New Closed System Drug Transfer Device Can Reduce Nurse Exposure to Antineoplastic Hazardous Drugs

A clinician handling chemotherapy drugs.
A clinician handling chemotherapy drugs.
A new CSTD significantly reduced surface contamination during a simulated antineoplastic hazardous drug administration when compared to baseline.
The following article features coverage from the 2017 Oncology Nursing Society’s Annual Conference in Denver, Colorado. Click here to read more of Oncology Nurse Advisor‘s conference coverage.            

Denver, CO — A new closed system drug transfer device (CSTD) significantly reduced surface contamination with cyclophosphamide and fluorouracil during simulated antineoplastic hazardous drug administration, according to research presented at the 2017 Oncology Nursing Society Annual Congress.

Researchers led by Kristin Rupp, RN, BSN, OCN, of the Desert Regional Medical Center Comprehensive Cancer Center in Palm Springs, California, sought to assess a new closed system drug transfer device to determine if it could reduce the incidence of surface contamination during the simulated administration of 2 frequently administered antineoplastic hazardous drugs. The study included 17 cancer centers in the United States.

The researchers collected wipe samples from administration locations (including 2 on the floor under the IV pole and 1 on the arm of the infusion chair) at baseline to determine existing contamination. After those wipe samples were collected, metal templates were secured in the same locations. After the closed system drug transfer device was used the researchers collected new wipe samples from the metal templates.

In total, 204 wipe samples were collected and analyzed for cyclophosphamide and fluorouracil by an independent laboratory. The analytic limit of detection for each drug was 0.002 ng/cm2. Cyclophosphamide and fluorouracil were detected in 74% of the baseline wipe samples, with levels of contamination ranging from less than the limit of detection to 3.88 ng/cm2 and 0.36 ng/cm2 for fluorouracil and cyclophosphamide, respectively.

After the simulated administration, only 2% of the wipe samples were at or above the level of detection, with 0.003 ng/cm2 for fluorouracil and 0.002 ng/cm2 for cyclophosphamide.

This difference in samples demonstrated a statistically significant difference when comparing baseline to the closed system drug transfer device (P <.001).

“Reducing environmental contamination with antineoplastic hazardous drugs should reduce nurses’ exposure,” the researchers concluded. “To improve safety in the clinical oncology workplace, future research must include performance assessment of closed system drug transfer devices in actual clinical practice.”

Read more of Oncology Nurse Advisor‘s coverage of the 2017 Oncology Nursing Society’s Annual Conference by visiting the conference page.

Reference

1. Rupp K, Tyler T. Assessment off a new closed system drug transfer device at 17 U.S. cancer centers. Oral presentation at: Oncology Nursing Society 42nd Annual Congress; May 4-7, 2017; Denver, CO.