Last year, the United States Pharmacopeial Convention (USP) published a new chapter on hazardous drugs and how to properly handle them in professional healthcare settings. Such standards apply to all health care personnel and health care facilities where hazardous drugs are manipulated, including administration.
The chapter is now under revision and will not be available until next year. The new chapter is said to expand the best practices and mandates of currently published chapters.
“This review focuses on existing guidance and the new activities of regulatory and advisory groups to improve adherence to HD safety precautions” (Polvich, Power, n.p.). The implementation of this new chapter will bring forth an important step forward for pharmacists, nurses, and other health care workers.
“Guidance documents for safe handling of HDs have been available for decades with the Occupational Safety & Health Administration (OSHA) publishing its earliest guidelines in 1986” (Polvich, Power, n.p.). Guidelines that have been written by professional groups are constantly developed, disseminated, and updated, however, surveys show that given recommendations are not always listened to. Because of this there has been very few improvement.
The National Institute for Occupational Safety and Health (NIOSH) recently sponsored a first ever, internet survey. It was used to determine current practices used to minimize chemical exposures and barriers to using recommended personal protective equipment (PPE) for a number of chemical hazards.
“Of the 2,069 respondents to the administration survey, 98% were nurses who worked primarily in hospitals, outpatient care centers, and physician offices” (Polvich, Power, n.p.). The results of the Health and Safety Practices Survey of Healthcare Workers helped determine that there were gaps discovered in many areas of their hazard modules.
All of those health care personnel had administered at least one antineoplastic drug a week before the survey took place. Of course, answers varied but, most respondents reported that they did not obey proper guidelines.
“The survey results show deficiencies related to the lack or infrequency of training, awareness of employer procedures, and awareness of national safe-handling guidelines. The survey results indicate that guidelines for the safe handling of HDs are not followed universally” (Polvich, Power, n.p.).
A following survey featured nurses and pharmacy practitioners. Respondents reported not always wearing gloves or gowns, not always using engineering controls or systems and sometimes using IV priming practices. These people compound antineoplastic drugs almost daily.
“Their conclusions are similar to others who have reviewed HCW adherence” (Polvich, Power, n.p.). The team concluded their research results through a variety of discussion factors that predicted adherence or non adherence to appropriate self-handling practices. “Failure to comply with HD self-handling precautions has been linked to exposure” (Povich, Power, n.p.).
For more information on this topic please read “Safe Handling of Hazardous Drugs.”
Polovich, PhD, RN, AOCN, M., & Power, MS, RPh, L. A. (2016, October 23). Safe Handling of Hazardous Drugs: Reviewing Standards for Worker Protection. Retrieved June 08, 2017, from http://www.pharmacypracticenews.com/Review-Articles/Article/10-16/Safe-Handling-of-Hazardous-Drugs-Reviewing-Standards-for-Worker-Protection/38331/ses=ogst?enl=true