179 - The Impact of Education on Intravesical Chemotherapy in the Perioperative Setting
Description: An increase in the volume of Intravesical Chemotherapy (IC) treatment at Houston Methodist Hospital (HMH) presents a growing need for chemotherapy safety and education among perioperative staff in the Main Operating Room, PACU and Urological Residency Program. A review of current practice regarding care of patients receiving IC was recognized that national regulatory safety standards established by the United States Pharmacopeia, Occupational Safety and Health Organization, American Urology Association, Society of Urologic Nurses Association, and The National Institute for Occupational Safety and Health were not fully utilized in the perioperative setting at HMH. The purpose is to improve the safety of patients and healthcare workers in the perioperative setting through education and development of safety protocols that align with evidence based practice and national regulations. Educational topics included personal protective equipment (PPE), administration, handling, disposal, and proper spill/ contamination procedures. A QI/QA method using a questionnaire survey was used. Tools comprised of pre and post surveys, educational slide presentation, demo and hands on practice with a Closed System Drug Transfer Device (CSTD). Interdisciplinary team included Nursing, Scrub Technicians, Environmental Health and Safety, Physicians, Pharmacy, Housekeeping, Supply Chain, Sterile Processing Department, and Patient Care Assistants. Post survey resulted in 41% knowledge increase; 31% comfort increase among OR staff. A 40% knowledge increase among PACU staff. 83% knowledge increase among HMH Urological residents. The creation of a chemo supply cart provided efficient workflows to the perioperative staff with quicker access to PPE. A new standardized OR and PACU cleaning process was developed. Engineering controls were applied for the housekeeping staff handling the waste containers to help isolate the hazard. Environmental Health and Safety and the Sterile Processing Department joined forces on cleaning and disposing of the hazardous chemicals. Pharmacy Services now dispenses (CSTDs) to all OR chemotherapy syringes and integrated an electronic medication order set to the EMR to improve medication administration. Lastly, current and appropriate post-operative patient education is now included in the discharge of patients receiving IC. Perioperative implementation of safety protocols diminished inadvertent exposure of hazardous drugs to healthcare staff and patients across HMH. The increase in knowledge and comfort has encouraged correct administration technique, decreased safety events, and improved compliance with standard operating procedures defined by national regulatory agencies. Moving forward, annual competencies for perioperative staff will ensure the efforts of this project remain intact. The Urological Residency Program at HMH also recognized the value of the education and invited project members to present the educational material annually.