Hazardous drug (HD) handling can occur in many healthcare settings. Procedures may involve administration of HDs or may be performed for patients who have recently received HDs, and their body fluids are a source of exposure. Variable amounts of HDs and their metabolites are excreted in the urine, stool, sweat, and other body excreta of patients receiving HDs. Precautions are necessary to avoid exposure while handling patients’ contaminated excreta, including blood, urine, feces, tissue specimens, effusions, and all body fluids. It is essential that nurses communicate with personnel in these settings where patients are cared for so that they will be aware of the potential for HD exposure. Non-nursing staff may be involved with the handling or processing of body fluids and tissue and need to be informed that the materials or substances require handling precautions (Olsen & Polovich, 2018).

Most drugs are excreted from body fluids within 48 hours, thus recommendations state that PPE, consisting of a gown and two pairs of HD-tested gloves, should be worn when handling body fluids of patients within 48 hours of drug administration. A face shield should be worn if splashing is likely adhering to PPE recommendations when handling the body fluids of patients who have received a HD within the past 48 hours (Olsen & Polovich, 2018; USP, 2019).

Additional resources can be found within:

Publications, PPE Infographics, and Safe Handling Toolkits

References:

Polovich, M. & Olsen, M. (2018). Safe Handling of Hazardous Drugs (3^rd ed). Oncology Nursing Society: Pittsburgh, PA.

U.S. Pharmacopeial Convention. (2019). General chapter <800> Hazardous drugs—Handling in healthcare settings.