Oncology Fundamentals Day for Technicians 2018 Session Descriptions

Human Error in Chemotherapy Preparation - Rachel Gilbert, M.A., Safety, Human Factors & Strategy, Rachel Gilbert Consulting, Toronto, ON

Speaker Biography

“We cannot change the human condition, but we can change the conditions under which humans work.”

-James Reason

This 45-minute online workshop will introduce pharmacy technicians to the concepts of human error and error-prevention as they relate to chemotherapy preparation.

Learning Objectives:

  1. Define human factors for the chemotherapy preparation context;
  2. Articulate 2-3 specific mechanisms of human error in chemotherapy preparation; and,
  3. Describe 2-3 error prevention strategies.
     

Logistics of Centralized Hazardous Drug Preparation - Sukhraj Gill, Pharmacy Technician, Cross Cancer Institute, Edmonton, AB 

Speaker Biography

Release of USP 797, USP 800, and NAPRA clean room and hazardous drug preparation standards in recent years has resulted in more stringent requirements for sterile drug preparation facilities resulting in the need to consider centralizing sterile drug production. This presentation will review the logistics of implementing sterile hazardous drug preparation for delivery at a remote site.

The goal was to provide a chemotherapy mixing service out of a Tertiary or Regional Cancer Centre pharmacy for delivery in a rural Community Cancer Centre (CCC) for 100% of the planned patient treatments, while maintaining the key principles.

Results indicated the implementation of the remote service delivery model was successful.

Learning Objectives:
 
  1. Describe the changes from the NAPRA/USP 797/USP 800 sterile drug preparation standards that have resulted in change of practice and how these changes are challenging sterile production facilities;
  2. Review Alberta’s plan for centralized production and distribution of parenteral chemotherapy preparations; and,
  3. Identify logistics for remote delivery of centrally prepared parenteral chemotherapy.
     

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Hazardous Drug Preparation - Michelle Koberinski, Oncology Certification Pharmacy Technician, BC Cancer Agency, Kelowna, BC

Speaker Biography

Michelle will discuss safe handling and aseptic preparation of hazardous drugs. She will also review proper use of a biological safety cabinet. The requirements outlined in NAPRA’s Model Standards for Pharmacy Compounding of Hazardous Sterile Preparations be the basis of the information presented. Michelle will offer suggestions on where to start with implementing NAPRA’s Model Standards at your facility.

Learning Objectives:

  1. Summarize safe and aseptic preparation of hazardous drugs;
  2. Outline proper use of a biological safety cabinet; and,
  3. Apply NAPRA’s Model Standards for Pharmacy Compounding of Hazardous Sterile Preparations.
     

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Technicians Checking Chemotherapy - Kelly-Ann Wakeford, Senior Pharmacy Technician, Juravinski Cancer Centre, Hamilton, ON

Speaker Biography

Technicians checking chemotherapy makes sense! With the ever-changing demands on pharmacy today, delegating the checking function to technicians helps the pharmacist meet the clinical demands for safer patient care. The workload keeps increasing, the regimens keep getting more complex, and what better way to use pharmacy resources than to have the technicians doing the technical job of checking. The technicians have been mixing chemotherapy for years; they have the knowledge and background of the technical aspects of this process so it makes sense to move them forward into the checking function.

With the technicians checking High Alert Medications, there has to be a training program established to assure that the technicians are qualified to accurately and safely check and dispense chemotherapy. We need to include our pharmacists in the process of designing the training program so we can assure them that they can trust the technicians checking chemotherapy safely and accurately.

There also has to be a quality assurance program in place to verify that the technicians are maintaining their skills and knowledge. Yearly certification should be built into your training program as well. In conclusion we need to make the technicians and pharmacists confident and comfortable with technicians checking chemotherapy. The pharmacist does the clinical job of verification of the chemotherapy orders first and then hands it off to the technicians to do the technical work of mixing, checking and dispensing the order. This will give the technicians more responsibility and a feeling of accomplishment to be able to perform within their scope of practice as the technicians are now licensed with the Colleges in their provinces.

Learning Objectives:

  1. Learn why there is resistance from technicians and pharmacists regarding technicians checking chemotherapy and how we can overcome this resistance;
  2. Identify what needs to be included in a training program and how to develop an in-house training and certification program;
  3. Identify what information and support technicians need to do the checking function; and,
  4. Identify the expectations of a licensed pharmacy technician according to their college and employer.
     

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Minimizing Exposure to Cancer Medications - Rhonda Kalyn, BSP, Pharmacy Communities Oncology Network Educator, Clinical Pharmacist, BC Cancer Agency, Kelowna, BC

Speaker Biography

Family members have the potential to become exposed to cancer drugs when they care for a patient who is taking cancer drugs at home. Recent studies of patients taking cancer medications at home show that surface contamination exists in areas where cancer drugs have been handled and that cohabitating family members can have detectible levels of cancer drugs in their urine.

Exposure to cancer drugs may be hazardous to the health of family members because many cancer drugs have potentially serious toxicities, such as secondary cancers, reproductive toxicity, and organ toxicity. Additionally, the intended effect of a cancer drug can be harmful to a family member who doesn’t have cancer. For example, some breast cancer drugs block the female hormone estrogen. Since estrogen is required for pregnancy, drugs that block estrogen could be harmful to someone who is pregnant.

All patients who receive cancer medications should be provided with instructions to handle their medications in a way that reduces potential exposure of family members to the drug. The instructions should cover precautions for family members who administer cancer medications, safe storage of cancer medications, procedures for handling body fluids, procedures for handling spills of cancer drug or body fluids, and how to dispose of contaminated supplies.

Learning Objectives:

  1. Describe how secondary exposure to cancer medications can be harmful to the health of family members;
  2. Discuss evidence of secondary exposure to cancer drugs in the home setting; and,
  3. Review safe handling recommendations for family members to avoid exposure to cancer drugs.

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