Prevention Guide - Safe Handling of Hazardous Drugs - Irsst

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11. PATIENT CARE ‣ the lid of the toilet should be closed and the toilet flushed twice after being used to eliminate the contamination. Clean the toilet rim, as well as the floor around the toilet, daily. The toilet should be cleaned with the usual cleaning products; the cleaning cloths used for this purpose should not be used on other surfaces; ‣ patients receiving drugs via infusion over extended periods (e.g. 24 hours) should use a plasticized mattress cover to avoid contaminating their mattress in the event of accidental disconnection of the infusion; ‣ a spill kit should be available in the home if the patient receives drugs when the CLSC (Local community service centre) nurse is not present (e.g. pump, selfadministration). Patients or their families should know how to use the spill kit. APES, p. 5-29 ♦ CSHP, Section 8.2.4 11.3.4 Use of Pumps to Administer Hazardous Drugs RATING: + Establish policies for pump maintenance. RECOMMENDATIONS 11.3.4.1 A portion of the pump inventory may be reserved for the patients receiving hazardous drugs via pump. Generally speaking, the pumps should be cleaned between patients and prior to being sent elsewhere in the institution. If pump management is centralized, a cleaning procedure can be established for potentially contaminated pumps before they are used by other patients (e.g. cleaning the outside of the pump with a towelette). 11.3.4.2 A policy should be established regarding the handling of potentially contaminated pumps by biomedical engineering workers, i.e., clean the pump before carrying out an intervention and wear a pair of gloves when performing preventive maintenance or repairs. 11-4 ASSTSAS PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS
11. PATIENT CARE Table 8. Hazardous Drugs: Duration of the Presence of Detectable Residues in the Excreta Drug Duration of the Presence of Detectable Residues in the Urine Duration of the Presence of Detectable Residues in the Stools Bleomycin sulfate 72 hr; 50% excreted in the first 24 hr -- Busulfan 12-24 hr -- Capecitabine 24 hr -- Carboplatin 24-48 hr; 60% in the first 24 hr -- Carmustine 4 days -- Cisplatin 7 days -- Cyclophosphamide 72 hr 5 days after oral dose Cytarabine 24 hr -- Dacarbazine 6 hr -- Dactinomycin 5 days; 20% in the first 24 hr -- Daunorubicin 48 hr 7 days Docetaxel 7 days 7 days; 80% in the first 48 hr Doxorubicin 6 days 7 days Epirubicin 7 days 5 days Etoposide 4 days 7 days Fludarabine 48 hr -- Fluorouracil 48 hr -- Gemcitabine 7 days -- Hydroxyurea 12 hr -- Ifosfamide 48 hr -- Imatinib mesylate 7 days 7 days Irinotecan 48 hr -- Lomustine 24 hr -- Mechlorethamine 48 hr -- hydrochloride Melphalan 48 hr 7 days Mercaptopurine 48-72 hr; 50% in the first 24 hr -- Methotrexate 72 hr; major problem during the first 8 hr 7 days Mitomycin 24 hr -- Mitoxantrone 6 days 7 days hydrochloride Paclitaxel 24 hr 5 days Pegaspargase Not detectable -- Tamoxifen -- 2 weeks Teniposide 5 days 48 hr Thioguanine 24 hr -- Thiotepa 24 hr -- Vinblastine sulfate 4 days 7 days Vincristine sulfate 4 days 7 days Source: ONS – Safe handling of hazardous drugs, 2003, p. 28. PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS ASSTSAS 11-5
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Prevention Guide Safe Handling of H
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Prevention Guide Safe Handling of H
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This guide has been developed by th
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Table of Contents PREAMBLE ........
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List of Tables Table 1 Medication C
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PREAMBLE In September 2004, the Uni
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1. INTRODUCTION 1.1.1 Survey Regard
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1. INTRODUCTION 1.3 Guide Structure
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2. RISKS RELATED TO THE USE OF HAZA
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Pharmacy Care Wastes Support Receiv
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3. PREVENTION OBJECTIVES AND ACTION
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4. GENERAL PREVENTIVE MEASURES 4 GE
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4. GENERAL PREVENTIVE MEASURES 4.1.
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4. GENERAL PREVENTIVE MEASURES 4.1.
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4. GENERAL PREVENTIVE MEASURES clea
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4. GENERAL PREVENTIVE MEASURES Tabl
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4. GENERAL PREVENTIVE MEASURES Gras
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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
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Page 106 and 107: 12. MANAGEMENT OF WASTE, ACCIDENTAL
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 142 and 143: APPENDIX 3 - SURVEY REGARDING PRACT
Page 149 and 150: APPENDIX 4 - HAZARDOUS SPILL MANAGE
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5. MEASUREMENT OF WORK SURFACE CONT
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