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Hazardous Drug Safety In The Hospital and At Home HF#7286

There are many things you need to know when you care for someone who is getting hazardous drug treatments.  It is important for caregivers to avoid direct contact with hazardous drugs and the patient’s body fluids. 

 

What is a hazardous drug?

 

Hazardous drugs are drugs used to treat patients with cancer, problems with the immune system, and some viral infections.  These drugs are known to cause harmful changes in normal cells in the body.  As a result, caretakers need to avoid any contact with the drugs..

 

How would I come into contact with hazardous drugs?

 

You may breathe in the drug when it is being drawn into a syringe or you break or crush an oral pill.  Contact can also occur by touching the urine, vomit, stool, and sexual fluids of someone getting treatment.  The drug may be in these body fluids for 48 hours after each dose. 

 

Why do hospital staff take more precautions?

 

Hospital staff will take extra care when handling these drugs and body wastes.  They may gown, double glove, and at times, wear face shields or masks.  They will dispose of the waste in special plastic bags.  They will take extra care when handling soiled linen.  These special precautions are because hospital workers have exposure from many persons. 

 

What do I need to do to protect myself from drug exposure?

 

Family members and caregivers need to take extra care to prevent exposure.  For your safety, follow the guidelines below when caring for someone during treatment and for 48 hours after each dose.

  • Wear gloves when handling any hazardous drug.
  • Wear gloves when handling any body fluid (urine, vomit, and stool).
  • Wear gloves when helping with toileting.  Close the toilet lid and flush.  Flush twice if the toilet is one with low volume or low pressure.
  • Wear gloves.  Hold the linen away from your body when you handle soiled linens.  Put it in a washing machine or plastic bag as soon as you can.  Don’t put any other laundry in the washing machine with the soiled linens.  Wash in hot water with detergent through two full wash and rinse cycles. 
  • When cleaning body fluids off surfaces or carpeting, wear gloves and use paper towels to wash the spots  with soap and water.  Rinse well. 
  • It is a good idea to refrain from sexual intercourse during this time. 
  • Wash your hands with soap and water after taking off your gloves once care tasks are completed.

 

How do I dispose of soiled waste?

 

Soiled throw away items such as gloves, paper towels, incontinence pads and diapers should be thrown out in special hazardous waste plastic bags.  Ask your nurse of where to dispose of these items. 

 

At home, soiled items should be placed in a plastic garbage bag.  Throw in the garbage right away. 

 

Do I need to take special precautions if I am breastfeeding, pregnant, or trying to become pregnant?

 

As well as gloves you should wear a protective disposable gown.  If possible, select another caretaker to handle the medicine or contaminated waste. 

 

Where should hazardous drugs be stored in the home?

 

Keep all hazardous drugs and items used with the drugs away from children and pets.  Keep the drug in its original, labeled container.  Store drug as directed on the label.  For instance, the drug may need to be stored in the refrigerator or out of light. 

 

How do I protect the skin of someone receiving a hazardous drug?

 

Clean the patient’s skin with soap and water.  Apply a moisture barrier to the perineal and perirectal area after urination and stooling. 

 

How should I break or crush a hazardous drug in pill form? 

 

You should ask your pharmacist if the drug is available as a liquid or suspension.  If not, break a pill while wearing gloves.  Use a pill splicer inside a small plastic bag.  The pill splicer should be stored in the sealed plastic bag.  To crush a pill, put on gloves.  Then, place the pill in a small plastic bag and seal it.  Crush the pill with the back of a spoon.  Pour it into a small pill cup.  The area should be washed with soap and water.  

 

Where do I dispose of any unused hazardous drugs?

 

Unused hazardous oral drugs should be taken to a MedDrop box in your area for disposal.  To find your local MedDrop ask your local pharmacist or check the Internet.  You will need to put the pill bottles in ziplock bag and drop them in the drop box. 

 

Note:  Do not dispose of any supplies used for injections or infusions in the drop box.  This includes needles and syringes. 

 

What do I do if I get hazardous drugs on my skin or eyes?

 

Any skin contact with a hazardous drug or body waste should be washed at once with soap and water.  Rinse and pat dry.  If the drug splashes in your eye, keep the eye open and rinse it right away with fast running lukewarm tap water for 15 minutes.  You should call the regional Poison Control Center in your area. 

 

Poison Control Center     800-222-1222

 

What do I do if there is a drug spill?

 

If you are giving an intravenous hazardous drug in the home, you will receive special instructions.  You will be told how to give the drug and dispose of the equipment.  You will receive a special plastic container to dispose of such items as syringes, vials etc.  You will receive a “Spill Kit” and instructions on how to use.  Before giving the drug, review the directions for giving the drug, disposal, and use of the Spill Kit.  Follow the directions closely.  Contact your home care provider if you do not understand the instructions or a drug spill occurs. 

 

If a drug spill does occur take these actions.

  • Protect others by making sure no one touches the medicine.
  • Open the spill kit.  Follow the instructions.
  • Protect yourself by wearing the protective items in the kit.
  • Place everything you used to clean up the spill in the special hazard bag.
  • Do not throw the bag in the regular trash.  Do not leave the bag where children or pets may open or disturb it.
  • Call your home care nurse about the spill and disposal of hazard material.




The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 11/21/2011

Copyright © 11/21/2011 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7286

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