Prevention Guide - Safe Handling of Hazardous Drugs - Irsst

10. ADMINISTRATION OF DRUGS
10.3 Preventive Measures
10.3.1 Planning and Use of Treatment and Patient Rooms RATING: +
Plan and use the treatment rooms such that exposure risks are limited.
RECOMMENDATIONS
10.3.1.1 Hazardous drugs should be administered in a controlled access environment:
‣ access to the treatment and patient rooms should be restricted to trained workers,
patients and, if necessary, a limited number of family members (who should be
informed of the risks involved). Pregnant visitors and children should not be allowed
in the treatment room. If their presence is unavoidable, they should be informed of the
risks involved and avoid coming into contact with potential sources of contamination
(e.g. excreta, vomitus);
‣ treatment rooms should be under neutral or negative pressure. There are no universal
recommendations regarding patient rooms (e.g. positive pressure rooms are preferred
for patients with bone marrow transplants to reduce the risk of microbial
contamination, rather than to ensure a reduction in the risk of environmental
contamination);
‣ materials and surfaces should be chosen for ease of cleaning (non-porous surfaces, no
carpets or cloth surfaces, reduction in the number of horizontal surfaces (which can
collect dust), etc.); (+++)
‣ workers and family members must not eat, drink, chew gum, apply makeup or store
food in the drug administration areas. The patients may eat and drink, if necessary (e.g.
long treatments); (++)
‣ workers must have access to a washroom reserved exclusively for their use; similarly,
the washrooms used by oncology patients should be reserved for their exclusive use;
‣ rest areas for workers and family members should be located outside the hazardous
drug administration areas.
ASHP, p. 1176 ♦ CS, p. 66
10.3.2 Personal Protective Equipment RATING: +++
Wear the proper personal protective equipment for administering hazardous drugs..
RECOMMENDATIONS
10.3.2.1 Gloves
Nurses must wear one (1) pair of gloves (see 4.1.7.7) to handle and administer hazardous
drugs, from the time they remove the drugs from their Ziploc ® type plastic bag.
‣ Nurses may wear two (2) pairs of gloves when handling hazardous drugs, as
recommended by a number of organizations. The members of the Committee feel it is
acceptable to wear only one pair of gloves, as these are changed between patients (i.e.,
frequently). Wearing only one pair of gloves requires greater care to avoid crosscontamination
(e.g. telephone, doors, chair arms, etc.) and defective gloves. The gloves
must cover the gown cuff.
‣ Nurses must wear two (2) pairs of gloves during procedures involving an increased
exposure risk (e.g. topical application of a hazardous drug). The first pair of gloves
must be worn under the gown cuff, while the second pair must be worn over the cuff
10.3.2.2 Gown
‣ Nurses must remove their gloves as soon as the procedure requiring the wearing of
gloves is completed. They must wash their hands with soap and water every time they
remove their gloves.
PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS ASSTSAS 10-3