Prevention Guide - Safe Handling of Hazardous Drugs - Irsst

More documents

Recommendations

Info

APPENDIX 3 – SURVEY REGARDING PRACTICES IN THE NETWORK ‣ 29 preparation cabinets are 4 ft. wide , while 26 are 6 ft. wide; the others are of varying sizes (i.e., 3 or 5 ft.). 21 cabinets were purchased prior to 1990, 13 during the 1990s and the remainder since 2000. ‣ Only 6 respondents out of 53 report using a closed-circuit preparation device (i.e., PhaSeal ® , Tevadaptor ® ) during the past year. Half of the respondents (26/52) used a needleless system for drugs administered by nurses. The oncology pharmacy produces an average of 8,615 ± 8,552 (median – 6,050; [100-43,680]) preparations annually. Seven respondents use a pump in their production. ‣ The practice compliance criteria were based on the NIOSH recommendations and ASHP guidelines to March 31, 2006. The following compliance rates were obtained based on the respondents’ evaluations of the various statements: COMPLIANCE CRITERIA COMPLIANCE RATE (%) The Pharmacy Department certifies the preparation cabinets (i.e., hoods, microenvironments) every 6 months. (n = 53) The cytotoxic drug sterile preparation room in the pharmacy only contains the preparation cabinets and the equipment required on a daily basis (i.e., NO refrigerators, no computers/peripherals, no desks, etc.). (n = 53) The Pharmacy Department has a dedicated area for the non-sterile handling of hazardous drugs (e.g. cyclosporin, tacrolimus) for the counting of solid oral forms. (n = 52) 81 45 12 3.2.4 Drug Preparation COMPLIANCE CRITERIA All cytotoxic drugs (i.e., for oncology) for the patients treated by your institution are prepared in a preparation cabinet. No cytotoxic drugs for parenteral administration are prepared in the units or in the home by nurses. (n = 53) Workers wash their hands before putting on and immediately after removing their gloves, to limit contact contamination. (n = 53) No cytotoxic drugs are placed in an automatic packaging machine. (n = 53) During the preparation of cytotoxic drugs in the pharmacy, the syringes are never filled more than ¾ full. (n = 52) The Pharmacy Department provides its workers with protective equipment (i.e., chemotherapy gloves, impervious gowns, protective shields and goggles) in the event a shipment containing damaged goods is received and the receiving workers are trained and know how to respond should this occur. (n = 52) Pharmacy Department workers wear protective goggles and a respirator (N-95 or better) at all times when cleaning the inside of the cabinet (e.g. when lifting the floor of the work surface). (n = 52) COMPLIANCE RATE (%) 94 92 92 87 58 56 A3-4 ASSTSAS PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS
APPENDIX 3 – SURVEY REGARDING PRACTICES IN THE NETWORK COMPLIANCE CRITERIA The protective gloves are changed no less than every 30 minutes or when pierced, torn or contaminated or if the worker must leave the preparation cabinet. (n = 53) Pharmacy workers wear two pairs of gloves recognized for use in chemotherapy preparation when handling cytotoxic drugs in preparation cabinets. (n = 53) The Pharmacy Department installs the tubing required for the administration of cytotoxic drugs and primes it (i.e., purges it to remove any air) in the pharmacy. (n = 53) Workers change their protective gown after 3.5 hours of use (i.e., half a day). (n = 52) Pharmacy Department workers are certified (i.e., re-evaluated) each year with respect to the handling, preparation, transport and use of hazardous and cytotoxic drugs. (n = 53) COMPLIANCE RATE (%) 51 45 40 35 6 3.2.5 Transport and Storage Following Preparation COMPLIANCE CRITERIA All of the cytotoxic drug sterile preparation containers (i.e., bags, syringes) are transported to the care units /clinics in a secure container. (n = 52) The pharmacy workers use uncontaminated gloves to handle the finished product and the cytotoxic drug transport bag. (n = 53) COMPLIANCE RATE (%) 83 26 3.2.6 Drug Administration (Chapter 10) COMPLIANCE CRITERIA The nurses never crush cytotoxic or hazardous drugs for oral administration. (n = 47) There is a rinsing procedure following the administration of cytotoxic drugs that minimizes the risk of occupational exposure. (n = 37) The nurses wear a protective gown and gloves during the handling of excreta from patients who have received cytotoxic drugs. (n = 51) The nurses wear a protective gown and at least one pair of gloves throughout the entire period of cytotoxic drug administration. (n = 51) The workers change the protective gown after 3.5 hours of use (i.e., half a day). (n = 52) The nurses wear a protective shield/goggles when there is a risk of splashing. (n = 51) COMPLIANCE RATE (%) 89 81 55 54 35 31 PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS ASSTSAS A3-5
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 and 10:
List of Tables Table 1 Medication C
Page 11:
PREAMBLE In September 2004, the Uni
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 21 and 22:
Page 23 and 24:
Pharmacy Care Wastes Support Receiv
Page 25 and 26:
Page 27 and 28:
Page 29 and 30:
Page 31:
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 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 146 and 147: APPENDIX 3 - SURVEY REGARDING PRACT
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?