Seeing a need and seeking a solution
With the assistance of student pharmacists like Alexsandra Nilges, the University of Kentucky plans to distribute 500 gallons of sanitizer every 2 weeks throughout the fall to support area health care providers and patients.
“All of the hand sanitizer was cleared out of the grocery store …”, I overheard from a nurse on the team as I left a patient’s room. That was at the earliest stages of COVID–19, when we, the inpatient pharmacy interns, were still onsite conducting medication histories in person.
This was also right around the time the shortage of personal protective equipment (PPE) and hand sanitizer for our front-line workers was becoming a nationally recognized issue. Leaving work that evening, I imagined different ways student pharmacists could get more involved. In March, FDA issued regulatory guidance for the temporary compounding of alcohol-based hand sanitizer products. Remembering this and the conversation I overheard at work, I e-mailed Clark Kebodeaux, PharmD, BCACP, our APhA–ASP Chapter Advisor at the University of Kentucky (UK) College of Pharmacy, to see if we could come up with a plan to compound hand sanitizer for University of Kentucky HealthCare (UKHC) and surrounding communities.
A call to action
In true fashion for the compassionate student body at UK, I was not alone in searching for a way to help, as fellow student pharmacists had asked him the very same question. Dr. Kebodeaux was already working internally with a team at UK and others on- and off-campus, including UKHC, the James B. Beam Institute at the UK College of Agriculture, Beam Suntory, and Alltech.
Pharmacists, as medication experts, have the unique training and skillset to compound sterile and non-sterile drug products. There were many considerations and logistical challenges to work through to adhere to FDA’s guidance and assure high-quality hand sanitizer made it to those who needed it most. That is where pharmacists are called to action. Safety measures, like social distancing and PPE, added an extra layer of complexity to the situation.
Outside the box collaboration
Training for a career in pharmacy primes you to work on a variety of health care teams. Interprofessional collaboration is in our nature, and this was an exciting opportunity to offer our flexibility, communication, and clinical skills as student pharmacists to professionals outside of our traditional network. When UK lab managers began working to source raw products to compound, it became clear we would need to look outside the typical health care realm. We turned to Kentucky’s bourbon industry for help. Kentucky distilleries had far greater manufacturing capabilities, allowing for large-scale production and a more efficient, timely impact.
Wasting no time, the James B. Beam Institute created the first batch of hand sanitizer using donations from the community: 250 gallons of ethanol from Beam Suntory and glycerin from Alltech. The bulk of the finished product was delivered to UK, where six students, Dr. Kebodeaux, and lab staff spent 5 hours in an assembly line in our sterile compounding lab rebottling, labeling, and packing the bulk product into useable containers for our front-line health care providers. For the next 500-gallon batch, the James B. Beam Institute, with faculty from UK College of Engineering, stepped in with machinery, drastically improving the process. Student pharmacists and engineering colleagues volunteered 10 hours that day to tackle the enormous task.
We continue to assist
Seeing a need and seeking a solution, this moment in history offered a new way for the pharmacy profession to serve our communities. To date, UK has had more than 50 student pharmacists and one PhD student volunteer in collaboration with members of the College of Agriculture and College of Engineering to bring this project to life. From here, we plan to make and distribute 500 gallons of sanitizer every 2 weeks throughout the fall to support our health care providers and patients.
We have certainly seized our moment at UK!
Alexsandra Nilges is a final-year PharmD/MBA candidate at the University of Kentucky College of Pharmacy. The author would like to acknowledge Clark Kebodeaux, PharmD, BCACP, R. Kip Guy, PhD; and Craig Martin, PharmD, MBA, for their assistance with the article.