Prevention Guide - Safe Handling of Hazardous Drugs - Irsst

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1. INTRODUCTION 1.3 Guide Structure The first three chapters are an introduction, describing the risks related to hazardous drugs and establishing prevention objectives. Chapter 4 describes the general preventive measures that apply to every step of the medication circuit in the institution. The order of the other chapters is based on the medication circuit in the institution: receiving of the drugs and their transport to the pharmacy, unpacking and storage, preparation, administration, etc. Each chapter is structured the same way: ‣ description of issues and risks related to the step concerned; ‣ identification of individuals at risk of exposure; ‣ preventive measures discussed and documented; these are presented in the following manner: Rating General recommendation Specific recommendations References Rating: the Committee assigned a confidence rating to each general recommendation, based on an evaluation scale regarding the level of scientific evidence supporting the recommendation. This scale has three levels: • +++ refers to strong evidence; • ++ refers to moderate evidence; • + refers to limited evidence and is the subject of discussion in the scientific literature; • in some cases, the rating applicable to the general recommendation does not apply to a specific recommendation; in this instance, the rating applicable to the specific recommendation appears in brackets following the recommendation. General recommendation: the title of the recommendation is in boldface and the wording is general in nature. 1-4 ASSTSAS PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS
1. INTRODUCTION Specific recommendations: each general recommendation is followed by one or more specific recommendations. References: this Section indicates whether the recommendation is also found in the guides of the organizations cited. The data are listed according to the page or Section of the guide (e.g. ASHP, page 1174; OSHA, Section Vc) where there is a similar recommendation. If a reference organization is not listed in this Section, that organization’s guidelines do not include recommendations in that specific area. Chapter 15 details the recommendations regarding medical and environmental monitoring. Various items are described in a number of appendices: drug list, procedures, etc. 1.4 Additional Sources of Documentation The work of the Committee resulted in the compilation of numerous documents related to the hazardous drug issue. The ASSTSAS Web site has a Section regarding hazardous drugs which includes the following tools and documents: ‣ questionnaire distributed to the institutions and link to the publication; ‣ summary of discussions with NIOSH; ‣ link with the CHQ documentation regarding facility standards; ‣ INSPQ offer of services regarding environmental monitoring; ‣ suggested bibliography; ‣ relevant hyperlinks (e.g. guidelines, guides, alerts proposed by various organizations, WHMIS, Material Safety Data Sheet (MSDS)). This Section will be updated periodically. 1.5 Guide Updates The store of knowledge regarding the risks related to hazardous drugs and how to prevent them is constantly growing and is continually being supplemented by new material. Moreover, as previously stated, some of the issues dealt with in this guide are not as well-supported by scientific evidence as others. With time, we feel that new light will be shed on some of these areas. Both the ASSTSAS and the Working Committee members will continue to follow this matter closely, in order to keep the guide current. We plan to publish updates as more knowledge becomes available. These will be posted on the hazardous drugs page of the ASSTSAS Web site. PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS ASSTSAS 1-5
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8. DRUG PREPARATION The product nev
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8. DRUG PREPARATION ‣ avoid sudde
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8. DRUG PREPARATION or “Caution
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8. DRUG PREPARATION 8.3.9 Preparing
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8. DRUG PREPARATION Wearing both
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9. TRANSPORT AND STORAGE FOLLOWING
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10. ADMINISTRATION OF DRUGS Adminis
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10. ADMINISTRATION OF DRUGS Nurses
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10. ADMINISTRATION OF DRUGS Primary
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10. ADMINISTRATION OF DRUGS Establi
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10. ADMINISTRATION OF DRUGS if a o
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10. ADMINISTRATION OF DRUGS 10.3.10
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10. ADMINISTRATION OF DRUGS 10.3.13
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10. ADMINISTRATION OF DRUGS contain
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11. PATIENT CARE 11 PATIENT CARE 11
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11. PATIENT CARE arrive (see 13.3.1
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11. PATIENT CARE Table 8. Hazardous
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12. MANAGEMENT OF WASTE, ACCIDENTAL
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13. HYGIENE AND SANITATION 13.2 Exp
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14. LAUNDRY 14 LAUNDRY 14.1 Issues
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15. MEDICAL, BIOLOGICAL AND ENVIRON
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15. MEDICAL, BIOLOGICAL AND ENVIRON
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16. REFERENCES 16 REFERENCES AHQ [1
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16. REFERENCES Nygren O., Lundgren
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APPENDIX 1 - GLOSSARY APPENDIX 1- G
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APPENDIX 1 - GLOSSARY TERMS DEFINIT
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APPENDIX 1 - GLOSSARY TERMS DEFINIT
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APPENDIX 2 - LIST OF HAZARDOUS DRUG
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APPENDIX 3 - SURVEY REGARDING PRACT
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APPENDIX 4 - HAZARDOUS SPILL MANAGE
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APPENDIX 4 - HAZARDOUS SPILL MANAGE
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5. MEASUREMENT OF WORK SURFACE CONT
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