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.

PURPOSE: Minimizing hazardous drug (HD) contamination is critical for protecting the health of healthcare workers (HCWs) and patients. Alarmingly, widespread HD contamination has been documented across a variety of clinical settings. Quantitative wipe sampling presents significant time and cost barriers, resulting in routine monitoring adherence rates around 25%. Closed-system drug transfer devices (CSTDs) and qualitative point-of-care tests can be implemented to overcome these barriers.

METHODS: In this study, we tested the effects of the BD PhaSeal Optima (Becton, Dickinson and Company), a recently introduced CSTD, on HD contamination at 2 chemotherapy infusion centers. Wipe samples were taken at 29 workstations at each location prior to and a year following CSTD implementation. Additionally, traditional liquid chromatography with mass spectrometry (LCMS/MS) analyses were compared against a novel lateral flow immunoassay HD testing device (BD HD Check; Becton, Dickinson and Company) to determine the validity of the qualitative assay.

RESULTS: We found a 46% reduction in HD contamination after incorporating the CSTD into clinical workflows. Across time points and sites, HD contamination reported by the BD HD Check device was 91% accurate against LCMS/MS and 98% accurate within its limits of detection.

CONCLUSION: Collectively, the evaluated CSTD and lateral flow immunoassay device may help to reduce HD contamination and provide real-time measures of contamination, respectively. As part of a multifaceted approach, these devices may help minimize barriers to routine monitoring, ultimately improving the safety of HCWs and patients.