The practice of segregating HDs from non-HDs in storage areas is nearly universal across facilities of all sizes.

Pharmacy’s commitment to emphasizing HD containment at every step in the HD continuum is noticeable in the unpacking process. The vast majority of facilities are unpacking HDs in either a neutral- or negative-pressure area.

While the majority of unpacking activities currently occur in a neutral pressure area, that is likely to change over the next few years given the strong move to utilizing negative-pressure rooms for HD unpacking. Over the past 5 years, the number of facilities moving their unpacking activities from neutral pressure areas to negative pressure areas has more than doubled and we expect this trend to continue.

Purchases of refrigerators for NIOSH Group 1 HD storage continue to increase. Most facilities (87%) meet the USP requirement for locating dedicated refrigerators in a negative pressure area with at least 12 ACPH, typically a storage room, buffer room, or C-SCA.

Given the potential for contaminating the entire tube system if an HD were to leak or break, pneumatic tube systems cannot be used to transport any antineoplastic agent or HD liquid. As such, compliance to this metric should be 100%.