Implementation of a Digital Visual Inspection Tool in a Centralized Antineoplasic Drug preparation Unit

Introduction
Chemotherapy preparation is a high-risk activity. Therefore, the inspection of compounded preparations is an essential step in ensuring process safety. Two inspection methods are used in our centralized antineoplasic drug preparation unit : in-process visual inspection and analatical control. However, each method has limitations : visual inspection requires the involvement of an assistant operator, leading to task interruptions, whereas analytical control requires the availability of a near-infrared absorption spectrum for each pharmaceutical product prepared. We therefore considered using augmented reality (AR) glasses to secure the preparation of drugs that cannot be analytically controlled.

Objective
To implement AR glasses within a centralized antineoplasic drug preparation unit.

Materials and Methods
First, the scope of use of the AR glasses was defined. Installation qualification (IQ) was then carried out with pharmacists, the prescribing software team, and the IT team. IQ assessed WI-FI access, interfacing with the prescribing software, voice-command functionality using simple instructions (« photo », « back », « next », « zoom »), Data Matrux code reading, image sharpness and image display at the release stage. Operational qualification (OQ), conducted outside the production area, was initiated with the entire team. It included defining, organizing, and configuring the preparation steps, as well as stimulating preparations using non -cytotoxic products. A satisfaction questionnaire was subsequently administered to the pharmacy technicians.

Results
IQ confirmed that WI-FI access and interfacing with prescribing software were functional. Voice commands were recognized without requiring operators to modify their usual way of speaking, regardless of the operator. Photographs were clear, provided that movement of the photographed object was limited. During OQ, three types of preparations were simulated : one bag, one syringe, and one infusor, corresponding to the three processes initially configured. Configuration of the preparation steps specific to our unit has not yet been completed. Furthermore, the questionnaire showed that all pharmacy technicians were statisfied, despite initial apprehension. AR glasses could therefore be used for drugs not eligible for analytical control.

Discussion
AR glasses contribute to securing chemotherapy preparation. However, implementation in routine production will be required to assess the actual impact of the device on preparation time, the workload of the assistant operator, reduction of the risk of errors, the pharmaceutical release stage and long-term satisfaction among pharmacy technicians.

Mesh terms: Pharmaceutical Preparations ; Augmented Reakity ; Antineoplasic Drugs