Prevention Guide - Safe Handling of Hazardous Drugs - Irsst

More documents

Recommendations

Info

10. ADMINISTRATION OF DRUGS 10.3.13 Administration via Aerosolization RATING: ++ Use an administration technique that limits the risk of exposure to pentamidine and ribavirin. RECOMMENDATIONS NOTE Pentamidine and Ribavirin The risk is lower if the patient is intubated and ventilated. In this case, some of the containment measures described below do not apply (10.3.13.1, 10.3.13.2, 10.3.13.3) or apply only in part, (depending on the situation) (10.3.13.4, 10.3.13.5). 10.3.13.1 These drugs should be administered in a cubicle or tent specifically provided for this purpose in a negative-pressure chamber with at least 6 air changes per hour. There are various tent and cubicle systems on the market, for example, Demistifier (Figure 22). If this equipment is not available, the room should have 12 changes of air per hour. Do not administer these drugs in a positive-pressure room. Keep the door to the room closed at all times to ensure that the negative pressure is maintained. The room should continue to be ventilated for 30 minutes after the end of the treatment. FIGURE 22 Various containment options for the administration of pentamidine or ribavirin 10.3.13.2 The air from the cubicle, tent or room should be exhausted to the outdoors; otherwise, it should be filtered through a HEPA filter. 10-14 ASSTSAS PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS
10. ADMINISTRATION OF DRUGS 10.3.13.3 The administration device should be equipped with a filter for patient exhalations and should automatically stop when the patient removes it from his mouth. Otherwise, it can be equipped with a patient interrupt mechanism. If the device does not stop automatically, when applicable, the patient can be given instructions regarding how to stop the nebulization. The patient should be encouraged to do so before calling the staff if he must remove the mask from his mouth to cough or if the mask becomes disconnected. 10.3.13.4 Unless it is an emergency situation, wait for at least five minutes following the end of the nebulization before interacting with the patient, to ensure that the air inside the cubicle or tent is free of drugs. Wait this length of time before entering the cubicle or lifting the sides of the isolation tent. In an emergency situation, workers should stop the nebulization as soon as possible. Protective equipment must be worn for any intervention inside the tent or cubicle. 10.3.13.5 Workers should not remain in the room during drug administration, except when the patient requires assistance. A visual (viewing window in the door) and/or vocal means of communication should allow remote monitoring of the patient. 10.3.13.6 If the drug is not administered in a cubicle or tent, workers must put on a N-95 respirator and goggles before entering the room. 10.3.13.7 Protective equipment (N-95 respirators, gloves, gowns and goggles) must be worn when handling the nebulizer and in situations where there is a high exposure risk (significant patient cough, accidental disconnection, uncooperative patient, lifting of the sides of the tent or entry into the cubicle). 10.3.13.8 The room should not be cleaned with dry equipment – mops and cleaning cloths should be damp. The room surfaces should be easy to clean and disinfect. 10.3.13.9 Pregnant workers should not work in areas where pentamidine and ribavirin are present. 10.3.13.10 Every precaution should be taken to limit the exposure of health care professionals to hazardous drugs. Thus, the Pharmacy Department should prepare the unit doses of hazardous drugs in aerosol form in a preparation cabinet (e.g. SPAG-2). In the event that this is not possible, the worker preparing the unit doses must wear protective equipment (N-95 respirator, gloves, gown, face shield or goggles (see 4.1.7.10)). Pentamidine (additional measures) 10.3.13.11 Measures must be taken to prevent the transmission of tuberculosis. ONS, p. 26 ♦ OSHA, Sections Vc2d, Appendix VI 2-2 10.3.14 Intrathecal 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. 10.3.14.1 Workers administering the drugs should use handling and administration techniques that minimize exposure risks: ‣ wear a gown, one pair of gloves (see 4.1.7.7) and face protection (see 4.1.7.10) ; ‣ use syringes and other devices with a Luer-Lock tip; fill the syringe no more than ¾ full; ‣ place a disposable, absorbent, plastic-backed pad under the injection site for the PREVENTION GUIDE – SAFE HANDLING OF HAZARDOUS DRUGS ASSTSAS 10-15
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 21 and 22:
Page 23 and 24:
Pharmacy Care Wastes Support Receiv
Page 25 and 26:
Page 27 and 28:
Page 29 and 30:
Page 31:
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 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 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 142 and 143: APPENDIX 3 - SURVEY REGARDING PRACT
Page 144 and 145:
APPENDIX 3 - SURVEY REGARDING PRACT
Page 146 and 147:
APPENDIX 3 - SURVEY REGARDING PRACT
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?