Background

The supply and use of parenteral anticancer therapies in hospitals is acknowledged as high risk for medication safety and financial accountability.  Health services may prepare products on-site or engage external compounders for supply.  It can be difficult to find accurate information to ensure safe and best practice.

Aim

To review current manufacturing information and develop standardised manufacturing, storage and labeling guidelines for anticancer therapies for the manufacturing unit of a large metropolitan tertiary hospital.

Method

A systematic review of evidence relating to storage and manufacturing procedures for all parenteral anticancer therapies manufactured at the hospital was undertaken.

Information that was sourced related to:

-       Dilution and storage conditions of originator brand vial  

-       Dilution, fluid, volume, storage and expiry of manufactured product for administration

-       Auxiliary labeling of final product

Where possible, fluids and container types were standardised to streamline manufacturing processes and optimise the use of a manufacturing robot.

Results

From the extensive literature review, a fully referenced Admixture Summary document was produced and implemented within the manufacturing unit.

Practices were updated to reflect the changes in manufacturing information from the review with training and support provided as needed to manufacturing staff. Electronic chemotherapy orders were also updated to reflect these changes.

Conclusion

The development and implementation of standardised manufacturing guidelines has improved consistency and facilitated best practice in manufacturing for these high risk medications.