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USP 800

  • 1.  USP 800

    Posted 18 days ago
    I have a question on the bleach cleaning of pt rooms and equipment at end of day. Is your RN staff participating in any of that activity? If so, how do you justify cost compared to housekeeping management?

    Kathryn Hoffmann


  • 2.  RE: USP 800

    Posted 17 days ago
    Hi
    No, we still rely upon housekeeping. And USP <800> provides no guidance for Infusion rooms and equipment. The section on cleaning/deactivation etc. is geared toward pharmacy compounding.

    That being said, housekeeping should be knowledgeable about what NOT to do when cleaning areas where chemotherapy is compounded and infused. This is based on wipe test studies and not on USP.

    Seth

    ------------------------------
    Seth Eisenberg RN ASN OCN BMTCN
    PROFESSIONAL PRACTICE COORDINATOR, INFUSION SERVIC
    Seattle Cancer Care Alliance
    Federal Way WA
    ------------------------------



  • 3.  RE: USP 800

    Posted 17 days ago
    Thank you!

    Kathryn Hoffmann






  • 4.  RE: USP 800

    Posted 16 days ago
    Hi Seth,

    After a spill, we had a recommendation to decontaminate/deactivate the chemo prior to our housekeepers cleaning the room. We recently had our first wipe testing completed, and we had our vendor wipe an area where we had a chemo spill 2 weeks prior to the wipe testing. The results came back that chemo was still detectable in the area above the "safe" limits. We are reviewing our process to see if there is a more effective way to deactivate/decontaminate after a spill. Right now we are using the same wipes pharmacy uses for their hoods (which are the size of a wet nap you get at a restaurant). We have looked at other products, but they all come in bulk bottles, or are geared more towards pharmacy staff. We are also trying to determine if there is a better product that our housekeepers can use to decontaminate after a spill. Any recommendations or guidance is always appreciated!
    Mary

    ------------------------------
    Mary D. Molloy MSN, RN, OCN
    Patient Care Manager, Heme/Onc
    Northwestern Memorial Hospital
    Chicago, IL
    312-472-1405
    ------------------------------



  • 5.  RE: USP 800

    Posted 16 days ago
    Do you use bleach wipes?

    Kathryn Hoffmann




  • 6.  RE: USP 800

    Posted 16 days ago
    Hi
    Not sure what wipes (from pharmacy) you are using. A few wipe facts:
    1. Normal germacidal bleach wipes (e.g., Clorox) do not neutralize HDs. Neither do any other antimicrobial wipes.
    2. SurfaceSafe, if used correctly, can effectively neutralize about 20 different drugs. They're best reserved for spills as they're too small (and too expensive) for doing an entire department. Wipedown 1-2-3 is also effective.
    3. HD Clean is designed to remove (but not neutralize)
    4. Peridox RTU can also be used. More info on that can be found HERE. Note that it does have a pretty strong smell, as do the 2 other sodium hypochlorite-based products.

    There is no single product that will do all of the currently used HDs so any product will be a compromise.

    More information on deactivation can be found HERE.

    Seth

    ------------------------------
    Seth Eisenberg RN ASN OCN BMTCN
    PROFESSIONAL PRACTICE COORDINATOR, INFUSION SERVIC
    Seattle Cancer Care Alliance
    Federal Way WA
    ------------------------------



  • 7.  RE: USP 800

    Posted 16 days ago
    Seth, do you have a special role in this endeavor? Very valuable information.

    Kathryn Hoffmann




  • 8.  RE: USP 800

    Posted 16 days ago

    Special role?

    Not really. I'm just a nurse who gives these drugs and has made this my "one thing" (to quote from Curly from City Slickers).

     

    Seth






  • 9.  RE: USP 800

    Posted 16 days ago
    So you have had this as a focus and have gained a lot of knowledge. You are a good resource!

    Kathryn Hoffmann




  • 10.  RE: USP 800

    Posted 15 days ago
    Hi Seth,

    We are using the surface safe wipes. We are going back and forth on should the nurse be the one to use the wipes or should our housekeepers deactivate/decontaminate. With the wipes being so small, we are concerned we aren't effectively cleaning the area.

    ------------------------------
    Mary D. Molloy MSN, RN, OCN
    Patient Care Manager, Heme/Onc
    Northwestern Memorial Hospital
    Chicago, IL
    312-472-1405
    ------------------------------



  • 11.  RE: USP 800

    Posted 15 days ago
    Hi Molly
    I am assuming that you are using the product as directed (3 pairs of wipes, waiting 30 seconds between each wipe).
    What drug(s) came back positive?

    As far as who does the actual cleaning, much depends on your system. For out department, the nurse involved with the spill does the Surface Safe wipes, as there might be a delay of 5-10 minutes before housekeeping can get there and I don't want the contaminated area left unattended. And housekeeping staffing is quite limited on weekends, holidays and evenings, so it makes sense in our system for the RN to do it.

    Seth

    ------------------------------
    Seth Eisenberg RN ASN OCN BMTCN
    PROFESSIONAL PRACTICE COORDINATOR, INFUSION SERVIC
    Seattle Cancer Care Alliance
    Federal Way WA
    ------------------------------



  • 12.  RE: USP 800

    Posted 14 days ago
    Thanks Seth! All of this information is helpful! I haven't gotten our official report, but the company did call to alert us to suggest closing the room that had the spill until we could reclean the room. The rest of our surfaces tested did not have detectable levels of HD's.

    Thank you!
    Mary

    ------------------------------
    Mary D. Molloy MSN, RN, OCN
    Patient Care Manager, Heme/Onc
    Northwestern Memorial Hospital
    Chicago, IL
    312-472-1405
    ------------------------------



  • 13.  RE: USP 800

    Posted 14 days ago
    I you don't mind sharing, what is your procedure for day to day cleaning of chemo administration areas?
    IV pumps?
    Tables/chairs?
    How do you clean between patients?

    After initial containment of a spill in chemo admin area, what are you cleaning with?

    Any responses would be greatly appreciated

    ------------------------------
    Jessica Taylor
    Altoona PA
    ------------------------------



  • 14.  RE: USP 800

    Posted 13 days ago
    Hi
    We clean with Sani-Cloth (black top) for most surfaces. Some of our equipment requires bleach wipes, which we also use for enteric contact isolation rooms. Other departments are using hydrogen peroxide wipes, but we switched because of the fumes (irritating to some employees) and the cause terrible streaking on stainless steel surfaces. Of course, none of these products will get rid of HD contamination. This is strictly for infection prevention.

    Seth

    ------------------------------
    Seth Eisenberg RN ASN OCN BMTCN
    PROFESSIONAL PRACTICE COORDINATOR, INFUSION SERVIC
    Seattle Cancer Care Alliance
    Federal Way WA
    ------------------------------



  • 15.  RE: USP 800

    Posted 11 days ago

    We use Cavicide. WE clean the chairs, Alaris infusion pumps, poles, table tops etc.

     

     

    Jaime L. Kist RN, MSN,RN-BC, ONC

    Clinical Educator II

    Trihealth Cancer Institute

    Outpatient Clinics

    513-503-8605

     

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  • 16.  RE: USP 800

    Posted 11 days ago
    Good question, are nurses in your institutions cleaning up post spills or just containing spill and housekeeping staff doing cleaning?

    Dee Ann Omatsu, APRN, PNP, CPON
    Clinical Oncology Educator

    Sent from Dee's iPhone😊




  • 17.  RE: USP 800

    Posted 11 days ago
    In my facility, the nurses are the spill team.
    Seth 
    Sent via mobile. 





  • 18.  RE: USP 800

    Posted 10 days ago
    What type of education do you give for chemo spill and annual competency?

    Dee Ann Omatsu, APRN, CPON




  • 19.  RE: USP 800

    Posted 7 days ago
    I used to do  in-person training every year. This year we switched to an LMS system. It's essentially a guided tour of the spill kit, and step-by-step how to use it.

    All new hires get the "in-person" training initially.

    Seth

    ------------------------------
    Seth Eisenberg RN ASN OCN BMTCN
    PROFESSIONAL PRACTICE COORDINATOR, INFUSION SERVIC
    Seattle Cancer Care Alliance
    Federal Way WA
    ------------------------------