Although the project for the central application of cytostatics was supposed to be completed during this year, in September, the exact date of commissioning of this system, which is very important for patients and staff in oncology, is not yet known.
The largest health institution says that they are bringing to an end the realization of that big project, which is important for the entire health community and oncology patients, but "Vijesti" sources claim that this system could be launched by the middle of 2024.
They also claim that the management, before the delivery of the device, should have thought about the preparation of the rooms, the air conditioning and the staff necessary to operate the device and prepare cytostatics, so that the project could be completed without delay during this year.
According to KCCG's answers, the device, i.e. the isolator for the central application of cytostatics, was acquired at the end of March 2023, when a public procurement contract worth 453.750 euros was signed, and the deadline for delivery was six months, as this type of equipment requires a longer period for production. And that deadline was "broken" by two months, and sources claim that the reason is the unpreparedness of the space for delivery and assembly.
The software, worth 254.100 euros, was acquired in mid-November, while the adaptation cost 144.654 euros.
"So, the equipment has already been installed and there is still air conditioning to be installed, after which the validation of the room will be done, and then the training of the staff. The exact date of the training will depend on the availability of the appointment of the application specialists after the installation and commissioning of the air conditioning", the response of KCCG states.
Sources explain that the tender for air conditioning lasts until December 15 and, if there are no complaints, the delivery time is 75 days from the date of conclusion of the contract.
When asked who will work on that device and whether there is a plan to hire new staff and train employees, they said that they received approval from the Ministry of Health for four pharmaceutical technicians, while they are still waiting for the approval of the authorities for two pharmacists, after which they will announce a competition for their reception.
They explained that this will be followed by a five-week education from experts who have done the training in other health centers that have that system.
A system that is ready for a cancer epidemic
The central preparation of cytostatics is a system that has been applied for several decades in all major oncology centers in Western Europe, the USA, and Australia, but which is now rapidly being introduced in medium-developed countries in the world, including the countries of the region, explained the KCCG.
They said that this system is being introduced precisely because of reliability, protection of employees from carcinogenic and mutagenic cytotoxic substances, but also huge savings when preparing chemotherapy and very expensive targeted immunotherapy.
"Precisely thanks to this type of therapy preparation in a large oncology clinic in Western Europe, but also in the surrounding area, the crowds in the waiting rooms in Day Hospitals for the application of therapy have been reduced because the appointment of the application is scheduled in advance, which, among other things, significantly affects the comfort and satisfaction of the patients, but also of employees", KCCG wrote in the reply.
They pointed out that putting this system into operation is a capital project of national importance for our country, as it includes the preparation of specific oncology therapy for all institutions where it is implemented on the territory of Montenegro.
That system, they claim, is also significant because it would leave a modern oncology service for generations to come, ready to respond to challenges in the future, including pandemics such as COVID-19, given the estimated increase in the number of oncology patients from as much as 47 percent to 2040 (WHO data from 2019).
"This system makes it possible to fulfill the legal norms of Occupational Safety, which enables better and more efficient protection of employed nurses and technicians who apply therapy, as well as doctors who work in day hospitals and wards, compared to the current method of preparation and minimizes the possibility of exposure to elevated doses cytotoxic and mutagenic substances", they said.
KCCG pointed out that the system enables computerized documentation of the preparation and application of accurate doses of drugs according to established oncology protocols, which are adapted to the patient's laboratory findings, with the complete exclusion of the human factor as a cause of error, so that the possibility of error in the preparation and application of this therapy does not exist.
Oncology dispensaries in the north and south in 2024?
In this institution, they also state numerous benefits of the project for the entire healthcare system, among other things, the possibility of decentralization of the oncology service in terms of application in centers in the north and south.
"The therapy would be prepared at the Institute of Oncology and transported closer to the patient's place of residence, which would, on the one hand, reduce significant funds for travel costs, and on the other, save time for patients who spend traveling, waiting and returning home, and that time with social psychological aspects can be used for the purpose of improving the quality of life", the answer reads.
KCCG also said that at the beginning of next year, the improvement of the oncology service will begin, where they expect the establishment of oncology dispensaries for the application of therapy in the north and south and the expansion of the Day Hospital of the Institute of Oncology. In this way, patients would be able to have a more comfortable time during the application of therapy, and the medical staff would have more time to devote to monitoring the effects and unwanted events of the treatment, educating patients and their family members, while providing psychological support to both.
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