is chart is taken from the WRHA Safe Handling of Hazardous Medications (Cytotoxic and Non-Cytotoxic) This chart is t Policy 110.160.010 July 2012 at http://home.wrha.mb.ca/corp/policy/files/110.160.010.pdf Please refer to this policy for more detailed information about the safe handling of hazardous medications. For the most recent version of the drug table, go to http://home.wrha.mb.ca/prog/pharmacy/drugs_safehandling.php Safe Handling of Hazardous Medications Chart Disclaimer The WRHA and CancerCare MB “Safe Handling of Hazardous Medications” chart was developed to provide direction in the safe handling of cytotoxic and non-cytotoxic hazardous medications as defined in the attached medication listing. The information presented in this chart is intended for use by staff of the WRHA and CancerCare MB only. The authors have made every effort to ensure that the information presented was accurate at the time of publication. As new research and experience broadens our knowledge, changes in handling requirements as well as the medication listing will be required. Neither the authors, reviewers, nor publishers can be responsible for errors, omissions, inconsistencies or continued completeness of the information contained in the chart or medication listing. The information in this chart and medication listing should not be used in place of the skill and professional judgment required when determining appropriate handling of these medications. Information on the medication listing will be reviewed and updated periodically, however ongoing accuracy at particular points in time cannot be assured. The onus is on the user to contact the WRHA Pharmacy Program for updates. January 2013 CYT O T O XIC HAZARD O US MEDICATI O NS NON-CYTOTO XIC HAZARDOUS MEDICATI ONS Precautions Injectable Solid Oral Dosage Form Compromised Dosage Form * Injectable Solid Oral Dosage Form Compromised Dosage Form * Receiving Pr otective wear (unpacking stock from warehouse, manufacturer , external pharmacy) Exam Gloves Exam Gloves Exam Gloves No special requirements No special requirements No special requirements P r otective wear - receiving stock that has been damaged (stock con- tents confirmed with packing slip) Chemo Gloves Procedure Mask Chemo Gown Chemo Gloves Procedure Mask Chemo Gown Chemo Gloves Procedure Mask Chemo Gown Exam Gloves Procedure Mask Exam Gown Exam Gloves Procedure Mask Exam Gown Exam Gloves Procedure Mask Exam Gown Preparation & Transport Prepared by Pharmacy Pharmacy Pharmacy Except Dissol ve & Dose Nurse (or Pharmacy f or specified medications) Pharmacy Pharmacy Except Dissol ve & Dose Preparation area Class II B2 biological saf ety cabinet or al ternate cl osed system Designated cytotoxic packaging area Designated cytotoxic packaging area Ward or Pharmacy Designated cytotoxic packaging area Designated cytotoxic packaging area Protective wear (for staff preparing the area) Chemo Gloves Shoe Covers None None None None None Protective wear (for staff preparing medication doses) Double Gloves (inner is Chemo Gl ove) Procedure Mask Chemo Gown Shoe Covers Chemo Gloves Double Gloves ( inner is Chemo Gl ove) Procedure Mask Chemo Gown Sterile Gloves (Pharmacy) Exam Gloves (Nursing) Exam Gloves Chemo Gloves Procedure Mask Exam Gown Packaging requirements (by Pharmacy) Each dose packaged separately Unit-dose Unit-dose No special requirements Unit-dose SOLIDS unit-dose LI QUIDS unit-dose or multi-dose Labeling requirements (for use in patient care area) CYTOTOXIC CYTOTOXIQUE CYTOTOXIC CYTOTOXIQUE CYTOTOXIC CYTOTOXIQUE WEAR GLOVES WEAR GLOVES DO NOT CRUSH WEAR GLOVES DO NOT CRUSH Packaging for transport (to patient care area, ot her pharmacy area, external pharmacy) Double Sealed Container (e.g. Ziploc® bags) Sealed Container (e.g. Ziploc® bag) Sealed Container (e.g. Ziploc® bag) No special requirements No special requirements No special requirements Clean-up protective wear Doubl e Gl oves ( inner is Chemo Glove) N95 Mask Protective Eye Wear Chemo Gown Shoe Covers Chemo Gloves Chemo Gloves Procedure Mask Chemo Gown Exam Gloves Exam Gloves Chemo Gloves Procedure Mask Exam Gown Administration & Disposal 1 Administration restrictions REFER TO SITE-SPECIFI C POLI CIES REFER TO SITE-SPECIFI C POLI CIES Administration precautions Chemo Gloves required Procedure Mask/ Chemo Gown recommended Chemo Gloves Chemo Gloves required Procedure Mask/ Chemo Gown r ecommended Exam Gloves Exam Gloves Do Not Crush Exam Gloves Do Not Crush Medication waste management Chemo Gl oves required Procedure Mask/ Chemo Gown recommended Chemo Gloves Chemo Gloves No additional precautions No additional precautions No additional precautions Human waste management Chemo Gloves required Procedure Mask/ Chemo Gown recommended Chemo Gloves required Procedure Mask/ Chemo Gown recommended Chemo Gloves required Procedure Mask/ Chemo Gown recommended No additional precautions No additional precautions No additional precautions Spill management REFER TO SPILL MANAGEMENT ALGORITHM (see Appendix B of WRHA Safe Handling of Hazardous Medications (Cytotoxic and Non-Cytotoxic) Policy 110.160.010 July 2012 at http://home.wrha.mb.ca/corp/policy/files/110.160.010.pdf) Chemo Gl oves required Procedure Mask/ Chemo Gown recommended Chemo Gl oves required Procedure Mask/ Chemo Gown recommended Chemo Gl oves required Procedure Mask/ Chemo Gown recommended 1 Shoe covers & protective eye wear should be worn whenever there is potential for splashing * Compromised Dosage Form: Any solid dosage form (tablet or capsule) that is changed in any way; e.g. splitting or crushing a tablet, opening a capsule to empty the powder, preparing a suspension from tablets. For the purposes of this policy all oral liquids, topical and inhalation preparations (including commercially prepared products) are considered compromised dosage forms. FORM #W-00490 03/2013