personal protective equipment use in chemotherapy administration
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Personal Protective Equipment Use in Chemotherapy Administration. Stacy J. Ravert, RN, BSN Master’s of Nursing Candidate University of Washington School of Nursing. What is Personal Protective Equipment (PPE)?. Personal protective equipment includes: Gloves Gowns Shoe covers - PowerPoint PPT PresentationTRANSCRIPT
Personal Protective Equipment Use in Chemotherapy Administration
Stacy J. Ravert, RN, BSNMaster’s of Nursing Candidate
University of WashingtonSchool of Nursing
What is Personal Protective Equipment (PPE)? Personal protective equipment includes:
Gloves Gowns Shoe covers Face/eye protection NIOSH approved respirator
Why are PPE important
1970’s found secondary cancers in patients who had received chemotherapy agents
Researchers have reported that nurses who are exposed to chemotherapy agents have increased incidence of cancers
Dermal exposure is thought to be the primary route of exposure to chemotherapy agents.
Inhalation may also be a significant source of exposure.
Skin Exposure to Chemotherapy
Dermal exposure from chemotherapy spill. Scaring is likely to occur.
Photo courtesy of: James Tinguely, TycoHealthcare
I Should Use PPE When: Preparing chemotherapy Introducing or withdrawing
needles from vials Transferring drugs using
needles or syringes Opening ampules Expelling air from drug
filled syringes Administering all
hazardous drugs by any route
I Should Use PPE When:
Spiking IV bags and changing any tubing in the biological safety cabinet Note: IV tubing should not be spiked at the
point of administration Priming IV tubing Handling leakage from tubing, syringe, and
connection sites Disposing of hazardous drugs and items
contaminated by hazardous drugs
I Should Use PPE When:
Handling the body fluids of a patient who received hazardous agents in the past 48 hours (longer if the hazardous agent has a longer half life)
Cleaning up of hazardous agent spills
Gowns
Should be: Lint free Made of low permeability fabric
i.e. polyethene-coated material Have a solid front Long sleeves Tight cuffs Back closure
Photo courtesy of Tycohealthcare
Gloves
Are essential Must be worn at all times when handling drug
packaging, cartons, drug vials, inventory control procedures, and when gathering hazardous drug and supplies.
Gloves should be powder free. Wash hands thoroughly prior to and after
donning gloves.
Photo courtesy of Tycohealthcare
Gloves continued Gloves should be worn for no
more than 30 minutes Change gloves immediately
if: They are torn Punctured Knowingly contaminated
Use thick Gloves Use gloves long enough to
cover gown cuffs.
Photo courtesy of Tycohealthcare
Gloves Continued
Gloves worn to handle chemotherapy agents should be disposed of as hazardous waste
Gloves must be tested for use with chemotherapy agents
Double glove Meets ASTM Standard D6319 (as noted on
glove box)
Double gloves and ASTM Standard
Nurses should double glove even when using gloves conforming to the ASTM standard to prevent potential skin contamination in the following situations: Gloves become inadvertently torn When removing contaminated gloves In the event of a glove puncture
What is ASTM
ASTM International is an international voluntary standards organization that develops and produces technical standards for materials, products, systems and services. It was formed in 1898 in the United States as the American Society for Testing and Materials by a group of scientists and engineers.
ASTM Standard D6319
This test measures the resistance of protective clothing materials to liquid or gaseous chemicals under the condition of continuous contact.
For chemotherapy gloves the standard is 30 minutes.
Shoe covers
Use if there is a potential for floor contamination
Use if cleaning up a chemotherapy spill Remove shoe covers with gloved hand before
leaving area Discard shoe covers as hazardous waste
Masks Surgical masks DO NOT
provide adequate protection Use a NIOSH approved
respirator (N95) that has been fit-tested Wear if air contaminated.
Must comply with OSHA’S respiratory protection standard
Use when cleaning up drug spills
NIOSH Approved maskPhoto courtesy of Tycohealthcare
Use Facial Protection
If possibility for splashing or uncontrolled aerosolization will occur
If goggles or safety glasses will not provide enough protection
OSHA recommends to use a NIOSH approved respirator
Web links to resources OSHA: Hazardous Drugs
www.osha.gov/SLTC/hazardousdrugs/recognition.html OSHA Technical Manual Section VI, Chapter 2
http://www.osha.gov/dts/osta/otm/otm_vi/otm_vi_2.html ASHP Pre-publication guidelines
http://www.ashp.org/bestpractices/new/HD-Prepub-final.pdf
NIOSH Alert: Preventing Occupational exposures to antineoplastic and other hazardous drugs in the health care setting http://www.cdc.gov/niosh/docs/2004-165/
ReferencesAmerican Society of Health-System Pharmacist. ASHP Guidelines
on Handling Hazardous Drugs. Accessed April 24, 2006, from http://www.ashp.org/bestpractices/new/HD-Prepub-final.pdf
Centers for Disease Control (2004). NIOSH Alert: Preventing Occupational exposures to antineoplastic and other hazardous drugs in the health care setting. Accessed April 24, 2006, from http://www.cdc.gov/niosh/docs/2004-165/
Occupational Safety Health Administration (last updated March 2, 2004). OSHA Technical Manual: Section VI: Chapter 2. Retrieved April 23, 2006, from http://www.osha.gov/dts/osta/otm/otm_vi/otm_vi_2.html
Polovich, M., White, J. M., Kelleher, L.O. (eds.) (2005). Chemotherapy and biotherapy guidelines and recommendations for practice. Pittsburgh, PA: Oncology Nursing Society.