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Closed-loop systems

infusion set with one spike at the top for infusing non-hazardous substances or flushing during the infusion, and four-side needle-free access ports for connecting the various chemotherapeutic treatments.

The equipment we have chosen is completely opaque to protect photosensitive drugs. It is made with tubes and parts that are completely biocompatible with all types of drug that we use. It also has needle-free self-sealing valves for the administration of chemotherapeutic drugs and at the downward access point dedicated to boluses, to protect the nurse. Additionally, secondary sets are provided with one-way valves to prevent potentially non- compatible substances from being mixed. In 2010, preparation work was centralised, creating a chemotherapy handling unit (UMACA) at our hospital pharmacy, which is responsible for both stocking the drugs and reconstituting , ready to send to the hospital unit for administration, thereby eliminating the risks associated with the preparation phase of chemotherapy for the ward operator. In 2011, we also evaluated the Alaris SE large-volume infusion pump to improve the infusion accuracy of these drugs and increase patient safety. In terms of its characteristics, it proved to be perfectly aligned with our needs: ● It is a single pump with two separate infusion lines, which prevents non-compatible drugs from being simultaneously and/or accidentally administered between the two lines.

● It has software that allows us to calculate the administration rate, to programme multiple administration phases of a certain drug (for example, initial dose with progressive increase in infusion rate or doses of drug given at pre-programmed intervals) and much more.

● The Restart Plus function is triggered in case of temporary occlusions and allows continuous automatic infusion if the resistance measurements or in-line pressure measurements indicate that the occlusion has been resolved in a time frame of 40 seconds, during which the pump performs an automatic in-line check, so we do not have to intervene for occlusion false alarms.


● Resistance and pressure parameters, and graphic monitoring, allow us to assess the state of the blood vessel in real time, thereby allowing us to minimise the risk of drug extravasation and/or occlusion.

● The AccuSlide system, which is integrated into every Alaris SE pump infusion set, prevents potential free flow of chemotherapeutic drugs when the infusion set is taken out of the pump. It also allows us to adjust accurately the infusion whenever there is the need to continue the infusion via gravity (for example, patient undergoing CAT or MRI).

● It offers a wide range of infusion sets, one of which is the multi-way.

● CareFusion has shown efficient customer service and on-going training of staff involved in the testing phase. In conclusion, by using these new systems and technologies, and with the opening of UMACA (chemotherapy handling unit) we have reorganised and optimised the way we work. It has taken us almost two years to achieve the objective we set ourselves, which was to improve the safety of operators handling antiblastic drugs, as well as the safety of patients undergoing treatment in our care. ●

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