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PA30304 > Safe handling of hazardous materials > Flashcards

Safe handling of hazardous materials Flashcards

1
Q

What are the four hazards in the work place?

A

Physical e.g. manual handling
Chemical e.g. corrosive
Biological e.g. viruses, vaccines
Psychological .e.g bullying, stress

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2
Q

Drugs that meet what criteria should be handled as hazardous?

A 
Carcinogenicity 
Teratogenicity 
Reproductive toxicity 
Organ toxicity at low doses
Genotoxicity
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3
Q

What is the NIOSH list?

A

List of harzardous drugs

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4
Q

NIOSH stands for what

A

National Institute for occupational safety and health

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5
Q

COSHH stands for what

A

Control of substances hazardous to health

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6
Q

PPE regulations were introduced when?

A

2002

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7
Q

What does IARC stand for?

A

International agency for research on cancer

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8
Q

What are the exposure routes of hazardous drugs?

A

Ingestion of contaminated foods
inhalation of drug aerosol or dust
absorption through skin
direct contact/injection

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9
Q

What are the risks of cytotoxic drugs to the patients?

A

Patients may develop secondary neoplasams from treatment with chemotherapy agents

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10
Q

what are the risks of cytotoxic drugs to hospital personnel?

A

Potential health hazard to those exposed through preparation and administration.

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11
Q

Where are the highest levels of surface contamination found?

A

In the pharmacy: Work surfaces, air-foil and floor in front of BSC

Administration area = highest levels on floor by the bed

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12
Q

Outline the hierarchy of control

A 
Assessment of risk 
Elimination
Substitution 
Good working practice 
Engineering controls 
PPE
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13
Q

How can we eliminate the risk of cytotoxic drugs?

A

Remove from general areas
Segregation of workflows - radiopharmacy/cytotoxics/ non-harzardous civas/biologicals

Purchase of ready to use liquids instead of powders - powders are much harder to handle so have greater risk (this is more substitution rather than elimination)

The development of new drugs

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14
Q

Administrative controls have 4 aspects - what are these?

A
  1. Education and training
  2. Availability of information
  3. SOPs, policies, agreed working practices
  4. Surveillance, monitoring and supervision
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15
Q

How can the use of procedures reduce the risk of cytotoxic drugs?

A

Minimum no. of staff
Adherence to recommended work practices substantially reduce worker exposure
Standardises prescribing, ordering and documentation to reduce areas
Clear, unambiguous and detailed written SOPs
Use of illustrations and diagrams (videos are ideal)

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16
Q

what are the benefits of monitoring the handling of cytotoxic drugs?

A

Lack of supervision and understanding has been shown to be a key factor in error rates

Good supervision ensures:

  • good technique adhered to
  • procedures undertaken accurately, correctly and safely
  • less waste as less goes wrong
  • enhances operator and patient safety
17
Q

What are the two aspects of engineering controls in terms of when handling cytotoxic drugs?

A
  1. product protection

2. operator protection (PPE)

18
Q

What personal protective equipment should be used when handling cytotoxic drugs?

A 
Gowns, sleeves
Gloves, glasses and masks
undergarments - best strategy is multiple layers
Mats, swabs
Shields, dispensing aids
Waste handling equipment
19
Q

What is good practice in terms of gloves in the use of ppe?

A

All gloves are permeable to some extent, and permeability increases with time.

Therefore should change regularly and should use nitrole or neoprene gloves as these offer better protection. Multilayers are also effective (due to air gap)

20
Q

What is the recommended practice when using luer-lock syringes?

A

Size used should be greater than the required volume - should never be more than 75% full (if we overfill syringe is more likely to leak)

Use vented needles or filtered needles to normalise vial pressures and minimise aerosols.

21
Q

Discuss the disposal of cytotoxic?

A

Should follow waste disposal guidelines - HTM 07-01 The safe management of healthcare waste memorandum.

Guidelines must be available on site for waste disposal.

Cytotoxic waste should be diposed of in bins with a purple lid.

22
Q

Cytotoxic waste should be disposed of in what coloured bin?

A

Purple

23
Q

The EU directive 2010/32/EU states what in terms of resheathing?

A

States that re-sheathing of needles is NOT permitted in a health care setting

risk of litigation if do not take measures to reduce risks of needle-stick injury

24
Q

How can we minimise the risk of harm caused by cytotoxic spillages?

A 
Safe packaging 
PPE
Containment 
Prompt action
disposal facilities
Spillage kits - neutralisers
Incident reporting and documentation
25
Q

What are CIVAS products?

A

Central intravenous additive service (CIVAS) products

26
Q

what are the risks of CIVAS products?

A 
infection 
thrombophlebitis
extravasation 
air embolism 
dose erros
incorrect drug given
incorrect site
incorrect rate
incorrect formulation
27
Q

What are the starting material specifications for subcutaneous products?

A

Volume restricted to

28
Q

What are the starting material specifications for intrathecal products?

A

Avoids antimicrobials, antioxidants, pyrogens and preservatives as can be toxic to the CNS

Should not contain any other additives ‘use sodium chloride as tonicity adjusting agent’

Particulates okay

Lower endotoxin limit

29
Q

What is the equation for calculating the endotoxin limit?

A

EL = K/M

K- the max no. of EU of toxin which the patient may receive without suffering toxic reactions

M= maxiumum dose of drug substance per person (or per kg) per hour

30
Q

What is the K value for parental preparations?

A

K= 350 per person EXCEPT intrathecal preparations

31
Q

What is the K value for intrathecal preparations?

A

14 per person

32
Q

What is trissel?

A

Contains drug monographs and provide stability and compatibility information. (no peer review)

33
Q

Most CIVAS product recalls are due to what?

A

Labelling errors

PA30304 (11 decks)

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