Cytotoxic drugs on the loose: alert, prevention, action!

Introduction
The handling of cytotoxic drugs is a risk to healthcare professionals, particularly pharmacists and nurses who are on the front line of their handling.

Objective
To assess healthcare workers’ knowledge about the risk of contamination by cytotoxic drugs and reduce the risk for healthcare workers using various training materials.

Method
An anonymous theoretical and practical survey was created to evaluate healthcare professionals’ knowledge about the use of surface decontamination kit and how to manage an accident involving cytotoxic contamination. In order to improve caregivers’ knowledge, various resources were developed to help professionals handle spills: training on the cytotoxic spill kit used by the hospital was implemented with an updated procedure; a video simulating the management of a spill was created; and a prevention leaflet was created for nursing staff involved in the administration of cytotoxic drugs.

Results
An anonymous survey with 10 questions was created. The survey was completed by 26 healthcare professionals, including 6 (23%) pharmacy technicians and 7 (27%) nurses and managers. Seventeen (65%) healthcare professionals stated that they did not know how to use the decontamination kit and 11 (42%) did not know where to find the corresponding procedure. Ten (38%) knew how to act in the case of a skin contamination and 7 (27%) knew how long to rinse the eyes in case of an eye contamination.
Training on the use of the decontamination kit was provided by a representative from the laboratory. Two one-hour sessions were organized, to which all professionals involved in the handling of cytotoxic drugs were invited. Twenty-nine professionals were able to participate.
The simulation video was produced by three pharmacy technicians and a pharmacy resident. In this video, one technician simulates a spill of a bag of cytotoxic drug and the second assists him with the hospital’s spill kit, following the steps of the procedure.
The prevention leaflet contains a reminder of the chemotherapy circuit in the hospital, the equipment to be worn during administration, and the first steps to follow in case of a spill in the department. This leaflet is intended for all departments that administer chemotherapy, especially those that do so infrequently.

Conclusion
Not all teams were familiar with the procedure to follow in case of a surface contamination due to a spill. A follow-up study will be conducted to assess the improvement in knowledge using a new survey.

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