| Ch 9 | Page 29/ 34 | |
| Cancer chemotherapy |
Preparation of chemotherapy | |
In dedicated health structures, two kinds of personal might prepare the chemotherapy:
- nurses,
- pharmacy personnel,
- or an association of both.
However, such preparation remains under the strict control of the pharmacist.
Such a unit is necessary when the number of weekly reconstitutions in a hospital reach one hundred and for every hospital or structure having a regional pivotal role in the treatment of cancer patients.
It should be a protected premises, free from any external contamination, airtight, overpressurised and easy to clean. The personnel should enter such premises in sterile clothing (overall, gloves, boots, mask, bonnet) and following surgical hand washing. These washing procedures should be repeated when they leave the premises.
The preparation hood, with an aspirating vertical flow, is equipped with a panel to protect the personnel
Other enclosure exist enabling improved drug monitoring and increased availability of personnel for other tasks.
All of these systems are intended to offer efficient protection of the personnel preparing the chemotherapy (it is known that without these precautions, chemotherapy traces would be found in their urine) and personnel would therefore be submitted to a high potential cancer risk induced by contamination.
The drugs and solvents necessary for the chemotherapy preparation are assembled together under the hood, thus enabling permanent control of prepared quantities. The personnel preparing the drugs should be allowed to work in the utmost calm in order to avoid technical or mathematical errors.
The preparation sheets and prescription book constitute further controls. The pharmacist is responsible for the perfect drafting of these documents.
Waste elimination is carried out in specific containers. It also permits a final precise control of the inflow of used drugs and the outflow of prepared solutions (by counting the empty packaging).
When such centralised units do not exist, a specific installation should be set up in each clinical ward.
The same hoods should be fitted, in a specific room, free from any cumbersome or unnecessary equipment or stores and with very little personnel disturbance.
The work place should be easy to decontaminate, chemically and bacteriologically.
In this room, it should be forbidden to drink, eat or smoke and prepare other injections. A specific refrigerator should be used for conservation.
The nurse should be allowed to prepare the solution in a calm setting in order to avoid dosage mistakes and protection errors.
However, such preparation in the clinical ward should be abandoned as soon as possible.
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