Prevention Guide - Safe Handling of Hazardous Drugs - Irsst

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10. ADMINISTRATION OF DRUGS if a one-way valve prevents the use of this technique, dilute the hazardous drug by using a syringe to inject 10 mL of compatible solution into the injection plug closest to the primary tubing (Figure 21). Do not withdraw the syringe and discard everything with the primary tubing. Compatible solution Drug bag Primary tubing Disconnection site Secondary tubing Area to be rinsed Toward the patient FIGURE 21 Rinsing the tubing with a syringe APES, p. 5-28 ♦ ASHP, p. 1189 ♦ CS, p. 68 ♦ CSHP, Section 8.8 ♦ NIOSH, p. 14 ♦ ONS, p. 24 ♦ OSHA, Section Vc2 10.3.8 Subcutaneous or Intramuscular Administration RATING: +++ Use an administration technique that limits exposure risks. RECOMMENDATIONS NOTE The recommendations applicable to the General Administration Measures Section (i.e., Section 10.3.4) should be complied with. 10.3.8.1 Workers administering the drugs should place a disposable, absorbent, plastic-backed pad on the work table for the containers; this pad will also absorb any contamination. Avoiding pushing on the plunger, remove the protective cap from the syringe over the absorbent pad. 10.3.8.2 Insert the needle without removing the air. 10.3.8.3 Workers administering the drugs should use handling and administration techniques that minimize exposure risks: ‣ a Z technique may be used for intramuscular administration of the drug (unless there is insufficient muscle mass – e.g. children), to reduce the risk of leaking. To use this technique, stretch the skin at the injection site at least 2 cm laterally, insert the needle at a 90 o angle into the area where the skin is stretched and inject the drug at a rate of 1 mL every 10 seconds, in order to allow the muscle fibres to dilate and absorb the solution. Wait 10 seconds after completing the injection to allow the drug to diffuse into the muscle. Finally, quickly withdraw the needle and allow the skin to move back 10-10 ASSTSAS PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS
10. ADMINISTRATION OF DRUGS into place; ‣ 0.2 mL of air may be injected at the end of the injection to reduce the possibility of a drug leak at the injection site (except in some cases, e.g. children); ‣ the needle must never be detached; discard the syringe and needle in a rigid cytotoxic waste container. APES, p. 5-29 ♦ ASHP, p. 1189 ♦ Bélanger, 1985 ♦ CSHP, Section 8.8 ♦ ONS, p. 25 10.3.9 Oral Administration RATING: ++ Use an administration technique that limits exposure risks. RECOMMENDATIONS NOTE The recommendations applicable to the General Administration Measures Section (i.e., Section 10.3.4) should be complied with. 10.3.9.1 Nursing staff must wear one (1) pair of gloves (see 4.1.7.7) (a gown is not necessary) when handling and administering solid form hazardous drugs - regardless of whether or not they are antineoplastic - from the time they remove the drugs from the plastic bag. For liquid formulations, both a gown and gloves must be worn. 10.3.9.2 Solid oral preparations (tablets) of hazardous drugs should not be crushed or cut outside the pharmacy. The pharmacy should provide these drugs in an oral syringe, in ready to administer, liquid oral form. (Do not use a Luer-lock syringe for oral preparations to avoid accidental parenteral administration.) When the crushing of tablets cannot be planned in the pharmacy, the nursing staff should use a technique that limits the risk of contamination risk (e.g. use a disposable device to crush the tablets for each patient; the device is used to crush each dose of a hazardous drug; the device is kept safely in a plastic bag and disposed of with the hazardous drugs when the patient is discharged). In view of the risk related to transferring the crushed drug (e.g. into applesauce), the nurse must wear a N-95 type of respirator. APES, p. 5-29 ♦ ASHP, p. 1189-90 ♦ ONS, p. 25 10.3.10 Topical Administration RATING: +++ Use an administration technique that limits exposure risks. RECOMMENDATIONS NOTE The recommendations applicable to the General Administration Measures Section (i.e., Section 10.3.4) should be complied with. 10.3.10.1 The caregiving staff must wear two (2) pairs of gloves (see 4.1.7.7) and a gown when handling and administering topical hazardous drugs (creams, ointments, etc.). 10.3.10.2 Workers should place a disposable, absorbent, plastic-backed pad under the limb to which the hazardous drug is being applied. PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS ASSTSAS 10-11
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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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Pharmacy Care Wastes Support Receiv
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3. PREVENTION OBJECTIVES AND ACTION
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4. GENERAL PREVENTIVE MEASURES 4 GE
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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
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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 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
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: APPENDIX 2 - LIST OF HAZARDOUS DRUG
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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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