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USP<800

  • 1.  USP<800

    Posted 07-13-2017 19:33

    Hello,

    My pharmacist and myself have been meeting and have some questions about the USP<800 Chapter regulations coming up 07/01/2018. So here goes.

    ü  Does your facility have a specific place to don and garb with chemotherapy PPE? We don't have one specific unit that does chemotherapy- the chemotherapy nurses travel to other units also.

    ü  How does your facility transport HD/Chemotherapy? [hand deliver, cart, container, etc]

    ü  How does your facility have you dispose of your PPE and chemotherapy equipment used without contamination of the environment?

    ü  Where does your facility place the chemotherapy/HD waste containers? [each room, in a dirty utility, in a centralized location]

    ü  Also, does your facility have a General Policy for HD/chemotherapy to be the umbrella  and then have Standard Operating Procedure specific to each topic? So, in the policy for each specific topic you would say "refer to ... SOP" Our facility got away from each specific topic due to nurses having trouble looking up specific topics/policies and have gone down to two policies.

     I will look forward to all the responses I receive for I know each facility does things just a little different. I can tell you we are a local hospital and not specific to chemotherapy.

     

    Thanks

    Patty Barding, MSN, RN, OCN


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  • 2.  RE: USP<800

    Posted 07-17-2017 12:52
    Hi Patty
    Some response may not be as helpful as we are outpatient, but:

    1. Gowning is done just outside, or inside the patient Infusion bay
    2. Transport by pharmacy courier to each patient's bay, although we're moving to have them stocked in a chemotherapy Pyxis for drugs that can be prepared ahead of time.
    3. PPE and tubing/empty bags go in HD container. We are revising our processes for gown disposal.
    4. We have yellow HD containers in each of our 49 Infusion bays. We use the BD trolley system, which I prefer because they are foot-pedal operated, slide horizontally instead of swinging open), and are on wheels, so they can be moved closer to the bed/patient/chair if needed.
    5. We have a specific chemotherapy administration policy, which covers aspects of safe handling. There are separate policies for HD PPE, and for HD spills. All of these policies have hyperlinks so that one click will bring up the other policy.

    Seth

    ------------------------------
    Seth Eisenberg RN ASN OCN® BMTCN™
    PROFESSIONAL PRACTICE COORDINATOR, INFUSION SERVICES
    Seattle Cancer Care Alliance
    Seattle WA
    ------------------------------



  • 3.  RE: USP<800

    Posted 07-17-2017 16:59
    Great discussion on USP <800>

    I wanted to be sure you had an opportunity to read the 7/11 article in The Voice as well.
    Michele

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    Michele Galioto RN MSN
    Oncology Nursing Society
    Pittsburgh PA
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  • 4.  RE: USP<800

    Posted 07-18-2017 10:16
    Yes I have read the article in The Voice and other ONS articles. Very informative and helpful.
    Patty Barding, MSN, RN, OCN
    Oncology Coordinator
    Decatur Memorial Hospital
    Decatur, Illinois
    217-876-5113

    CONFIDENTIAL: This email message and any attachments are for the sole use of the intended recipient(s) and may contain HIGHLY CONFIDENTIAL PERSONAL HEALTH INFORMATION. It is to be used only to aid in providing specific healthcare services to this patient. Any unauthorized review,use, disclosure, or distribution is a violation of Federal Law (HIPAA) and will be reported as such. If you are not the intended recipient or a person responsible for delivering this message to an intended recipient, please contact the sender by reply email and destroy all copies of the original message immediately.





  • 5.  RE: USP<800

    Posted 07-18-2017 09:35
    Thanks for responding Seth,
    We have an area outside each persons room, yet since there can be trace chemotherapy on the outside of the bags I am not sure this is a great place for ours to go.
    The HD container sounds interesting and will need to check into this. We have one on the unit I work on in our dirty utility and that could be 100 ft. from the actual room we are administering. Any suggestions on this?
    The hyperlinks in the administration policy sounds like a feasible thing so if you are in one policy you can look at the other policy.
     
    Patty Barding, MSN, RN, OCN
    Oncology Coordinator
    Decatur Memorial Hospital
    Decatur, Illinois
    217-876-5113

    CONFIDENTIAL: This email message and any attachments are for the sole use of the intended recipient(s) and may contain HIGHLY CONFIDENTIAL PERSONAL HEALTH INFORMATION. It is to be used only to aid in providing specific healthcare services to this patient. Any unauthorized review,use, disclosure, or distribution is a violation of Federal Law (HIPAA) and will be reported as such. If you are not the intended recipient or a person responsible for delivering this message to an intended recipient, please contact the sender by reply email and destroy all copies of the original message immediately.





  • 6.  RE: USP<800

    Posted 07-24-2017 09:53
    Hi Patty
    Interestingly, if you read Connor's 2010 study on wipe testing and exposure in 3 US cancer centers, the highest concentration of HD residue was on the lid of an HD disposal container in a a soiled utility room. The setup you describe is quite common in hospitals. I've spoken with nurses who have detailed the "droplets" going down the hall to the soiled utility room where the container is kept. So keeping it near the source of administration makes a lot of sense. It's also more expensive and comes with some logistical concerns.

    Seth


    The HD container sounds interesting and will need to check into this. We have one on the unit I work on in our dirty utility and that could be 100 ft. from the actual room we are administering. Any suggestions on this?

    ------------------------------
    Seth Eisenberg RN ASN OCN® BMTCN™
    PROFESSIONAL PRACTICE COORDINATOR, INFUSION SERVICES
    Seattle Cancer Care Alliance
    Seattle WA
    ------------------------------



  • 7.  RE: USP<800

    Posted 02-27-2018 12:09
    ​Seth,
    Do you dispose of your empty chemo bags in the yellow trace bins in your infusion area?

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    Sarah Merkle RN MSN
    CNS
    PIH Health
    Whittier CA
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  • 8.  RE: USP<800

    Posted 8 days ago
    Seth, I am a nursing manager and we are trying to get our policies updated for USP800. Any advice on where I can get the info to include in my chemo administration policy? Especially regarding use of CSTDs.

    ------------------------------
    [Diedra] [Restoff] [BSN, RN]
    [Nurse Manager]
    [Pinckneyville Community Hospital Cancer Care and Infusion Clinic]
    [Pinckneyville] [IL]
    [drestoff@pvillehosp.org]
    ------------------------------



  • 9.  RE: USP<800

    Posted 8 days ago
    ​Are you able to share any of your policies?

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    Jessica Taylor
    Nurse Manager
    James E Van Zandt Va Medical Center
    Altoona PA
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