Prevention Guide - Safe Handling of Hazardous Drugs - Irsst

More documents

Recommendations

Info

4. GENERAL PREVENTIVE MEASURES 4.1.5 Identification and Safety RATING: +++ Ensure safe storage and transfer of hazardous drugs at every step of the medication circuit. RECOMMENDATIONS 4.1.5.1 Access to the Pharmacy Department must be restricted, at all times, to pharmacy workers. 4.1.5.2 Access to floor reserves and areas on care units where hazardous drugs are kept should be limited to the caregiving staff. 4.1.5.3 Antineoplastic drugs and their waste must be properly identified with the symbol described in CSA standard Z317.10, i.e., the symbol capital "C" and, under it, the words "CYTOTOXIC – CYTOTOXIQUE" in capital letters (Figure 2). Both the words and the symbol must appear on a dark grey rectangle. This logo is used for the antineoplastic hazardous drugs listed in Appendix 2 of this guide. FIGURE 2 "Cytotoxic" Hazard Symbol 4.1.5.4 Other hazardous drugs (which are not antineoplastic agents) should bear a warning or a "CAUTION" label. There is currently no recognized symbol for identifying other hazardous drugs which are not antineoplastic agents (and therefore, cytotoxic). Committees in both the United States and Canada are working on such a symbol. In Canada, the Globally Harmonized System (GHS), which will eventually replace the WHMIS, should cover hazardous drugs and establish symbols based on the effects of products. It will not be in use, however, until 2008-2010. While the term "Caution" is general and does not refer solely to the recommendations in this guide, the Committee members have decided not to create another identification symbol while awaiting a decision from regulatory authorities. (++) APES, p. 5-37 ♦ ASHP, p. 1175-76 ♦ CS. p. 65 ♦ CSA, Z317.10-01, Section 9.1.2 ♦ CSHP, Section 4.3 ♦ NIOSH, p. 12 ♦ ONS, p. 23 ♦ OPQ, Section 4.5 ♦ OSHA, Section Vc6 4-4 ASSTSAS PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS
4. GENERAL PREVENTIVE MEASURES 4.1.6 Integrity of Hazardous Drugs RATING: +++ Check the integrity of hazardous drug containers. RECOMMENDATIONS 4.1.6.1 Workers should check the integrity of hazardous drug containers throughout the medication circuit; in the event of a broken or damaged container, see Chapter 12. ASHP, p. 1175 ♦ OPQ, Section 6.2.2 4.1.7 Protective Equipment RATING: +++ Wear proper protective equipment for the handling of hazardous drugs and cytotoxic waste. RECOMMENDATIONS 4.1.7.1 The proper protective equipment for the task (as described in Table 4) must be worn throughout the medication circuit. Under Article 51 of the LSST, it is the employer’s responsibility to provide the necessary personal protective equipment. 4.1.7.2 Workers must wash their hands with soap and water before and after wearing protective equipment. An alcohol-based product may also be used before putting on gloves, to eliminate bacterial contamination. As these products do not eliminate chemical contamination, they must not be used after removing gloves. 4.1.7.3 Workers must visually inspect the protective equipment (gloves, gowns, respirators, etc.) before putting it on, to ensure that it is not defective. 4.1.7.4 The protective equipment must be put on and taken off according to a sequence that avoids chemical contamination of the worker or microbial contamination of the products. As they may be contaminated, the outside of the gloves or gown must not be touched with bare hands. Table 5 and Figure 6 Procedure for Removing Gloves describe the sequence to be followed to avoid self-contamination. 4.1.7.5 The protective equipment must be disposed of in a cytotoxic waste receptacle. 4.1.7.6 Workers must not wear the protective equipment outside the designated areas (e.g. sterile preparation room, airlock, treatment room). 4.1.7.7 Gloves The gloves used to handle hazardous drugs must be powder-free, made of latex, nitrile, polyurethane or neoprene and comply with ASTM standard D-6978-05 (standard for chemotherapy gloves). Due to the allergenic properties of latex, other materials are often used. Vinyl gloves are not recommended, as they are more permeable to hazardous drugs. Gloves may be sterile or non-sterile. Workers should change gloves (single or double gloves) every 30 minutes or less (in the event of contamination, spillage, breakage, end of the procedure or technique or contact with another patient). All gloves have some degree of permeability to hazardous drugs. This permeability increases over time - 30 minutes is an average time that ensures protection. PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS ASSTSAS 4-5
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 23 and 24: Pharmacy Care Wastes Support Receiv
Page 31: 2. RISKS RELATED TO THE USE OF HAZA
Page 34 and 35: 3. PREVENTION OBJECTIVES AND ACTION
Page 37 and 38: 4. GENERAL PREVENTIVE MEASURES 4 GE
Page 39: 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 108 and 109:
Page 110 and 111:
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 138 and 139:
Page 140 and 141:
Page 142 and 143:
APPENDIX 3 - SURVEY REGARDING PRACT
Page 144 and 145:
Page 146 and 147:
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

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?