Nursing And USP<800>: What’s different from NIOSH and WA Law?

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Seth Eisenberg RN OCN. ®. BTMCN. ®. Comparison: Gloves. NIOSH. Washington State. USP<800>. Double chemotherapy gloves (ASTM rated) for chemotherapy; consider for non-antineoplastic HDs.. Powder-free chemotherapy gloves when handling . ID: 682676 Download Presentation

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Nursing And USP<800>: What’s different from NIOSH and WA Law?




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Slide1

Nursing And USP<800>: What’s different from NIOSH and WA Law?

Seth Eisenberg RN OCN

®

BTMCN

®

Slide2

Comparison: Gloves

NIOSH

Washington State

USP<800>

Double chemotherapy gloves (ASTM rated) for chemotherapy; consider for non-antineoplastic HDs.

Powder-free chemotherapy gloves when handling

chemotherapy drugs

or when there is potential contact with chemotherapy contaminated items or surfaces

Two pairs

of chemotherapy gloves are

required.

Must meet American Society for Testing and Materials

(ASTM) standard

D6978 (or its successor).

For all activities

associated with drug administration.

Two pairs of gloves when there is a “significant risk of breakage or contamination or permeation,”

e.g., during compounding, extended handling periods, and cleaning up large HD spills

Required for administering antineoplastic HDs, including non-

antineoplastics

and for reproductive

risk only HDs

.

Slide3

Comparison: Gowns

NIOSH

Washington State

USP<800>

Disposable, with long sleeves, elastic or knit cuffs, and closed fronts.

Disposable, closed front, long sleeves, and elastic or knit cuffs

made of polyethylene-coated polypropylene or

other nonabsorbent,

nonlinting

protective material as determined by the PPE hazard assessment.

Disposable,

with ability to resist chemotherapy

; long sleeves, elastic or knit cuffs, closed front, and without seams or closures that could allow HD exposure.

Wear gowns for all activities

associated with drug administration—

opening the outer bag, assembling

the delivery system, delivering the drug

to the patient, and disposing of all equipment used for administration.

Wear gowns whenever there is a

reasonable possibility of a hazardous drug splash or spill such as in compounding, preparing and administering

.

Remove and dispose of gowns at the end of hazardous drug handling activities, when leaving the hazardous drug handling area and as soon as possible when damaged or contaminated

Appropriate PPE

must be worn when administering HDs

. After use,

PPE must be removed and

disposed of in a waste container

approved for trace-contaminated HD waste at the site of drug administration.

Cloth laboratory coats, scrubs, and isolation gowns are prohibited. Must not be worn outside of HD handling areas.

Slide4

Comparison: Respiratory Protection

NIOSH

Washington State

USP<800>

Refers to general OSHA recommendations [29 CFR 1910.134] and CDC [42 CFR 84].

Does not specify type or use.

Use

appropriate

respiratory protection or equivalent respiratory protection during spill cleanup and whenever there is a significant risk of inhalation exposure to hazardous drug particulates

If risk of respiratory exposure when cleaning spills is “larger than what can be contained with a spill kit,” and if

“a known or suspected airborne exposure to powders or vapors” occurs.

Use an appropriate

chemical cartridge-type respirator

for events such as large spills of volatile hazardous drugs, e.g., when an intravenous (IV) bag breaks or a line disconnects

Full-face chemical cartridge respirator or

PAPR

.

Slide5

Comparison: CSTDs

NIOSH

Washington State

USP<800>

Consider

CSTDs to protect

nursing personnel during drug administration.

Mentioned as example in hazard assessment.

Required

for administration of antineoplastic HDs when dosage form allows.

Evaluate and implement appropriate engineering controls to eliminate or minimize employee exposure. Examples of engineering controls include, but are not limited to:

CSTDs…

Slide6

Comparison: Education

NIOSH

Washington State

USP<800>

Regular training for all personnel handing HDs.

HD training to all employees with occupational exposure

at the time of their initial job assignment and whenever a new HD or a new process related to handling an HD that the employees have not previously been trained is introduced into their work area

.

Training required prior to handling HDs, and

annually thereafter. All training and competency assessment must be

documented.

Must include: Overview of entity's list of HDs and their risks; HD SOPs; proper use of PPE and devices; Spill management and response to exposure; Proper disposal of HDs and trace-contaminated materials

Slide7


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