Safe Handling of Chemo Drugs
By: Jennifer Liu
INTRO
Intro
- Chemotherapeutic agents are a risk to HCP's due to its inherent toxicity and the extent to which the workers are exposed to the drug
- Primary routes of exposure: direct skin contact and inhalation of aerosolized drug products
- Risks include of exposure: increased risk of cancer, organ damage, teterogen
- Although risk cannot be completely eliminated, a variety of things can be done to reduce risk
Safe Handling
Safe Handling
- Transfer chemotherapy tablets/ powder into syringe barrel without touching them (wear PPE)
- Open capsules in a biohazard hood
- Dissolve tablets in water rather than crush them
- Prepare each dose on an absorbant pad on an uncluttered surface
- Discard materials that have been in contact with tablets/ capsules (medicine cups, oral syringes) as hazardous waste
- Wash hands after preparing medication
PPE
- Gloves
- Tested to protect against chemotherapy agents are recommended
- Minimum acceptable standard is powder free latex surgical gloves (0.007 inches)
- Should be changed after each administration OR if contamination or puncture occurs OR every 60 min
- Gown
- Must be worn whenever chemotherapy agents are being manipulated or administered
- Disposable, impermeable/ low permeability fabric, lint free, with back closure and long cuffed sleeves (should be tucked into gloves)
- Mask
- Designed to protect against aerosolized products N95 or N100 recommended
- Plastic Face Shield
- Must be worn whenever chemotherapy agents are being manipulated or administered
- Safety glasses or regular eye glasses are not adequate
*Must be worn when handling any patient's blood or body fluids*
Transport
- cytotoxic drugs must be placed in a closed, leak-proof bag
- transport from the pharmacy must be done in a rigid, shock-resistant, leak-proof container that can can be easily cleaned and decontaminated
- the bottom must be covered in an absorbant pad
- mechanical transport systems such as pneumatic tubes must not be used
- stress on content
- whole transport system would be compromised if a leak occured
- transport container must be labeled with the "Cytotoxic" hazard symbol
Safe Administration
- PPE must be worn
- Up to 48 hours post administration of IV chemo agents
- Up to 7 days post administration of oral chemo agents
- Plastic absorbant pads should be placed under tubing and syringes
- Only syringes and tubing with Luer-Lok connections should be used
- Infusion bags should be changed at waist level
Safe Administration
Safe Disposal
- All syringes and needles should be discarded in containers that are puncture-resistent, leak proof, that have lids that seals securely, and are labeled with the biohazard symbol
- Bags and solution administration sets should be discarded intact in labeled resealable containers that are puncture-proof and leak-proof
- PPE used during handling and administration should be disposed of in a biohazard labeled container
- Recommend all toilets to be flushed twice
- Briefs should be disposed in a biohazard container up to 7 days of chemo administration
- Contaminated, non-disposable linen should be handled with PPE and disposed following the agency's policy of handling and disposal of infectious linens
- Biohazard containers should be a different colour from regular waste/ sharps containters