Protect Yourself and Others When Handling Hazardous Meds

Oncology nurses aren’t the only ones at risk from hazardous meds.

Hazardous meds are used for more than just cancer treatment. Think about methotrexate for autoimmune diseases...or mycophenolate mofetil (CellCept) to prevent organ rejection after a transplant.

It’s scary because hazardous med exposure may increase risk of cancer, pregnancy loss, or offspring with disabilities.

And reports are surfacing of hazardous med residue on elevator buttons...and unit clerks and aides testing positive for hazardous meds in their urine.

Stay alert for “hazardous med” warnings on med labels, in the EHR, or in automated dispensing cabinets. For example, look for “do not crush” labels on hazardous oral limit exposure.

Some clinicians may not be concerned about protecting themselves if they haven’t had health issues...or are past childbearing age. About 10% of nurses never wear gloves when giving chemo...and 40% never wear a gown.

But explain that NOT following precautions might harm others. For example, wearing a lab coat instead of a disposable gown while giving hazardous meds could contaminate break rooms or other common areas.

Follow your hospital’s hazardous med policy for protective gear.

For instance, you may need a disposable chemo gown plus 2 pairs of chemo-tested gloves when giving an IV hazardous med, such as cyclosporine (Sandimmune) or cyclophosphamide.

But wearing ONE pair of chemo gloves without gowning may be okay for giving an intact hazardous ORAL pill, such as spironolactone (Aldactone) or megestrol (Megace).

Check for defects or tears before using protective equipment...and don’t reuse disposable garb.

Remove used gloves before answering phones, programming pumps, typing on keyboards, avoid contaminating other surfaces.

At discharge, educate to keep oral hazardous meds in their original container. Advise caregivers to wear gloves or use a “no-touch” technique to give oral hazardous meds...such as by pouring tabs into the bottle cap.

Get our chart, Handling Hazardous Meds FAQs, for more on disposal, spills, handling body fluids, and discharge education.

Key References
  • Am J Nurs 2019;119(1):28-35
  • Am J Health Syst Pharm 2018;75(24):1996-2031
Nurse’s Letter. May 2019, No. 350532

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