By BRIAN HOWARD, Messer Construction Co.
Starting in December 2019, the USP 800 guidelines will be the official standard for any healthcare personnel or facility that receives, prepares, administers, transports or disposes of hazardous drugs. Pharmacies, hospitals, health systems, healthcare professionals, clinics and veterinary offices will all be required to comply with the new standard, protecting both patients and healthcare workers. Messer Construction Co. has been preparing for the latest pharmacy update by renovating facilities with the proper requirements in order for them to remain fully operational and fully compliant.
While most healthcare is focused on patient well-being, this standard encompasses anyone coming into contact with the hazardous drugs, as exposure to even small amounts can have a negative impact on health. With the USP 800 standards, worker and environmental exposure to hazardous drugs will be minimized. Failing to adjust to the new standard is not only a hazard for the safety of those handling the drugs but will also lead to fines and potential closures of facilities until the USP 800 requirements are met.
A variety of regulations and standards are included in the USP 800:
- training related to handling, receiving, labeling, packaging, transport, disposal and cleaning of hazardous drugs;
- personal protective equipment updates; and
- required administrative devices and techniques.
Besides how the hazardous drugs are safely handled by employees, USP 800 has strict guidelines for major facility engineering and building, including pressurized rooms and ductwork. Some facilities can adjust by purchasing and installing updated equipment, while others must undergo major renovations and construction to fully comply.
In order to facilitate fully compliant pharmacies under the guidelines in USP 800, Messer has been working on several complex construction projects at seven separate pharmacies in Nashville since February 2019. These updates represent a major investment, totaling more than $3 million across nearly 6,000 square feet of pharmacy space. Besides the actual build, equipment is an additional cost in a very competitive market, as pharmacies nationwide must purchase items meeting the USP 800 standard. With more demand, comes a longer lead time for time-sensitive renovations.
One of the larger aspects of the USP 800 is the build of pressurized rooms, with some needing additional exhaust improvements. The proper exhaust is required to maintain accurate pressurizations. Without these controlled rooms, studies have found contamination from hazardous drugs in areas outside of labs, including break rooms and retail space. When preparing, scooping or opening vessels containing any powdered-based drugs, the particles can easily become airborne. Without proper containing pressure, each time a door is opened, these airborne particles have the chance to be circulated between rooms.
With the required negative pressure rooms, hazardous drugs are less likely to contaminant rooms in the vicinity because the negative pressure room creates a vacuum, only allowing airflow in and not out. These rooms must be monitored for continual proper pressure and are outfitted with special sensors.
With each space being different, some pharmacies require highly secure rooms built within existing spaces. Messer has constructed these in a way that works logistically without negatively impacting the pharmacy workflow. Within existing pharmacies, especially those in hospitals, construction does have an impact on adjacent spaces, so it’s important construction providers work closely with each pharmacy through frequent communication to ensure a successful renovation within the mandated deadline.
USP 800 brought change and new standards for all aspects of handling hazardous drugs. With proper planning, communication and adherence to deadlines, construction companies can help pharmacies b become fully compliant and create a healthier environment for all.
Brian Howard is a senior project executive at Messer Construction Co. and has been with the company since 2000. Besides working with USP 800 pharmacy updates, Howard is on an advisory board with the Academies of Nashville Public School and is a member of Associated General Contractors of Middle Tennessee.