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PROTOCOL OF ACTION AGAINST DRUGS SUSCEPTIBLE OF CONTACT WITH SUSPECT COVID-19 PATIENTS IN A PSYCHIATRIC HOSPITAL

European Statement

Patient Safety and Quality Assurance

Author(s)

JUAN MIGUEL PEÑALVER GONZALEZ, EVA MARIA ROBLES BLAZQUEZ, MARINA MARTINEZ DE GUZMAN

Why was it done?

The possibility of hospitalized patients with COVID-19 has required substantial changes in protocols and workflows, including those related to the use of medications.

What was done?

The objective is to develop an action protocol to be followed against drugs that may have been in contact with patients suspected of COVID-19 infection in our hospital.

How was it done?

1-Anticipation of risk of cross contamination: it must be ensured that the drugs of suspected COVID-19 patients are not handled together with the rest of the medication.
2-Decrease in traffic and limit cross contamination:
– Temporarily increase the stock of medicines in the medicine cabinets to decrease the frequency of restocking.
– Dispense only the medications necessary to minimize the volume of items returned to the Pharmacy.
– Store medications in multiple containers with fewer doses per container to minimize tactile contamination of the container when removing medications. To do this, after reviewing the inventory reports, drugs that are not used are withdrawn to make room for drugs with more movement.
– Do not use the same storage box for >1 drug, thus reducing cross contamination from other stocks.
3-Safe storage of critical items: place drugs with high demand, scarcity or that require stricter control in drawers with greater supervision and periodic inventory.
4-Security policy for returns: unused medications are placed in a plastic bag labeled with the date and sent to the Pharmacy, where they are stored in a safe place and separate from the rest of the medication. After at least 3 days, the viability of any possible SARS-CoV-2 virus will be eliminated from their surfaces (ISMP-N van Doremalen et al. 2020). It is not allowed to return multi-dose vials, single-dose or multi-dose formulations (creams, eye drops, syrups) of medications that have been in the room of the suspected COVID-19 patient.
5-When handling drugs in the plant, professionals should follow a “clean hands” approach, performing hand hygiene before and after accessing the drug.

What has been achieved?

An action protocol is agreed with the Nursing Directorate; it is pending approval in the next few days and the circuit will be simulated.
Limitations: After several months on alert for COVID-19, there have been no cases in our hospital. However, said action measures will be in force in any case of alert.

What next?

This circuit and measures are easily applicable to Pharmacy Services of other hospitals with a higher incidence of COVID-19 infection than ours.
Likewise, this protocol is valid for any other infectious agent that may appear in the future.

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