Handling Injectable Cytotoxic Drugs in Clinical Areas in NHS Hospitals

The NHS makes the following key recommendations for cytotoxic users:

NHS Key Recommendations

  • Ready-to-administer bags should either be accessed using spike free connections (needle free bags) which then remain connected for disposal or should be spiked with closed system devices (working over a tray) to allow safe disconnection (of the closed system device) following administration. Any connections which do not specifically require disconnection should remain in place.
  • Closed system caps should be added to syringes for IV use following removal of the storage cap immediately before connecting to the patient. (There is not currently a solution for intrathecal or sub-cutaneous injections).
  • Cytotoxic bladder instillations should always use closed system catheters.

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