Innovations in Chemotherapy Preparation Safety
Use of Telepharmacy and Barcode Technology in the IV Admixture Area
The objectives of this project were to add safeguards to the chemotherapy preparation process in the form of telepharmacy and barcode technology. Telepharmacy can enable optimal use of pharmacists by allowing them to check chemotherapy preparations remotely. By viewing digital images of the preparation process, a pharmacist can verify that the correct quantity of medication was transferred from the primary source to a secondary container without being physically present at the time of transfer. Barcode technology allows for an electronic verification that the correct medication was selected before preparation.
Presentation objectives include a description of the potential benefits of use of telepharmacy and barcode technology in the chemotherapy preparation process, along with an explanation of barriers to successful implementation of this technology. The presentation will conclude with a discussion on the application of this technology to other healthcare settings to improve safe medication preparation processes.
Placement of an inspection camera in a biological safety cabinet allows for taking of digital pictures at various stages of the chemotherapy preparation process. A technician can photograph the vials to be used along with fluids and diluents. A photograph of the syringe containing the ordered volume of chemotherapy can be taken prior to transfer into the secondary container. The pharmacist can then view these pictures remotely from a check station while checking the finished product. Telepharmacy hardware also incorporates a barcode scanner, which can be used to scan the product prior to preparation.
Using this system for chemotherapy admixtures, preparation processes were enhanced in four areas:
- Barcode verification of the chemo product is used to ensure that the correct drug is selected based on the order;
- The pharmacist is able to visually inspect the syringe, containing chemotherapy, before it is injected into a secondary container to ensure that the technician withdrew the correct volume from the vial;
- Small pitch font on chemotherapy vials can be digitally enlarged to aid the pharmacist when checking the finished product;
- Contaminated syringes and vials can be disposed of in the chemo preparation area, without the risk of contaminating other areas of a clean room.