Prevention Guide - Safe Handling of Hazardous Drugs - Irsst

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10 ADMINISTRATION OF DRUGS .................................................................................................................... 10-1 10.1 Issues and Risks .............................................................................................................. 10-1 10.2 Exposed Workers ............................................................................................................ 10-1 10.3 Preventive Measures ....................................................................................................... 10-3 11 PATIENT CARE ............................................................................................................................................... 11-1 11.1 Issues and Risks .............................................................................................................. 11-1 11.2 Exposed Workers ............................................................................................................ 11-1 11.3 Preventive Measures ....................................................................................................... 11-2 12 MANAGEMENT OF WASTE, ACCIDENTAL EXPOSURE, SPILLS AND RETURNS .................................................................................................................................................................... 12-1 12.1 Issues and Risks .............................................................................................................. 12-1 12.2 Exposed Workers ............................................................................................................ 12-1 12.3 Preventive Measures ....................................................................................................... 12-2 13 HYGIENE AND SANITATION ....................................................................................................................... 13-1 13.1 Issues and Risks .............................................................................................................. 13-1 13.2 Exposed Workers ............................................................................................................ 13-2 13.3 Preventive Measures ....................................................................................................... 13-2 14 LAUNDRY ......................................................................................................................................................... 14-1 14.1 Issues and Risks .............................................................................................................. 14-1 14.2 Exposed Workers ............................................................................................................ 14-1 14.3 Preventive Measures ....................................................................................................... 14-1 15 MEDICAL, BIOLOGICAL AND ENVIRONMENTAL MONITORING ................................................... 15-1 15.1 Issues and Risks .............................................................................................................. 15-1 15.2 Exposed Workers ............................................................................................................ 15-3 15.3 Preventive Measures ....................................................................................................... 15-4 16 REFERENCES .................................................................................................................................................. 16-1 APPENDIX 1- ............................................................................................................................................................. A1-1 Glossary ................................................................................................................................. A1-1 APPENDIX 2 .............................................................................................................................................................. A2-1 List of Hazardous Drugs (according to NIOSH) and According to the Classifications of the MSSS Liste de médicaments-établissements ......................................................................... A2-1 APPENDIX 3 .............................................................................................................................................................. A3-1 Survey Regarding Practices in the Network .......................................................................... A3-1 APPENDIX 4 .............................................................................................................................................................. A4-1 Management of Hazardous Drug Spills ................................................................................. A4-1 APPENDIX 5 .............................................................................................................................................................. A5-1 Measurement of Work Surface Contamination Caused by Antineoplastic Agents ............... A5-1 PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS ASSTSAS v
List of Tables Table 1 Medication Circuit Steps, Exposed Workers and Main Sources of Exposure......................... 2-7 Table 2 Antineoplastic Drugs or Drug Combinations Known to Be Carcinogenic or Probably Carcinogenic in Humans and Available in Canada ................................................ 2-11 Table 3 Classification of Preventive Methods ....................................................................................... 3-3 Table 4 Personal Protective Equipment Recommended According to Medication Circuit Tasks .......................................................................................................................................... 4-9 Table 5 Sequence of Operations for Putting on and Removing Personal Protective Equipment ................................................................................................................................ 4-10 Table 6 Features of the Various Types of Biological Safety Cabinets ................................................ 7-10 Table 7 Contamination of Objects in Contact with a Patient who has Received Cyclophosphamide (CP) .......................................................................................................... 11-1 Table 8 Hazardous Drugs: Duration of the Presence of Detectable Residues in the Excreta ................................................................................................................................ 11-5 List of Figures Figure 1 Medication Circuit ..................................................................................................................... 2-5 Figure 2 “Cytotoxic” Hazard Symbol ...................................................................................................... 4-4 Figure 3 Disposable, Fluid-resistant Mask with Attached Shield ........................................................... 4-6 Figure 4 Disposable Eye Shield: The frame is reusable and must be cleaned. The lens is discarded without cleaning. ............................................................................................ 4-7 Figure 5 Respirator with Chemical Cartridges and Dust Filter............................................................... 4-7 Figure 6 Procedure for Removing Gloves if the gown is kept on and two pairs of gloves are worn .......................................................................................................................................... 4-11 Figure 7 Camera System Allowing Remote Validation by the Pharmacist ........................................... 7-3 Figure 8 Pass-through ............................................................................................................................... 7-4 vi ASSTSAS PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS
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: Table of Contents PREAMBLE ........
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
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7. PLANNING THE ONCOLOGY PHARMACY 7
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7. PLANNING THE ONCOLOGY PHARMACY
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7. PLANNING THE ONCOLOGY PHARMACY b
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Fridge 7. PLANNING THE ONCOLOGY PHA
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7. PLANNING THE ONCOLOGY PHARMACY T
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8. DRUG PREPARATION The product nev
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8. DRUG PREPARATION ‣ avoid sudde
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8. DRUG PREPARATION or “Caution
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8. DRUG PREPARATION 8.3.9 Preparing
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8. DRUG PREPARATION Wearing both
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9. TRANSPORT AND STORAGE FOLLOWING
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10. ADMINISTRATION OF DRUGS Adminis
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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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Prevention Guide - Safe Handling of Hazardous Drugs - Irsst

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