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Hazardous Drug Solutions

How effective are your safe handling practices?

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Hazardous Drug Safety

Ready to learn more? Let’s have a conversation.

Solutions you 
can count on

You shouldn’t have to compromise on hazardous drug safety.

From the compounding pharmacist to the nurse who administers treatment to the staff cleaning a facility, an exposure can occur at almost any moment during the hazardous drug journey. The risk of hazardous drug exposure to healthcare workers is real and significant.


There’s no room for compromise.


With evidence-based insights on your current safe handling practices, rapid hazardous drug detection and closed-system drug transfer device (CSTD) solutions, the BD Hazardous Drug Solutions portfolio is designed to protect you—and the team you count on.

 

Assess. Plan. Protect.

The BD Hazardous Drug Solutions team collaborates with you to understand the real risks of hazardous drug exposure and surface contamination in your facility—and then tailor the solution that’s right for your safety, economic and clinical needs.

An integrated approach designed to help address the threat of hazardous drug exposure and create a clear plan to protect your healthcare workers with BD product recommendations and training.

A unique end-to-end program designed to help you understand, develop and implement hazardous drug surface contamination monitoring in four steps: assess, develop, test, track.

BD® HD Check System

The first rapid hazardous drug detection* system that provides easy-to-read binary results in less than 10 minutes to help facilitate routine monitoring and evaluate your institution’s safe handling practices.

*The BD® HD Check System tests for select hazardous drugs— cyclophosphamide, doxorubicin and methotrexate. Surfaces with contamination at or above the limits of detection have 95% specificity and sensitivity.

BD® HD Check System

The first rapid hazardous drug detection* system that provides easy-to-read binary results in less than 10 minutes to help facilitate routine monitoring and evaluate your institution’s safe handling practices.

*The BD® HD Check System tests for select hazardous drugs— cyclophosphamide, doxorubicin and methotrexate. Surfaces with contamination at or above the limits of detection have 95% specificity and sensitivity.

BD® HD Check System

The first rapid hazardous drug detection* system that provides easy-to-read binary results in less than 10 minutes to help facilitate routine monitoring and evaluate your institution’s safe handling practices.

*The BD® HD Check System tests for select hazardous drugs— cyclophosphamide, doxorubicin and methotrexate. Surfaces with contamination at or above the limits of detection have 95% specificity and sensitivity.

Solutions with demonstrated impact

A first-of-its-kind study published in the American Journal of Health-System Pharmacy (AJHP) highlighted the value of integrating BD PhaSeal™ Optima System and BD® HD Check System into routine clinical practice.1

  • 46% reduction in hazardous drug contamination after incorporating BD PhaSeal™ Optima System into clinical workflows1

  • Of the 5 hazardous drugs that showed pretest contamination at one testing site, 4 showed fewer contaminated surfaces posttest, and ALL showed reduced post-test contamination concentrations1

  • As part of a multifaceted approach, the BD PhaSeal™ Optima System and BD® HD Check System may help minimize barriers to routine monitoring, ultimately improving the safety of healthcare workers and patients1

Ready to advance your facility’s safe handling practices? Let’s get started.

Hazardous Drug Solutions
Ready to advance your facility’s safe handling practices? Let’s get started.
References
  1. Brechtelsbauer E. Identification and reduction of hazardous drug surface contamination through the use of a novel closed-system transfer device coupled with a point-of-care hazardous drug detection system. Am J Health Syst Pharm. 2023;80(7):435-444. doi:10.1093/ajhp/zxac336.

Widespread, 
well-documented risk

More than 8 million healthcare workers are potentially exposed to hazardous drugs each year.

This includes personnel throughout the entire hazardous drug journey—from pharmacists, nurses and technicians to those in housekeeping and environmental services and shipping and receiving roles.1

 

Potential for serious consequences

The risks of hazardous drug exposure are real and significant.

The Risks

Detrimental effect on DNA Detrimental effect on DNA
Detrimental effect on DNA
Increased cancer rates Increased cancer rates
Increased cancer rates
Internal organ damage Internal organ damage
Internal organ damage
Reproductive issues Reproductive issues
Reproductive issues

2.5-fold to 5-fold increase in total chromosomal aberrations among healthcare workers handling hazardous drugs2-4

1.5-fold increase in nonmelanoma skin cancer and 3.7-fold increase in non-Hodgkin lymphoma among pharmacy techs5
Leukemia risk is significantly increased in nurses with hazardous drug exposure (10.65-fold) vs risk in those without exposure6

Increased risk of liver damage among nurses handling antineoplastic drugs7

2.0-fold increased risk of miscarriage among staff handling antineoplastic drugs,8 along with an increase in risk of malformations in offspring9
Exposure to hazardous drugs may present a reproductive risk for men and women actively trying to conceive10

Exposure can occur anywhere on the HD journey

Exposure may occur anywhere hazardous drugs are present in your facility—from pharmacy receiving and preparation to administration and disposal.

 

 

A study of six hospitals found that frequently contacted surfaces at every stage of the hospital medication system had measurable levels of hazardous drug contamination.11

 

It’s time to assess and advance your facility’s 
safe handling practices. BD can help.

Hazardous Drug Solutions
Ready to advance your facility’s safe handling practices? Let’s get started.
References
  1. Centers for Disease Control and Prevention (CDC). Hazardous drug exposures in health care. The National Institute for Occupational Safety and Health (NIOSH) Web site. http://www.cdc.gov/niosh/topics/hazdrug. Accessed April 11, 2023.
  2. Cavallo D, Ursini CL, Perniconi B, et al. Evaluation of genotoxic effects induced by exposure to antineoplastic drugs in lymphocytes and exfoliated buccal cells of oncology nurses and pharmacy employees. Mutat Res. 2005;587(1-2):45–51. doi:10.1016/j.mrgentox.2005.07.008.
  3. McDiarmid MA, Oliver MS, Roth TS, Rogers B, Escalante C. Chromosome 5 and 7 abnormalities in oncology personnel handling anticancer drugs. J Occup Environ Med. 2010;52(10):1028–34. doi:10.1097/JOM.0b013e3181f73ae6.
  4. Roussel C, Witt KL, Shaw PB, Connor TH. Meta-analysis of chromosomal aberrations as a biomarker of exposure in healthcare workers occupationally exposed to antineoplastic drugs. Mutat Res. 2019;781:207-217
  5. Hansen J, Olsen JH. Cancer morbidity among Danish female pharmacy technicians. Scand J Work Environ Health. 1994;20(1):22–26. doi:10.5271/sjweh.1433.
  6. Skov T, Maarup B, Olsen J, et al. Leukaemia and reproductive outcome among nurses handling antineoplastic drugs. Br J Ind Med. 1992;49(12):855–861. doi:10.1136/oem.49.12.855.
  7. Sotaniemi EA, Sutinen S, Arranto AJ, et al. Liver damage in nurses handling cytostatic agents. Acta Med Scand. 1983;214(3):181–189. doi:10.1111/j.0954-6820.1983.tb08593.x.
  8. Lawson CC, Rocheleau CM, Whelan EA, et al. Occupational exposures among nurses and risk of spontaneous abortion. Am J Obstet Gynecol. 2012;206(4):327.e1-8.
  9. Hemminki K, Kyronen P, Lindbohm ML. Spontaneous abortions and malformations in the offspring of nurses exposed to anaesthetic gases, cytostatic drugs, and other potential hazards in hospitals, based on registered information of outcome. J Epidemiol Community Health. 1985;39(2):141–147. doi:10.1136/jech.39.2.141.
    National Institute for Occupational Safety and Health (NIOSH). Current intelligence bulletin 68: NIOSH chemical carcinogen policy. By Whittaker C, Rice F, McKernan L, Dankovic D, Lentz 
  10. TJ, MacMahon K, Kuempel E, Zumwalde R, Schulte P, on behalf of the NIOSH Carcinogen and RELs Policy Update Committee. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH) Publication No. 2017‐100. https://www.cdc.gov/niosh/docs/2017‐100/pdf/2017‐100.pdf. Accessed March 20, 2020.
  11. Hon CY, Teschke K, Chu W, Demers P, Venners S. Antineoplastic drug contamination of surfaces throughout the hospital medication system in Canadian hospitals. J Occup Environ Hyg. 2013;10(7):374–383. doi:10.1080/15459624.2013.789743.

Is your facility up to date with current best practices?

For decades, clinical organizations have provided evidence-based recommendations to help protect healthcare workers from the risks of hazardous drug exposure. As protective technology and knowledge advance, these guidelines evolve. Staying current is a critical part of keeping your team safe.

On-demand webinars and resources

Check out these videos to learn more about the Safe to Touch Consensus Conference statements and hazardous drug guideline compliance.

“A Change Worth Making: Implementation of a novel CSTD and point-of-care HD detection system”

“Hazardous Drug Administration from Start to Finish — Have You Considered the Details”

MiKaela M. Olsen

DNP, APRN-CNS, AOCNS®, FAAN 

Clinical Program Director, 

The Johns Hopkins Health System

“Safe to Touch: How Nursing and Pharmacy can Partner on HD Surface Contamination Monitoring”

Closed-system drug-transfer device (CSTD) usage guidelines

The use of CSTDs has been widely recommended by different organizations, including the United States Pharmacopeial Convention (USP),1 American Society of Health-System Pharmacists (ASHP),2 and the National Institute for Occupational Safety and Health (NIOSH).3

“CSTDs should be used when compounding HDs when dosage form allows.”

— USP General Chapter <800> Hazardous Drugs—Handling in Healthcare Settings

“HDs must be administered safely using protective medical devices and techniques. Examples of protective medical devices include needleless and closed systems.”

— USP General Chapter <800> Hazardous Drugs—Handling in Healthcare Settings

“For these reasons, USP chapter 800 has determined that CSTDs should be used when compounding HDs and that CSTDs must be used when administering antineoplastic HDs when the dosage form allows and the device is physically or chemically compatible with the HD to be used.”

— ASHP Guidelines on Handling Hazardous Drugs2

“Consider using devices such as closed-system transfer devices, glove bags, and needleless systems when transferring hazardous drugs from primary packaging (such as vials) to dosing equipment (such as infusion bags, bottles, or pumps).”

— NIOSH alert 2004: Preventing occupational exposures to antineoplastic and other hazardous drugs in health care settings.3

Surface contamination monitoring guidelines

Organizations, health agencies and conferences around the world, such as the USP,1 Spanish Society of Hospital Pharmacists (SEFH)4 and the 2020 Safe to Touch Consensus Conference on Hazardous Drug Surface Contamination,5 recommend routine monitoring as part of a comprehensive safe handling program.

“Environmental wipe sampling for hazardous drug surface residue should be performed routinely (e.g., initially as a benchmark and at least every six months, or more often as needed, to verify containment). […] Repeat the wipe sampling to validate that the deactivation/decontamination and cleaning steps have been effective.”

— USP General Chapter <800> Hazardous Drugs—Handling in Healthcare Settings1

 

“To be efficient, any surface contamination monitoring plan should include an assessment of the contamination risk present in the different sections of the HPD’s compounding area. This is essential to determine where to sample and establish a suitable monitoring frequency. [...]”

— 2021 SEFH practice guidelines4

Recommended sampling locations

Standards and guidelines have identified several locations in pharmacy and patient administration areas where routine wipe sampling for HD surface contamination might be beneficial.

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      Training and education recommendations

      Comprehensive safe handling programs include comprehensive training and routine reassessments. Both the USP1 and Oncology Nursing Society7 provide specific recommendations for annual HD education.

      “All personnel who handle HDs must be trained based on job functions… Personal competency must be reassessed every 12 months.”

      — USP General Chapter <800> Hazardous Drugs—Handling in Healthcare Settings1

      “Comprehensive didactic education and documentation of clinical competence is required for all HCW and must be reassessed at least every 12 months.”

      — Oncology Nursing Society—Safe Handling of Hazardous Drugs7

      Your partner on best practices

      Ample evidence exists to support the prevalence of hazardous drug exposure and associated health risks to healthcare workers. Implementing a comprehensive safe handling program can pose multiple challenges. It’s a step worth taking.

      From our BD Safe Handling Assessment to tailoring a cost-effective hazardous drug safety solution that’s right for your facility, BD can help.

      Ready to find out how up to date your facility is with guidelines and best practices?

      Reach out to learn more about a BD Safe Handling Assessment today.

      Hazardous Drug Solutions
      Ready to advance your facility’s safe handling practices? Let’s get started.
      References
      1. United States Pharmacopeial Convention. USP General Chapter <800> Hazardous Drugs—Handling in Healthcare Settings. https://www.usp.org/compounding/general-chapter-hazardous-drugs-handling-healthcare. Published February 1, 2016. Updated June 26, 2020. Accessed April 11, 2023.
      2. Power LA, Coyne JW. ASHP Guidelines on Handling Hazardous Drugs. Am J Health Syst Pharm. 2018;75(24):1996-2031. doi:10.2146/ajhp180564.
      3. National Institute for Occupational Safety and Health (NIOSH). NIOSH alert 2004: Preventing occupational exposures to antineoplastic and other hazardous drugs in health care settings. http://www.cdc.gov/niosh/docs/2004-165/pdfs/2004-165.pdf. Accessed August April 11, 2023.
      4. Valero-García S, González-Haba E, Gorgas-Torner MQ, et al. Monitoring contamination of hazardous drug compounding surfaces at hospital pharmacy departments. A consensus Statement. Practice guidelines of the Spanish Society of Hospital Pharmacists (SEFH). Farm Hosp. 2021;45(2):96–107. doi:10.7399/fh.11655.
      5. Gabay M, Johnson P, Fanikos J, et al. Report on 2020 Safe to Touch Consensus Conference on Hazardous Drug Surface Contamination. Am J Health Syst Pharm. 2021;zxab134. doi:10.1093/ajhp/zxab134.
      6. Domingo T, Fontán G, Enríquez M, et al. Guía monitorización de superficies de medicamentos peligrosos. 1. ed. Instituto Español de Investigación Enfermera; Consejo General de Enfermería; 2021.
      7. Polovich M, Olsen, M eds. Safe Handling of Hazardous Drugs. 3rd ed. Pittsburgh, PA: Oncology Nursing Society; 2018.

      Assessing current practices

      Your facility likely already has safety measures that help prevent hazardous drug exposure. How well is your program protecting your staff? Are you up to date with evolving standards and guidelines? Is your staff in compliance? Are there opportunities to optimize your approach?

      BD can help uncover the answers.

      BD Safe Handling Assessment

      Using a proven and comprehensive methodology, the BD Safe Handling Assessment is designed to identify areas of risk and provide a detailed, actionable road map for safe handling of hazardous drugs with BD products for oncology care.

      Joint Commission Resources (JCR) Assessment and Toolkit

      Developed by the JCR and sponsored by BD, the Self-Assessment of Safe Handling Practices for Hazardous Drugs is a confidential online survey used to identify existing USP <800> compliance gaps. For help on closing those gaps, the Improving Safe Handling Practices for Hazardous Drugs Toolkit provides detailed guidance on standards, guidelines and best practices.

      BD® HD Surface Contamination Monitoring Program

      The BD® HD Surface Contamination Monitoring Program is a unique end-to-end program designed to help your facility set up, customize and sustain surface contamination monitoring in just four steps: assess, develop, test and track. The program, along with the 
BD® HD Check System, puts the power of providing data-driven continuous quality improvements for a safe work environment directly in your hands.

      Ready to take a closer look at your hazardous drug safety practices?

      Set up a Safe Handling Assessment today.

      Hazardous Drug Solutions
      Ready to advance your facility’s safe handling practices? Let’s get started.

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