Prevention Guide - Safe Handling of Hazardous Drugs - Irsst

More documents

Recommendations

Info

Figure 9 Sample Layout of an Oncology Pharmacy with a High Preparation Volume ....................................................................................................................................... 7-7 Figure 10 Sample Layout of a Small Oncology Pharmacy ....................................................................... 7-8 Figure 11 Minimum Distances Recommended for the Positioning of Biological Safety Cabinets ...................................................................................................................................... 7-9 Figure 12 Phaseal ® Closed-circuit System ................................................................................................ 8-2 Figure 13 Cleaning Procedure for Drug Bags Prepared in the Preparation Cabinet ................................................................................................................... 8-9 Figure 14 Procedure for Cleaning a Syringe in the Preparation Cabinet ................................................ 8-10 Figure 15 Collecting the Air at the Top of the Bag ................................................................................. 10-5 Figure 16 Priming the Drug Bag .............................................................................................................. 10-5 Figure 17 Air Removal Using the “Retrograde” Technique ................................................................... 10-6 Figure 18 Removing Air from the Tubing Before Priming .................................................................... 10-6 Figure 19 Wrap the Tubing Connection Site with a Piece of Gauze when removing the Infusion Tubing .................................................................................................................. 10-7 Figure 20 Rinsing the Tubing Using the Retrograde Technique ............................................................ 10-9 Figure 21 Rinsing the Tubing with a Syringe ........................................................................................ 10-10 Figure 22 Various Containment Options for the Administration of Pentamidine or Ribavirin ................................................................................................................................. 10-14 PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS ASSTSAS vii
PREAMBLE In September 2004, the United States National Institute for Occupational Safety and Health (NIOSH) published an alert recommending more stringent preventive measures for the preparation and handling of hazardous drugs. This document quickly attracted attention in Quebec, where a number of institutions began questioning their preventive measures. The AQESSS Montreal Prevention Committee, as well as a number of institutions and organizations, have turned to the ASSTSAS for answers regarding medical and biological monitoring. In addition, some institutions whose pharmacy departments were being remodelled or were about to undergo remodelling wished to ensure the implementation of the proper measures, e.g. the type of pressure gradient required between the clean room , the antechamber and the general pharmacy. In 1995, the ASSTSAS – whose mission is to promote occupational health and safety in health and social services institutions – had published a prevention guide in this regard, which it was planning to revise in 2005. Due to the issuing of the NIOSH recommendations, this revision was completed earlier. Following a review of the reference material and extensive work in collaboration with a university hospital (CHUS) to assess the applicability of the NIOSH recommendations, the ASSTSAS felt it necessary to draw on the expertise and assistance of other stakeholders to produce a prevention guide which would reflect the diversity of the issues and points of view. The Association thus formed a committee with mandate to produce a prevention guide for the safe handling of hazardous drugs in Quebec health care institutions. This committee included professionals and stakeholders from the health care network with expertise and an interest in the hazardous drug issue. They have been introduced in a previous section. Some members were included in this committee in view of their expertise, while others were delegated by organizations with an interest in the issue (APES, AQATP, AQESSS, AQIO, CHQ, INSPQ, IRSST, MSSS). All of the members were asked to confer with their peers and collaborators in their respective environments. This guide sets out the Committee’s recommendations regarding how to safely handle hazardous drugs. It refers to practices which may present a risk of exposure to those working closely with or at a distance from these drugs. The recommendations contained in this guide are in keeping with the general recommendations of the majority of recent guides published in North America, Europe and Australia. This guide does not claim to address every issue, as some require further research. If necessary, updates will be published to supplement or clarify information regarding some of these issues. The measures proposed in this guide should be considered recommendations; they are not normative and are not mandatory. Each workplace is to implement them based on its individual circumstances. While the guide is primarily intended for health care workers, some recommendations apply to users of the health care network and their families. These recommendations are intended to protect these individuals from direct contact with sources of contamination and to ensure harmonization between institutional and home care. Patients and families who are properly informed regarding hazardous practices will be able, in turn, to help protect workers. viii ASSTSAS PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS
Page 1 and 2: Prevention Guide Safe Handling of H
Page 3 and 4: Prevention Guide Safe Handling of H
Page 5 and 6: This guide has been developed by th
Page 7 and 8: Table of Contents PREAMBLE ........
Page 9: List of Tables Table 1 Medication C
Page 14 and 15: 1. INTRODUCTION 1.1.1 Survey Regard
Page 16 and 17: 1. INTRODUCTION 1.3 Guide Structure
Page 19 and 20: 2. RISKS RELATED TO THE USE OF HAZA
Page 23 and 24: Pharmacy Care Wastes Support Receiv
Page 31: 2. RISKS RELATED TO THE USE OF HAZA
Page 34 and 35: 3. PREVENTION OBJECTIVES AND ACTION
Page 37 and 38: 4. GENERAL PREVENTIVE MEASURES 4 GE
Page 39 and 40: 4. GENERAL PREVENTIVE MEASURES 4.1.
Page 41 and 42: 4. GENERAL PREVENTIVE MEASURES 4.1.
Page 43 and 44: 4. GENERAL PREVENTIVE MEASURES clea
Page 45 and 46: 4. GENERAL PREVENTIVE MEASURES Tabl
Page 47: 4. GENERAL PREVENTIVE MEASURES Gras
Page 50 and 51: 5. RECEIVING AND TRANSPORT 5.3.2 De
Page 53 and 54: 6. UNPACKING AND STORAGE 6 UNPACKIN
Page 55 and 56: 6. UNPACKING AND STORAGE 6.3.3 Unpa
Page 57: 6. UNPACKING AND STORAGE 6.3.6 Spil
Page 60 and 61:
7. PLANNING THE ONCOLOGY PHARMACY 7
Page 62 and 63:
7. PLANNING THE ONCOLOGY PHARMACY
Page 64 and 65:
7. PLANNING THE ONCOLOGY PHARMACY b
Page 66 and 67:
Fridge 7. PLANNING THE ONCOLOGY PHA
Page 68 and 69:
7. PLANNING THE ONCOLOGY PHARMACY T
Page 70 and 71:
8. DRUG PREPARATION The product nev
Page 72 and 73:
8. DRUG PREPARATION ‣ avoid sudde
Page 74 and 75:
8. DRUG PREPARATION or “Caution
Page 76 and 77:
8. DRUG PREPARATION 8.3.9 Preparing
Page 78 and 79:
8. DRUG PREPARATION Wearing both
Page 80 and 81:
9. TRANSPORT AND STORAGE FOLLOWING
Page 82 and 83:
10. ADMINISTRATION OF DRUGS Adminis
Page 84 and 85:
10. ADMINISTRATION OF DRUGS Nurses
Page 86 and 87:
10. ADMINISTRATION OF DRUGS Primary
Page 88 and 89:
10. ADMINISTRATION OF DRUGS Establi
Page 90 and 91:
10. ADMINISTRATION OF DRUGS if a o
Page 92 and 93:
10. ADMINISTRATION OF DRUGS 10.3.10
Page 94 and 95:
10. ADMINISTRATION OF DRUGS 10.3.13
Page 96 and 97:
10. ADMINISTRATION OF DRUGS contain
Page 99 and 100:
11. PATIENT CARE 11 PATIENT CARE 11
Page 101 and 102:
11. PATIENT CARE arrive (see 13.3.1
Page 103:
11. PATIENT CARE Table 8. Hazardous
Page 106 and 107:
12. MANAGEMENT OF WASTE, ACCIDENTAL
Page 108 and 109:
Page 110 and 111:
Page 112 and 113:
13. HYGIENE AND SANITATION 13.2 Exp
Page 115:
14. LAUNDRY 14 LAUNDRY 14.1 Issues
Page 118 and 119:
15. MEDICAL, BIOLOGICAL AND ENVIRON
Page 120 and 121:
15. MEDICAL, BIOLOGICAL AND ENVIRON
Page 123 and 124:
16. REFERENCES 16 REFERENCES AHQ [1
Page 125:
16. REFERENCES Nygren O., Lundgren
Page 129 and 130:
APPENDIX 1 - GLOSSARY APPENDIX 1- G
Page 131 and 132:
APPENDIX 1 - GLOSSARY TERMS DEFINIT
Page 133:
APPENDIX 1 - GLOSSARY TERMS DEFINIT
Page 136 and 137:
APPENDIX 2 - LIST OF HAZARDOUS DRUG
Page 138 and 139:
Page 140 and 141:
Page 142 and 143:
APPENDIX 3 - SURVEY REGARDING PRACT
Page 144 and 145:
Page 146 and 147:
Page 149 and 150:
APPENDIX 4 - HAZARDOUS SPILL MANAGE
Page 151 and 152:
APPENDIX 4 - HAZARDOUS SPILL MANAGE
Page 153 and 154:
5. MEASUREMENT OF WORK SURFACE CONT
show all

Prevention Guide - Safe Handling of Hazardous Drugs - Irsst

Create successful ePaper yourself

Delete template?

Save as template?