According to the National Institute of Occupational Safety and Health (NIOSH), hazardous drugs (HDs) have six defining characteristics.
The characteristics of hazardous drugs Include:
Thus, any drug that exhibits any of these characteristics is hazardous and should be handled with caution. This even includes pharmaceuticals classified as "investigational new drug(s)" or INDs.
According to the American Society of Health Practitioners (ASHP),
"Medical care employees face elevated risk of exposure to hazardous drugs at key points in the distribution chain."
This is especially true during the manufacturing process, and receipt of shipments. Frontline workers like registered nurses face especially high risks as they are responsible for the compounding, and administration of these drugs. Also, exposures can occur while handling the waste of treated patients.
Accidental exposure has been associated with acute and short-term reactions and long-term effects.
Thus, health care facilities need to place a premium on educating staff about the best practices for handling hazardous drugs. Below, we'll discuss both:
Occupational exposure to hazardous drugs has been shown to affect health care workers at the chromosomal level.
Some of these effects are:
Other Risk Factors of Overexposure include:
The reason exposure is necessary is due to the fact that many drugs need preparation before being administered. This work creates an opportunity to absorb the drugs—generally through skin contact. The most common methods of exposure while preparing include:
Also, administering the drugs to patients, also creates potential exposure events especially:
One of the simplest practices for keeping health care workers safe from exposure is a written drug safety and health plan. Ideally, this health and safety plan will meet Hazard Communication Standard (HCS) requirements as mandated by the US Department of Labor.
Having a plan helps to protect your staff and keep exposures as low as reasonably achievable (ALARA).
Ideally, the safety plan is readily available and easily accessible to all employees. As such, it should address all aspects of the safe handling of the various drugs your facility stocks. To be most effective, it should be developed as a collaborative effort from all relevant departments. This ensures that specific measures can be taken to ensure effective staff protection.
Additionally, a facility wide plan should include the following precautions:
Note: This measure is also recommended by The Joint Commission (JCAHO).
While only one facet of protection, making sure that critical safety equipment continues to function during an outage:
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