Administering Hazardous Drugs
“USP <800> is probably one of the best things to come along for nursing safety in a very long time.”
A nurse’s instinct is to put your patients first. With USP <800> it’s time to also focus on your safety, as well as the safety of those around you.
Hazardous Drugs like antineoplastics save lives but also pose a handling risk to those transporting, mixing and delivering them. USP <800> defines processes intended to minimize the exposure to hazardous drugs in healthcare settings.
What are the risks for nursing?
Use this video to:
- Understand the risks to nursing.
- Educate a peer who may not recognize the risks.
- Help other departments understand why the risk is real and important to address.
“Unfortunately, some of those practitioners who’ve been around for a really long time are sending a message to newer practitioners that it’s okay not to be careful when handling hazardous drugs. We owe our healthcare practitioners who are new the correct orientation and modeling the right behavior so that they’ll take care of their health too.”
“When we’re in pharmacy, when we’re compounding things, we have all these engineering controls around us. We have a hood in which to make it, we have the room that’s negative pressure, we have the PPE that we use and then we hand off this drug, this toxic agent to a nurse who has to administer it to the patient. They have none of those controls around them. So CSTDs provide that control.”
“Implementing USP <800> may require some additional work on behalf of the nurse. Certainly if you’re not used to wearing a gown you will need to put on a chemotherapy gown. If you’re not used to double-gloving, it’s going to take more time for double-gloving. If you’re not used to using a CSTD, it may require more time. But in the big picture, it’s going to be worth it because just as we get in our cars we put on our seatbelts now, it does require a few extra seconds to buckle in but we wouldn’t think about driving around without our belts on. This is the same concept.”
Administering HD and the Necessary PPE.
Getting Started. People and Processes.
Managing an HD Spill.
OSHA: Controlling Occupational Exposure to Hazardous Drugs
NIOSH List of Antineoplastic and Other Hazardous Drugs in Healthcare Settings, 2016
NIOSH: 2004 Alert. Preventing Occupational Exposures to Antineoplastic and Other Hazardous Drugs in Health Care Settings
ASHP: Guidelines on Handling Hazardous Drugs
ONS: Joint position statement from the Oncology Nursing Society, the American Society of Clinical Oncology, and the Hematology/Oncology Pharmacy Association
Get Ready for <800>
A useful approach to help conceptualize USP <800> is to think about the journey of an HD through your organization and the HD interaction points. Chapter <800> contains handling requirements from receipt through disposal.