Prevention Guide - Safe Handling of Hazardous Drugs - Irsst

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