the Safe Handling of Hazardous Drugs Committee selected the criteria and seven members commented this selection. The criteria had to be assessable and representative of the recommendations. The original wording of the Guide has been maintained. The Research Electronic Data Capture (REDCap) platform was chosen to create the online questionnaire.

Results
Approximately a hundred working hours were required for the selection of criteria. The final selection included 440 criteria, divided in six themes, namely general measures (n=50), pharmacy (n=118), care units (n=180), hygiene and salubrity (n=64), laundry facilities (n=10) and spill and accidental exposure (n=18).
REDCap was used through an institutional license and the annual costs remained limited. About fifty hours were required for the design and coding of the REDCap questionnaire. Criteria were coded on a dichotomous scale (ie, Compliant, Non-Compliant, or Not Applicable). A criterion was to be rated non-compliant if the care facility determined that there were opportunities for improvement; the dynamic questionnaire displayed a box inviting users to describe the corrective actions to be taken for any non-compliant criterion. Access to the platform was made via a single secure link. As of June 17, 2021, 48 Quebec care facilities participated in the self-assessment. Centers were invited to respond in collaboration with all stakeholders involved, including pharmacy, nursing, hygiene and salubrity, occupational health and safety, and laundry. Centers will have the opportunity to compare their compliance with that of all participating establishments when 30 responses have been obtained.

Discussion/conclusion
The tool developed will be used in 2021-2022 by members of the community of practice on hazardous drugs in Quebec. Participating centers will have the opportunity to repeat the self-assessment exercise and update their compliance in real time. The results will allow the centers to document their practices, to make a to do list of improvements and to compare themselves with other centers.

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