Prevention Guide - Safe Handling of Hazardous Drugs - Irsst

More documents

Recommendations

Info

7. PLANNING THE ONCOLOGY PHARMACY 7.3 Preventive Measures 7.3.1 Identification RATING: +++ Clearly identify the entrances to the Pharmacy Department. RECOMMENDATIONS 7.3.1.1 The oncology pharmacy premises (i.e., access door) must be identified with the “Cytotoxic” hazard symbol. ASHP, p. 1175-76 ♦ OSHA, Section Vb1 7.3.2 Planning the Oncology Pharmacy RATING: +++ Plan the oncology pharmacy for the preparation of hazardous drugs in accordance with the following recommendations. RECOMMENDATIONS NOTE The design parameters, such as the pressure gradient values, air exchange values and other technical parameters, as well as the quality of the materials, will be specified in a document prepared by the CHQ. The general principles are outlined here. 7.3.2.1 The oncology pharmacy should include a sterile preparation room and an ISO 7 airlock or an airlock in compliance with the recommendations of the Ordre des pharmaciens du Québec. The pharmacy should also include an unpacking room/area (see 6.3.1), a storage room/area (see 6.3.5), a data entry room/area and a patient counselling room (see Figures 9 and 10). 7.3.2.2 There should be pressure gradients between the sterile preparation room, the airlock and the other rooms in the pharmacy, in order to avoid spreading contaminants from the sterile preparation area to the adjacent areas and bringing microbial and particulate contamination into the sterile preparation area. The pressure values are defined in the CHQ planning standard. With respect to the general principles, the most important variable for the efficacy of a sterile preparation room is whether it is airtight (to maintain the pressure gradients). ‣ The unpacking and storage areas should normally be under a slightly negative pressure; however, the airtightness of these areas cannot be ensured, contrary to what is required in the sterile preparation room and airlock. ‣ The sterile preparation room should be under negative pressure and the airlock under positive pressure. ‣ All of the air in the sterile preparation room, airlock and unpacking and storage areas should be exhausted to the outside of the building through a HEPA filter. ‣ The air in the pharmacy offices may be recirculated; however, as a precaution, this air should be recirculated to the pharmacy only. ‣ There should be monitoring and alarm systems with respect to the parameters of the ventilation and safety cabinets (monitoring of pressures, heat and humidity, etc.). 7-2 ASSTSAS PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS
7. PLANNING THE ONCOLOGY PHARMACY 7.3.2.3 Workers must enter the sterile preparation room through the airlock. The drugs and preparation materials enter and leave the sterile preparation room through one or two pass-throughs, depending on the volume of activity. The use of two pass-throughs allows one to be used for the entry of materials and the other for their exit (in order to avoid cross-contamination). 7.3.2.4 Airlock ‣ A mechanism should prevent the opening of both doors of the airlock at the same time. ‣ The airlock should contain storage space (open shelves) for protective clothing (gowns, gloves, shoe covers, caps, masks), a small scrub sink with foot controls and soap and paper towel dispensers or an automatic hand dryer, an eye wash fountain, a chair (ideally, bolted to the wall to facilitate floor cleaning), a waste receptacle for the paper hand towels and another, for the disposable PPE, marked “Cytotoxic waste” + the letter “C”; some hooks for the gowns. ‣ The airlock should be divided into two separate areas, identified by a line on the floor or another form of demarcation: o a “chemically clean” area (airlock entry side), which should be free of chemical contamination. This area contains the sink and is where the workers put on the PPE. o a “chemically dirty” area (sterile preparation room side), where the PPE is removed. 7.3.2.5 Sterile Preparation Room ‣ The furniture in the sterile preparation room should be kept to a bare minimum, i.e., sterile preparation cabinets, space for a cart or a mobile work surface, cytotoxic waste receptacle. ‣ Inside the sterile preparation room, the preparation cabinets should be positioned to minimize the areas of turbulence, away from doors, drafts (i.e., heating and air conditioning) and high traffic areas. Figure 11 shows the proper distances when positioning preparation cabinets. The sterile preparation room should have a minimum surface area of 7m 2 per preparation cabinet or comply with the CHQ set of standards. ‣ There should be a visual link (window) between the sterile preparation room and the pharmacy, in order to view the work in progress. A visual and voice communication system can also be provided to allow the pharmacist to validate the work without having to go in and out of the preparation room. This link can be established using a camera and an intercom (Figure 7). (++) ‣ ‣ ‣ ‣ ‣ ‣ ‣ FIGURE 7 Camera system allowing remote validation by the pharmacist PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS ASSTSAS 7-3
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 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 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: 12. MANAGEMENT OF WASTE, ACCIDENTAL
Page 110 and 111:
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 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

Create successful ePaper yourself

Delete template?

Save as template?