Strategies to Promote Hazardous Drug Safety

With at least 8 million healthcare workers in the United States exposed to hazardous drugs on a regular basis³, implementation of safe handling practices is imperative. Hazardous drugs can be detrimental to the health of medical personnel if not handled properly. Exposure to these drugs can lead to organ toxicity⁴, reproductive issues, skin rashes, and – with extensive exposure – even cancer³.

Establishing systems to reduce hazardous drug exposure in healthcare settings ensures protection for those who routinely work with these drugs. Medical facilities need to examine which hazards are present in their environment and develop effective and innovative ways to mitigate exposure risks². Consider some of the following methods to promote safe handling of hazardous drugs.

One way for healthcare organizations to mitigate occupational drug exposure is through staff education. Healthcare facilities should provide evidence-based training focused on the risks of repeated hazardous drug exposure, and methods to protect against it.

Identify Drugs in This Category
Antineoplastics, some antivirals, and bioengineered drugs can be hazardous drugs. Ensure that containers have appropriate labels and signage, and that healthcare staff understand which drugs require special handling.

Create Tailored Training Strategies
Tailor training for each role in the hazardous drug compounding and administration protocol. For example, pharmacists have different handling practices than bedside nurses who deliver the medications. Likewise, shipping and receiving personnel require their own procedures to ensure safety when handling these drugs.

Keep Training Current
Guidelines and training should be kept current to ensure safe handling of these drugs. The US Pharmacopeia (USP <800>) provides safe handling requirements for potentially toxic drugs. Their most up-to-date regulations may necessitate changes in personal protective equipment (PPE), drug transport, and preparation policies¹. Training may also need to be updated to reflect other new guidelines.

Any staff member who comes into contact with hazardous drugs should receive this essential training. In addition, periodic staff reviews should be conducted to ensure that those who work with hazardous drugs have the most up-to-date training.

Use proper labeling to identify hazardous drugs at every stage from transport to disposal. Also, store hazardous drugs correctly. Containers must be able to withstand and contain these drugs, and be stored in a manner that prevents packaging leaks. Some drugs, for example, like certain antineoplastics, need to be stored away from non-hazardous drugs¹.

In addition, safety data sheets should be readily available to staff. These sheets provide detailed information on all hazardous drugs, what PPE to use when handling them, and how to clean up spills⁴.

In addition to clear labeling and safety data sheets, there should be standard operating procedures in place that are easily accessible to all personnel. These policies should address all relevant aspects of working with hazardous drugs. For example, transport, receiving, and storage guidelines to protect supply personnel as well as medical professionals.

Establish Clear Procedures for Working With Hazardous Drugs
Use detailed procedural guidelines for preparing and administering drugs. These guidelines will protect oncology pharmacists and nurses, as well as other healthcare personnel, and empower them to handle drugs in a consistently safe manner.

Institute Standard Operating Procedures
Standard operating procedures for spill cleanup, and disposal of hazardous drug waste and patient waste are also vital⁴. Well-defined operating procedures promote a culture of safety in the healthcare workplace and improve workflow.

Of course, training and policies can only be effective if medical staff have the necessary equipment to do their jobs safely. For example, according to the European Agency for Safety and Health at Work (EU-OSHA), staff should use closed system drug-transfer devices (CSTDs) to administer antineoplastics whenever possible⁴.

Use CSTDs for Preparing and Administering Hazardous Drugs
CSTDs ensure a safe, closed system for drug preparation and administration. CSTDs ensure that hazardous drug vapors, aerosols and liquids cannot leak out of the device, and that the drug remains sterile.

CSTDs like Simplivia’s Tevadaptor® have been shown to extending practical (in-use) shelf life of drug vials. This reduces drug wastage, and means that more patients can receive life-saving treatment. Tevadaptor® CSTDs also enable meaningful savings as the drugs used in chemotherapy and other cutting-edge treatments can be very expensive.

Provide Proper PPE
When handling hazardous drugs, healthcare staff should wear appropriate PPE. This can include face and eye protection, gloves, gowns, and shoe covers⁴. These items should not be reused. Proper handwashing is also essential.

Ensure Access to Disposal Equipment
To promote the safe disposal of hazardous drugs and related equipment, medical staff should readily have access to spill kits and sharps containers.

Integrate Effective Engineering Controls
Engineering controls, such as biological safety cabinets, isolators, or ventilation tools to filter or control airflow are another line of protection against occupational drug exposure². For instance, some drugs must be prepared in a negative-pressure environment so as to not leak out of their packaging¹.

Just as organizations need to provide training on the risks of hazardous drugs, staff need training on how to use CSTDs and other equipment.

Train Nurses and Pharmacists on How to Use CSTDs
For example, pharmacists need training on how to compound hazardous drugs using CSTDs. Nurses likewise need training on safe drug administration with CSTDs. Training on CSTDs may include working with syringe adaptors, vial adaptors, luer locks, and other components.

Simplivia CSTDs Help Promote Hazardous Drug Safety
Simplivia’s innovative Chemfort CSTD meets NIOSH standards, is easy to use, and provides safety and confidence for pharmacists, nurses and other healthcare professionals when handling hazardous drugs. The patented ToxiGuard® technology at the heart of both CSTDs prevents the escape of hazardous drugs into the environment while simultaneously ensuring sterility of the administered drug.⁵

At Simplivia, we are dedicated to supporting a culture of safety in healthcare facilities everywhere. Learn more at www.simplivia.com.