Employers post safe handling methods and procedures, but sometimes departments become lax in their commitment to safety. Choosing a fabric lab coat instead of a disposable gown, or wearing gloves beyond the recommended 30 minutes puts clinical and non-clinical personnel at risk (Conner & McDiarmid, 2006; ASHP, 2006). PPEs are a temporary barrier between hazardous drug contamination and the nurse or other healthcare professional to prevent a health hazard. Contaminated clothing must be never returned to the home.
Glove thickness does not determine dermal safety from hazardous drugs. Exam gloves made from polyvinyl chloride do not protect the wearer from drug exposure
(Wallemacq, Capron et al., 2006). Single gloves are only acceptable during receiving, unpacking, and storing hazardous drugs unless there is a risk of splashes or spills. Look for glove manufacturer test data for permeation resistance compared to hazardous drug chemotherapy glove guidelines (ASTM, 2019).
Disposable gowns offer temporary and partial defense against hazardous drugs. These gowns are an indispensable part of a nurse's protective gear. A lab coat and/or scrubs do not provide the same protection as a disposable gown rated for the task at hand. Gowns should be worn within a C-PEC, whether handling uncoated tablets or compounding hazardous drugs.
Surgical masks are not enough to prevent hazardous drug exposure on their own. An N95 respirator paired with a surgical mask may be allowed for certain hazardous drugs, as listed on the drug information sheet. N95 masks have a shelf life, and over time the nose bridge and strap may degrade, resulting in a risk of exposure for nursing staff. Check mask manufacturer’s storage conditions to ensure stocked respirators are current and stored correctly to ensure the best possible best protection against hazardous drug aerosols and vapors.
Eye and Face Shields
Vapors, aerosols and splashes from hazardous drugs cause irritation and potential long-term damage not only to the eyes but also to other organs. Glasses alone do not provide sufficient protection. Glasses-wearers should choose full-face shields and/or goggles to avoid the risk of hazardous drug exposure.
Sleeve, Hair, and Shoe Coverage
Always check sleeve and shoe covers for holes or other manufacturing defects before entering a potentially harmful area or handling hazardous drugs. When compounding hazardous drugs, double shoe covers are required, and both layers must be removed before leaving a C-PEC.
Personal Protective Equipment Disposal
Disposal of PPE after contact with hazardous materials must be done properly to avoid contamination. Never wear disposable PPE more than once. Adhere to these safety guidelines regarding PPE disposal:
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