可塑剤ＤＥＨＰを溶出する恐れのある注射薬における輸液セットの対策についての一考察―医療施設の現状調査および看護師の意識調査―

Abstract

It is widely known that lipid-soluble injections (e.g. Paclitaxel) elute di (2-ethylhexyl) phthalate (DEHP), a plasticizer used in polyvinyl chloride (PVC) administration sets. A survey of the current situation in medical facilities revealed that 50% did not take adequate measures against this and in most of them, pharmacists were not involved in selecting administration sets. In the case of Kobe Teishin Hospital, the Medical Treatment Safety Management Committee decided to provide Paclitaxel and other injections together with PVC administration sets containing tris (2-ethylhexyl) trimellitate (TOTM), a plasticizer, which is less easily eluted than DEHP, in accordance with doctors' instructions. A questionnaire survey of hospital nurses conducted to compare the situation between before and after providing the TOTM sets revealed that their provision had eliminated the confusion nurses felt when administering injections and reduced the stock of administration sets. In conclusion, our findings show that it is necessary for pharmacists be involved in the selection of medical equipment for administering drugs to help ensure safety, that drugs are used properly, and economic use of resources.