Working with animals can be unpredictable. The plan for mitigating risks for employees and customers shouldn't be. Consider potential points of exposure and know the procedure for addressing them before a dangerous situation arises.
Hazardous drugs should be handled with extra care and only by people who are knowledgeable about them. Accidents are more likely to occur when someone unskilled tries to handle these drugs.
Leakage of vapors, liquid, or particles from the medication can be harmful to both clinical or non-clinical staff. So it's everyone's business to understand clearly who is authorized to handle these substances and who isn't and to respect those rules.
Preparing medications is a key point of risk. Solutions that are aerosolized or inhaled and powders that need to be diluted raise the risk of air contamination. Liquids can spill as well, letting particles into the air. And needle sticks can occur when prepping syringes or IV sets.
Every surface, vial, container, or other piece of equipment is a potential source of contamination. The use of CSTDs can make these processes safer by blocking the release of any drug concentration
Hazardous drugs should have their place -- specifically in a pharmacy area and in the treatment rooms. These areas should be clearly designated, and no eating or drinking should be allowed in them to help reduce risks of accidental ingestion. Keep a careful inventory of these medications and have specific guidelines for storing, labeling, and distributing them.
Working With Large Animals
Administering hazardous drugs in a veterinary setting can pose unique risks, especially when working with large animals because the doses can be high. There's a risk of contamination to anyone that comes into contact with these medications, as they can absorb through the skin and can vaporize into the air. They may inadvertently get on someone's hand, who then touches their face.
You also may come into contact with the animal's bodily fluids when administering medication. An animal taking hazardous drugs may shed some of the substance through fluids for a short time after.
Proper protective equipment, including gloves, gowns, protective eyewear and masks can help, but only if you know how to use them. Ensure staff members who handle hazardous drugs know how and when to use protective equipment, including proper removal and disposal.
Careful clean-up takes on a whole new meaning with hazardous drugs. Staff members should also don personal protective equipment while thoroughly disinfecting any surfaces or areas where contamination may have occurred. PPE is necessary when cleaning bedding or linens, as well as sanitizing any area where an animal who has taken hazardous drugs has soiled or excreted other bodily fluids. Establish specific protocols for disinfecting treatment areas. Additionally, syringes and other single-use items must be disposed of safely.
Have a plan for how to handle spills or other accidental exposures. Ensure employees know how to safely clean up spills, and have supplies on hand in any areas where spills might occur. Include protocols for documenting the incident and reporting it, if necessary. If someone was in the area when a spill or other incident occurred, and was not properly protected, make sure they get any necessary medical help.
These are just some suggestions for the types of protocols that should be in place for veterinary settings that use hazardous drugs. More specific guidelines will vary based on the specific hazardous drugs in use, how frequently they're administered, and even logistical factors, such as the layout and ventilation in your practice.