HD Safety Beyond the Pharmacy & How to Stratify Risk
The last webinar in the more recent Rhazdrugs series was a truly amazing exchange of pain points, solutions and support. So much information was shared that we had to break the recap blog out into two parts. Part one is posted in the Safety First Blog.
Here are key takeaways 4 and 5:
4. Beyond Pharmacy: Institution-Wide Access
Participants emphasized that hazardous drug safety extends beyond pharmacy departments. Environmental services staff, home health workers, and clinicians working remotely all need access to handling guidelines.
As I mentioned in Part 1, the group offered suggestions for getting buy-in on Rhazdrugs. One idea was to illustrate to the powers that be how easy Rhazdrugs makes it for environmental services staff and others to access safety protocols without access to the EHR. This not only improves safety, but also helps check off USP <800> communication requirements.
Rhazdrugs is even safely accessible outside of your organization because each site is IP-restricted. For instance, if a home health person needs to access the hazardous drug safety protocols while at a patient’s home, they simply enter their hospital/health system email address into Rhazdrugs, and they can access all of the safety information even if they’re not behind the firewall.
We added this IP-restricted safety feature because there are so many users who leave campus and who need access. Our goal is to make this safety information not only easy to understand but easy and safe to access.
5. Scientific Approach to Risk Stratification
As if categorizing potentially hazardous drugs wasn’t stressful enough, NIOSH made major changes to the drugs considered hazardous and how to classify them in the latest update. Several of our clients discussed how they are handling the changes from a cultural standpoint while using scientific information and broad buy-in to cover their bases.
Legacy Health is using scientific justification to relax some handling protocols based on NIOSH’s updates - particularly for certain antineoplastics that have moved from Table 1 to Table 2, removed from the NIOSH list, or not reviewed by NIOSH at all. This opens up the option for an assessment of risk (AOR) for these drugs.
Some are adding additional tables to drugs that are not on the NIOSH list and may not meet the description of a hazardous drug but nonetheless need communication on how to handle.
Example:
- Category 3 and 3A drugs don't require manipulation but are very small molecules
- Category 4 and 4A require manipulation (4 being large molecules, 4A being small ones)
Getting buy-in from a broader group is imperative. In addition to the USP steering committee, the changes will be reviewed by environmental services, corporate compliance, and infection control departments.
Legacy Health said, “If we're going to change this, if we're going to relax things, we want everyone’s approval, everyone's support.”
Wrapping it up
As I said in the webinar, this type of gathering and communication is my dream. The group agreed that it was helpful so we will definitely host more of these events. Stay tuned!
In the meantime, the recordings of this session and the entire series is available on our website.
As always, if you have questions, we'd love to hear from you at info@rpharmy.com
