Making hand sanitizer, from left: Kyle Farina, PharmD, pharmacy resident; and Melissa Brega, PharmD, and Amber Ng, PharmD, both Assistant Directors of Pharmacy Operations.
As the COVID-19 crisis has worn on, many Mount Sinai teams have found ways to pitch in and make do. One of them is the Pharmacy Department, which recently gathered a small team to make hand sanitizer to be used in the Health System’s pharmacies.
“We are always looking for ways to work smarter, and to use our resources wisely,” says Susan Mashni, PharmD, Vice President and Chief Pharmacy Officer, Mount Sinai Health System. The project came about for several reasons. Most important, there is a nationwide shortage of hand sanitizer, which led the U.S. Food and Drug Administration to release a new protocol, allowing pharmacies to make sanitizer internally for their own use. Around the same time, an inventory of the chemical storage space at the Mount Sinai Hospital Pharmacy found multiple gallons of highly concentrated alcohol, the kind normally used in laboratories.
“We were actually looking for something else, and we found the alcohol,” says Gina Caliendo, PharmD, Senior Director of Pharmacy, The Mount Sinai Hospital. “It had been there for so long that we didn’t know who had originally purchased it.”
The alcohol was perfectly usable, she says, and with that in hand, the next task was finding the other ingredients—hydrogen peroxide, glycerin, and a denaturing agent, usually an oil, that renders the alcohol undrinkable.
“The problem is that all of the ingredients you need to make it were also in short supply,” Dr. Caliendo says. The Department sent out a call to Mount Sinai’s research laboratories, and “the lab people answered right away,” she says, but ultimately the team found suppliers who could provide bigger quantities.
For the scented oil, there were many potential choices—peppermint, anise, wintergreen, clove, or eucalyptus. Dr. Mashni informally polled other Mount Sinai leaders on the daily operations call, and the winner was lavender. “We were able to find lavender oil in the appropriate amount,” Dr. Caliendo says. “And it had the added aromatherapy aspect. Lavender can help calm people down a little bit.”
Making hand sanitizer was a first for everyone. So the team studied the instructions, and did some math to scale the portions down, and Dr. Caliendo practiced making it at home. Finally, a small team went into action at The Mount Sinai Hospital Pharmacy, strictly following the FDA guidance. “We mixed the sanitizer, packaged it, labeled it, then quarantined it for three days to kill any spores in the bottles.”
The eight-ounce bottles they produced have been dispersed to pharmacies, where staff members use them for routine hand hygiene and in tasks like handling and preparing sterile products. The project may have been small scale, especially compared with the pharmacy’s other tasks, such as supporting system-wide studies and guidelines for the COVID-19 crisis. But it was gratifying to the team.
“Making some of our own sanitizer meant just a few more bottles that could be used on patient units or more public locations like the cafeteria,” Dr. Mashni says “It was something we could work together on—a way we could help out.”