Resumen de Evaluation and selection of closed-systems for safe cytostatics handling
Eva González-Haba Peña, Silvia Manrique Rodríguez, Ana Herranz Alonso, Cristina Casado Reina, M. N. Sánchez Fresneda, María Sanjurjo Sáez
Purpose: To review, evaluate and analyse the economic impact of the implementation of several closed system techniques used in handling cytostatic drugs in a Tertiary General Hospital.
Methods: A literature review of the technical features of the various components that constitute a closed system and luer solution bag connection system was carried out. We designed a pilot study in order to analyse and compare the different characteristics of a multi-way infusion set like system, a closed-system transfer device and a combined closed system transfer device with a luer solution bag.
Results: Several devices involved in the different steps of the handling cytotoxic drug process were described. During the preparation step, we assessed more comfort in using closed vial access device without anchoring and using solution bag with luer connection due to an easier handling. One disadvantage of the multi-way infusion set secondary sets over valve system is that priming is needed, with the subsequent increase in preparation time. Regarding transport, the use of the closed system transfer device was more comfortable because, as it has no extension, saves space. In the administration step nurses also showed preference for the closed system transfer device. The three systems evaluated, multi-way infusion set, closed-system transfer device and combined, are closed systems and therefore considered as safe devices. From a microbiological point of view, we believe the risk does not depend on the system used, provided proper work procedures are followed.
The estimated economic impact of the implementation of these security systems in our centre would be approximately 160,000 euros, depending on annual variations according to activity.
The system selected to be used in our hospital was the closed system transfer device in combination with the closed system transfer device with luer solution bag.
Conclusions: The implementation of these systems in our centre has improved the level of security of the workflow, not only during the preparation and transport of cytostatic drugs in the Pharmacy Service, but also during administration in the cancer care unit
