Prevention Guide - Safe Handling of Hazardous Drugs - Irsst

3. PREVENTION OBJECTIVES AND ACTION PLAN
3 PREVENTION OBJECTIVES AND ACTION PLAN
Any prevention process must have an objective. The Committee is proposing one general objective and two
specific objectives.
3.1 General Objective
To reduce health care worker exposure to the lowest level possible, while preserving the integrity of the drug and
the health of the patients and their families.
3.2 Specific Objectives
‣ To reduce the environmental contamination level as much as technically possible.
‣ To eliminate the biological contamination of workers.
The ultimate objective is to ensure that workers are not contaminated. Absorption of hazardous drugs exposes
workers to the risks related to hazardous drugs. Unlike the patient, the worker derives no benefit from such
exposure. Achieving these objectives requires the implementation of the general and specific recommendations
contained in this guide.
3.2.1 Action Plan
This guide proposes an extensive review of the professional practices related to the health and safety of workers
who may be exposed to hazardous drugs. It is directed, in particular, toward the Occupational Health and Safety
Managers in each institution, the Heads of the Pharmacy Departments, the Directors of Nursing, and the union
representatives of the workers concerned. The Committee members are proposing that those institutions wishing
to review their practices adopt a structured approach, i.e.:
‣ that the institution create a Hazardous Drug Committee and designate its members (Section 4.1.2 of the guide
suggests a list of the individuals who should, ideally, be part of the Committee);
‣ that all members of the Hazardous Drug Committee in each institution read this guide carefully;
‣ that the Hazardous Drug Committee assess the risks in its facility.
First, the potentially exposed individuals and their numbers, the products used and the frequency of their use must
be identified. Although not mandatory in hospitals, the work station record prescribed by the Occupational Health
and Safety Act (Section 52) may be used for this purpose.
Second, the Committee should also assess the compliance of the practices, equipment and facilities, based on the
recommendations in this guide. The grid shown on the ASSTSAS Web site may facilitate this assessment.
Finally, the level of environmental contamination of the work areas likely to be contaminated (pharmacy,
oncology clinic, rooms of patients who have received chemotherapy, etc.) must be checked. [To this end, see
Chapter 15 and Appendix 5 for information regarding the tests offered by the INSPQ]. This overall assessment of
the situation may help determine intervention priorities (among other things).
‣ This risk assessment will enable the Hazardous Drug Committee of each institution to determine the corrective
measures to be implemented in the form of an action plan with an institution-specific timeline. The actions can
be prioritized according to several criteria, i.e.:
the respective level of contamination in the pharmacy, administration areas (e.g. oncology clinics)
and care areas (e.g. the rooms of patients receiving chemotherapy), as well as in all other areas
assessed; in general, according to the data in the scientific literature, the pharmacy is more
contaminated than the administration and care areas. However, depending on the facilities, equipment
and practices, this situation may vary from one institution to another. In addition, the environmental
assessment will allow the targeting of risk situations and possible solutions in a given area. For
example, substantial contamination of drug transport bins may mean that the drug bags were poorlycleaned
when they left the preparation cabinet. Based on this observation, it is possible to improve
the drug bag cleaning practices and introduce a periodic bin cleaning program.
PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS ASSTSAS 3-1