Final Flashcards
hazardous drugs possess one or more of the following
antineoplastic or cancer causing
organ toxicity
genotoxicity
reproductive and developmental damage causing harm
where can you find a list of hazardous drugs
National Institute for Occupational Safety and Health (NIOSH)
Assessment of Risk for handling HDs
Identify those drugs in your system which need to be assessed
assess the risk
treat the risk
monitor and review the risk
routes to handle exposure
skin absorption and transfer: PPE
Aerosolization
Aerosolization
cancer drugs can aerosolize more than other drugs, which is why they are compounded in a BSC or CACI with vertical air flow in a negative pressure room vented to the outside
buffer room must have 30 air changes per hour
vent on the roof must be 10 feet high
Ante room must be ISO 7
hazard communication program
substances that present a potential health hazard to workers must be included in an employers hazard communication program
training with documentation
appropriate signage
responsibilities when handing HDs
all staff who participate in compounding must be trained and sign a statement saying they understand hazardous drugs, the risks involved, how to protect themselves while compounding and are willing to participate in compounding
fingertip testing and media fill testing must be done every 6 months
facility requirements for receiving, storing and compounding HDs
requires that specific areas are designated including:
receipt and packeting
storing HDs
compounding preparations
CPEC requirements
vertical laminar airflow
ISO class 5
10 foot piece of pipe
buffer room and ante room requirements
ISO class 7 and ISO class 7
closed system transfer
drug transfer device that mechanically prohibits the transfer of the environmental contaminants into the immune system and escape of the hazardous drug or vapor concentrations outside the system
CSTD
NOISH recommends healthcare workers use a CTD throughout the hazardous drug handling chain from pharmaceutical compounding to patient dose administration to reduce HD contamination as part of the HD safety program and used in conjugation with other engineering controls
donning
same as non hazardous just with additional gloves and shoe covers
doffing garb
remove outer pair of sterile gloves
remove outer shoe covers one at a time, stepping over the line
remove gown slowly starting by pulling at the shoulders and turning inside out
careful not to let gown touch the garb underneath
discard in yellow trace waste
remove inner gloves
exit the CSEC and perform hand hygiene
hazardous sterile compounding garb requirements
must wear two pairs of chemotherapy gloves
must wear two pairs of shoe covers
must remove gloves and gown shown within compounding room as you exit
may not reuse chemo gowns
