Prevention Guide - Safe Handling of Hazardous Drugs - Irsst

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3. PREVENTION OBJECTIVES AND ACTION PLAN the effectiveness of the measure. The better an action can eliminate contamination at the source, the more effective it is. For example, washing the drug vials received from distributors will allow the removal of a source of contamination at the beginning of the preparation circuit. the feasibility and costs. When reading this guide, you will note that some measures are easy to implement and require practice modifications with no financial impact on the institution (e.g. separating the hazardous drugs from the other drugs in storage); other measures require a practice change with an acceptable financial impact (e.g. double gloving, purchase of appropriate cases for the transport of hazardous drugs, certification of work methods); finally, other measures have a substantial financial impact (e.g. retrofitting of the sterile preparation room in the pharmacy). It is thus reasonable to immediately implement the measures which can be put into practice quickly, with a view to implementing the more difficult measures over a longer period of time. For information purposes, Table 3 illustrates the “traditional” classification of preventive measures. Due to the current situation regarding preventive measures (as revealed by the results of the survey conducted in Quebec in the spring of 2006) (Appendix 3), we feel that this guide will lead to a revamping of work methods in health care institutions. Each institution must prioritize its own actions. As seen above, the sources of exposure can vary from one institution to the next. The action plan must thus take into account the situation in each institution, including its level of contamination (which it will periodically be asked to document through the surface contamination analyses offered by the Institut national de santé publique (INSPQ) Toxicology Laboratory). In any case, the principle of prudent practice should be applied to every step of the medication circuit. In short, this guide cannot set a single timeline for the province of Quebec as a whole, due to the variability of the situation in each institution. 3-2 ASSTSAS PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS
3. PREVENTION OBJECTIVES AND ACTION PLAN Table 3. Classification of Preventive Methods Preventive Methods Engineering controls Layout of the premises and use of equipment to reduce the risk Collective protection Work practices Organization Personal protective equipment (PPE) Personal protection, dependent on the level of compliance with the recommendations Examples Hood or isolator Ventilation Closed-circuit preparation or administration system Needleless systems Preparation techniques in the hood Drug administration techniques Techniques for removing the PPE Cleaning of the premises (to avoid spreading the contamination) Collection of cytotoxic waste Spill recovery Hazardous drug inventory, data sheets (with update) and identification with labels Training for positions at risk of exposure and assessment of techniques Environmental monitoring Procedure in the event of spills Post-accidental exposure follow-up procedure Damaged goods return procedure Respiratory Protection Program Management of cytotoxic waste Etc. Gloves Gowns Face protection Respirator (RPA) PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS ASSTSAS 3-3
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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
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Page 70 and 71: 8. DRUG PREPARATION The product nev
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Page 76 and 77: 8. DRUG PREPARATION 8.3.9 Preparing
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Page 80 and 81: 9. TRANSPORT AND STORAGE FOLLOWING
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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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