Prevention Guide - Safe Handling of Hazardous Drugs - Irsst

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8. DRUG PREPARATION 8.3.9 Preparing Non-sterile Hazardous Drugs RATING: +++ Ensure optimal protection when preparing non-sterile oral hazardous drugs. RECOMMENDATIONS 8.3.9.1 Exposed workers must wear a protective gown and one (1) pair of gloves (see 4.1.7.7) for the non-sterile preparation of drugs (e.g. counting drugs). They should wear two (2) pairs of gloves for topical or liquid preparations. The wearing of face protection is recommended if there is a risk of splashing (see 4.1.7.10). 8.3.9.2 A work area should be clearly defined and equipment reserved for the hazardous drug preparations (e.g. properly identified, dedicated counter): ‣ a Class 1 biological safety cabinet exhausted to the outdoors should be used when handling powders. If a separate hood is not available. the sterile hood may be used, provided that it is decontaminated following its use with non-sterile drugs; ‣ the equipment used (e.g. scale, pill counter, spatula, etc.) for the non-sterile preparations of hazardous drugs should not be used to prepare other drugs; ‣ the tray used to count solid oral forms of hazardous drugs should be cleaned following each use with a gauze pad soaked in detergent and water, and subsequently rinsed with water. 8.3.9.3 The preparation of creams, ointments and oral solutions, as well as the crushing of hazardous drug tablets, should be performed in a protected environment (Class 1 or Class II hood, glove box). Workers should be double-gloved and wear the same type of gown as for work in the hood. If topical preparations are prepared using injectable drugs (e.g. mechlorethamine cream), the measures used for an injectable drug should be adopted. 8.3.9.4 The bagging machines (or other automated equipment) should not be used to package unit doses of oral forms of hazardous drugs. Manual bagging devices (e.g. blister cards) should be used, as these prevent cross-contamination with other, non-hazardous drugs. 8.3.9.5 The Pharmacy Department should attempt to limit additional handling of hazardous drugs by other health professionals. Unit doses of hazardous drugs in liquid oral form should be prepared in the pharmacy and placed in an oral syringe, ready for administration. However, a Luer-Lock syringe must not be used for oral syringe preparations, to avoid accidental parenteral administration. 8.3.9.6 Any material used to prepare oral forms of hazardous drugs must be disposed of in the receptacles for cytotoxic waste. For practical purposes, a single type of waste receptacle should be used for all hazardous drugs prepared in or outside the oncology pharmacy. If a waste receptacle identified with the “Cytotoxic” hazard symbol is not used for the other hazardous drugs prepared outside the oncology pharmacy, the receptacle used should, at the very least, be marked “Pharmaceutical Waste – Incineration”. APES, p. 5-9, 5-10 ♦ ASHP, p. 1182-83, 1189 ♦ CSHP, Sections 8.7.1, 8.7.3 ♦ ONS, p. 22 ♦ OSHA, Section Vc1g 8-8 ASSTSAS PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS
8. DRUG PREPARATION Soak a gauze pad with cleaning solution (water or alcohol) Clean the tubing. Avoid touching the cleaned section with the gloves. Remove one outer glove. Holding the cleaned section with the inner glove, clean the rest of the tubing. Clean one side of the infusion bag. Holding the cleaned side of the bag with the inner glove, clean the rest of the tubing. Clean the other side of the bag. Finish by cleaning the injection site. FIGURE 13 Cleaning technique for drug bags prepared in the preparation cabinet Remove the second outer glove, holding the infusion bag in the left hand. PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS ASSTSAS 8-9
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Prevention Guide Safe Handling of H
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Prevention Guide Safe Handling of H
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This guide has been developed by th
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Table of Contents PREAMBLE ........
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List of Tables Table 1 Medication C
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PREAMBLE In September 2004, the Uni
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1. INTRODUCTION 1.1.1 Survey Regard
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1. INTRODUCTION 1.3 Guide Structure
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2. RISKS RELATED TO THE USE OF HAZA
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2. RISKS RELATED TO THE USE OF HAZA
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Pharmacy Care Wastes Support Receiv
Page 25 and 26: 2. RISKS RELATED TO THE USE OF HAZA
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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 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 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 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
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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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