Issue of waste generated by chemotherapy at home - evaluation of the anti-flow device

Introduction

Good manufacturing practice encourages considering risks of chemical contamination in the cytotoxic circuit. At Dieppe Hospital Center, pharmacy provides diffusers of Fluorouracil (5FU) for home administration. We observed a significant number of non-compliance with cytotoxic waste disposal rules, linked to the lack of knowledge of chemical risk. The recent commercialization of a secure, anti-flow device could improve the disposal safety of diffusers. Our objective is to evaluate this device.

Materials and methods

This device prevents any flow in the environment when connecting / disconnecting and transporting the diffuser. We have trained hospital staff to its use and sent an information letter to the city nurses. After 4 months of trials, we carried out the evaluation by survey. Criteria for judgment included ease of use, preparation time, and safety gain.

Results

During this test period, we equipped 190 diffusers, for 43 patients, which involved 28 liberal nurses and 4 oncology nurses. The response rate of the preparers was 100%, that of the nurses of 32%. For each one, the device is easy to use but not very intuitive and requires prior training. The preparers consider that the loss of time is acceptable if the device proves to be useful at the end of the circuit. Nurses consider the device useful and are in favor of its development.

Conclusion

Considering the satisfactory results, we decided to maintain the use of this device for 5FU diffusers. In the future, this device could be of interest for any infusion of drug at risk, but its cost represents for the moment a limit.