Abstract
2150
Objectives: To evaluate a change of practice from using unit doses of 99mTC-Filtered Sulfur Colloid (99mTc-FSC) to bulk vial dispensing of 99mTc-FSC for routine and add-on procedures in the operating room.
Methods: Prior to being able to draw unit doses from a 99mTc-FSC bulk vial(s), the United States Pharmacopeia (USP) Sterile Compounding Chapter (797) guidelines were taken into account. Some of the tasks needed to be completed include air quality certification and environmental monitoring of the biological safety cabinets and hot lab area. Further, Nuclear Medicine Technologists (NMT) were required to document various handling training such as aseptic technique and media fill testing. Once the hot lab, laminar flow hoods and NMTs satisfied all required parameters for low risk sterile compounding, an initial trial period of dispensing 99mTc-FSC unit doses from a bulk vial began. To assess feasibility, data was collected for the three listed endpoints: (1) To evaluate operational efficiency, a survey was conducted amongst team members to determine if bulk vial use improved the 99mTc-FSC ordering/dispensing process and overall 99mTc-FSC turnaround time. (2)To evaluate the improvement of 99mTc-FSC delivery time once an add-on STAT order is placed. (3)To measure cost savings, we documented, in a three month period, the number of individual doses dispensed from a bulk vial and compared it to the hypothetical cost of ordering individual unit doses from the radiopharmacy. Results: Survey results from NMT and stakeholders demonstrated that 99mTc-FSC bulk use was highly favored. NMTs could readily draw unit doses from the bulk vials when needed for scheduled patients and any add-on/STAT requests. The turn-around time for our stakeholders was significantly reduced from an estimated two hours to less than 15 minutes wait time. Additionally, the project proved to be highly cost effective. A cost comparison was done for the month of April 2017, with a total estimated savings of $9,410.00 in one month. Conclusions: The overall consensus favored utilizing bulk 99mTc-FSC over purchasing unit doses from the radiopharmacy. The use of bulk 99mTc-FSC has effectively streamlined our operation, proven to be financially favorable and improved turnaround time for add-on procedures by making the drug easily accessible and reducing the wait time for 99mTc-FSC.