Hazards in History
According to NIOSH, early concerns about occupational exposure to antineoplastic drugs first appeared in what year?
What is the 1970's
This is an externally ventilated device designed to minimize worker and environmental HD exposure when directly handling HDs:
What is a Biological Safety Cabinet (BSC)
Manipulation or Not: Withdrawing any volume from a bag or syringe and adding to another bag or syringe
Manipulation, therefore must be compounded in a negative pressure, externally ventilated environment
True or False: Wearing gloves will protect you from contamination and it is not required to preform hand washing after removing gloves used for handling hazardous drugs.
What is False - Hands must always be washed with soap and water after removing gloves.
True or False: The MAR will tell me if a drug is hazardous or not
What is True - alerts are provided on the MAR for hazardous drugs and also includes a Do Not Crush or Chew alert.
NIOSH first published list of hazardous drugs came out in what year?
What is 2004 - The list was compiled from information provided by four institutions that had generated lists of hazardous drugs for their respective institutions, as well as a list from the Pharmaceutical Research and Manufacturers of America (PhRMA). The 2004 list was updated in 2010, 2012, and 2014. The current update (2016) adds 34 drugs, five of which have safe-handling recommendations from the manufacturers. In 2014, a new format was developed for the list of hazardous drugs.
This research agency maintains and publishes a list of antineoplastic and other HDs used in healthcare.
What is NIOSH - The National Institute for Occupational Safety and Health
True or False: Only chemotherapy drugs are considered hazardous
What is False - there are 3 groups of hazardous drugs according to NIOSH that includes antineoplastic (chemotherapy), Non-antineoplastic drugs that meet one or more of the NIOSH criteria for a hazardous drug. Note that some of these drugs may also pose a reproductive risk for susceptible populations, and drugs that primarily pose a reproductive risk to men and women who are actively trying to conceive and women who are pregnant or breast feeding,
True or False: Chemotherapy gloves are the only type of gloves to be worn when handling hazardous drugs
What is True, gloves must meet the ASTM Standard Practice for Assessment of Resistance of Medical Gloves to Permeation by Chemotherapy Drugs
What is one way we add barriers to/protect against potential leaks or spills from compounded hazardous IVs?
What is use of hazardous zip sealing bags and double bagging.
These three groups released a joint position statement on Ensuring Healthcare Worker Safety When Handling Hazardous Drugs in 2016
Who are ONS (Oncology Nursing Society), American Society of Clinical Oncology (ASCO), and the Hematology Oncology Pharmacy Association (HOPA). The recommendations were approved by the Oncology Nursing Society Board of Directors, July 2019. Approved by the Hematology/Oncology Pharmacy Association Board of Directors, August 2019.
These are the guidelines that describes practice and quality standards for handling hazardous drugs (HDs) to promote patient safety,worker safety, and environmental protection.
What is USP 800
True or False: Crushing or splitting tablets that are hazardous are considered High Risk
What is True - crushing or splitting tablets should never be done in a patient care area. Alternate formulations or compounding must be done with appropriate PPE and engineering controls.
True or False: An isolation gown is appropriate to protect myself from hazardous drugs
What is False - only gowns that are disposable made of polyethylene-coated polypropylene or other laminate materials and shown to resist permeability by HDs, close in the back, be long sleeved, and have closed cuffs that are elastic or knit, must not have seams or closures that could allow HDs to pass through.
When transporting hazardous drugs, you should always have one of these
What is a Spill Kit
This group acknowledged the occupational risks of HDs and issued recommendations for their safe handling more than 30 years ago
Who is OSHA - The Occupational Safety and Health Administration
These are considered containment supplemental engineering controls that provide adjunct controls to offer an additional level of protection during compounding and administration.
What are Closed System Transfer Devices (CSTD)
True or False: Compounding/manipulating of both sterile and non-sterile hazardous drugs requires specific primary engineering control equipment.
What is True
Handling an oral syringe containing liquid hazardous drug requires what kind of PPE
What is one pair of chemotherapy gloves
True or False: when receiving/removing from a tote medications purchased from a wholesaler, you must wear chemotherapy gloves
What is True - Studies have shown that it is possible for the outer container of a HD can be contaminated. Antineoplastic HDs and all HD APIs must be unpacked (i.e., removal from external shipping containers) in an area that is neutral/normal or negative pressure relative to the surrounding areas.
This professional organization that represents pharmacists published its first guidance on hazardous drugs (HDs) in 1983
Who are ASHP (American Society of Health-System Pharmacists) - published its first guidance on hazardous drugs (HDs) in 1983as part of the 1983–84 ASHP Practice Spotlight: Safe Handling of Cytotoxic Drugs. This was followed by technical assistance bulletins in 1985 and 1990 and the ASHP Guidelines on Handling Hazardous Drugs in 2006.
Examples of Potential opportunities of exposure based on activity include: receiving, dispensing, compounding, administration, patient care, spills, waste, and what activity?
What is Transport - moving HDs within a healthcare setting
An oral, topical, inhaled, or other non-injectable hazardous drugs that do NOT require manipulation are considered High or Low risk
What is Low risk
Items such as gloves, gowns, respirators, goggles, face shields, and others that protect individual workers from hazardous physical or chemical exposures.
What is Personal Protective Equipment (PPE)
This type of Primary Engineering Control that will be used at the Peoria facility provides ISO Class 5 or better air quality for sterile hazardous compounding, is externally ventilated with no recirculation, and is located within a negative pressure room.
What is a Class II type B2 Biological Safety Cabinet that has total exhaust to the outside after passing though filters.