The technician’s point of view on the use of robots for the preparation of cytotoxics

F. Pichon, R. Oubaïda, L. Derai, V. Chancelade, S. Dieng, A. Ahalli, E. Barbagelata and the entire team of technicians
Curie Institute, service Pharmacie,
26 rue d’Ulm 75248 Paris cedex 05

Since 2010, the Curie Institute has been performing dose banding for 6 cytotoxic molecules. Until the end of 2010, the dose banding process was done manually. In order to improve production, a manufacturing automated system to manufacture cytotoxics was devised in collaboration with the pharmacists, technicians and the technical team. Since its delivery to the unit in September 2010, 5 technicians act as referral agents for automation. The objective of this work is to show the technicians’ perception of this new activity.
To do so, a survey was conducted with the team of technicians on automation of dose banding using 2 types of questionnaires: one for the referral agents using the automated system and another for non-referral agents whether working in the unit or not.
Analysis of the questionnaire was based on 3 parts: the technician’s impressions faced with the arrival of this new machine, changes in organisation that this involved and also an evaluation of quality and safety.

1) Technicians’ impressions

Overall, the arrival of the automated system was seen in a positive light (a single negative response). Almost the entire team had already seen the automated system work and wanted to work with the machine on an occasional basis.
In answer to the question as to whether the automated system had improved their working conditions, 60% thought that this was the case at least “a little” while 30% thought it had improved things “a lot” Nevertheless, all the technicians agreed that the automated system eased their work on a daily basis and that it was now an indispensable tool for the Cytotoxic Preparation Unit, though without considering that it replaced the technician.
It was observed that all the referral agents having worked on the automated system were satisfied with their work. They felt less under stress than when handling directly.
Questions were also put as to fatigue and physical discomfort. All those questioned felt some fatigue at the end of the day spent on the automated system as there are still some unavoidable manual tasks (fitting infusion sets, fitting air connectors) and relatively intense activity (on average 60 bags a day). However, compared with a day of manual handling, the technicians felt less tired.

2) Organisation

Every day, a number of campaigns were planned to complete the dose banding stock. For each daily session, just one technician works on the automated system. According to the survey, all referral technicians managed to complete all the planned campaigns. Nevertheless, they all had to be given help at some time in the day. As a result, all those concerned wished for 2 technicians to be assigned constantly to the automated system.

3) Quality and safety

Initially, all the technicians felt safe when using the machine. They also thought they managed their work tool better. For 75% of the referral agents, producing a bag using the automated system was a guarantee of safety as compared with a manually manufactured bag. This percentage can be explained by the fact that there are systematic weighing checks as well as recognition of the product during the automated manufacturing process.

To conclude, the technicians made the automated system their own, seeing it as an essential element in the way the unit worked and providing an additional qualification in daily work.

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