| Objective: Based on the residual and the remaining amounts of drugs in the waste after the cytotoxic drugs are used,classify and elaborate on the safe protection measures for each step in the process of handling cytotoxic waste.Ultimately,this will provide a scientific basis for healthcare institutions and government organizations to develop guidelines and policies for the cytotoxic waste handling protection.Methods:(1)A questionnaire was conducted to collect information on the disposal of cytotoxic waste in medical staff.(2)By collecting information on cytotoxic drug prescriptions,the amount of drug left in the vial that is not fully used(wasted amount)was calculated,along with its cost,and the degree of wastage was examined.(3)The methods were established to determine the content of cytotoxic drugs,including Cyclophosphamide,Ifosfamide,Cisplatin,and 5-Fluorouracil,and the drug residual amounts in the infusion bags and empty vials after use were detected.The drug residual amounts in empty vials after drugs dispensed by both intelligent dispensing robots and manual dispensing was compared.(4)Based on the data obtained from the study on the residual and remaining amounts of cytotoxic drugs in vials and infusion bags,the hazards of various wastes generated in the process of handling cytotoxic drugs were analyzed,and protective measures were formulated for the safe disposal of cytotoxic waste.Results:(1)A total of 85 online questionnaires were distributed,and 75 were validly returned,resulting in a valid return rate of 88.24%.Among the 75 participates,more than half had little knowledge of cytotoxic waste and its hazards.(2)During the three-month study period,a total of 3,509 cases of waste-generating prescriptions were collected.The wasted drug was a total of 314,898.625 mg,accounting for 4.91% of the total drug use,and the cost of wasted drug was 315,884 Yuan,accounting for 2.80% of the total drug use cost.(3)After the intelligent dispensing robot dispenses the drug,the residual amounts of150 empty vials ranged from 1.130 to 29.450 mg,with a percentage range of the residual amounts from 0.73% to 4.90%.When the drug was manually dispensed,the residual amounts of 120 empty vials ranged from 1.030 to 43.350 mg,with a percentage range of the residual amounts from 0.73% to 8.67%.The percentages of residual amount for the two dispensing methods were 2.23%(1.66%,3.36%)and 3.02%(1.52%,4.40%),respectively,with p < 0.001.The percentages of residual amounts for different sizes of infusion bags were 1.97%±0.63%,1.09%(0.94%,1.38%),and 0.70%(0.57%,0.82%),respectively,with p < 0.001.Conclusions:(1)At present,medical staff’s awareness of the classification and hazards of cytotoxic waste is not optimistic,and their understanding of waste safe handling measures is relatively low.Therefore,hospitals should develop special labelling,classification,collection,storage,transportation,and disposal methods for cytotoxic waste.(2)Cytotoxic drugs have a high level of wastage.Reducing the remaining amounts of cytotoxic drugs left in vials can help save medical resources and reduce exposure risks during cytotoxic waste handling.(3)Intelligent dispensing robot were found to leave less residues in empty vials of drugs compared to manual dispensing methods.Additionally,the larger the size of the infusion bag,the less the percentage of the residual amounts.(4)For the multiple steps of classification,collection,transportation,storage,final disposal of cytotoxic waste and the disposal of excretion from chemotherapy patients,safe handling protective measures for the cytotoxic waste,developed at both the direct and indirect contact levels,can reduce the risk of exposure for medical staff. |
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