Sequential Wipe Testing for Hazardous Drugs: A Quality Improvement Project

Monitoring for the presence of hazardous drug (HD) residue is recommended as part of a comprehensive HD safety program. However, a single wipe test provides limited information without the ability to evaluate interventions.

This quality improvement project was designed to evaluate the benefits of performing sequential HD wipe testing during a six-month period in an ambulatory cancer center.

Four areas in the pharmacy department and two areas in the infusion department were selected for testing, which was conducted at three time points. Cyclophosphamide, doxorubicin, 5-fluorouracil, methotrexate, and paclitaxel were tested using liquid chromatography coupled with tandem mass spectrometry.

The initial test demonstrated HD contamination on the legs of the IV pole and the pharmacy transport bin. All other areas were below the limit of detection. Changes were made to cleaning practices in the pharmacy and infusion departments prior to the subsequent tests at the three- and six-month time points, which produced levels below the limit of detection.