Should PPE be used when handling bodily fluids of those receiving hazardous drugs and for how long?

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 are 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 (NIOSH, 2023; Polovich & Olsen, 2018).

Most drugs are excreted through 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 and goggles should be worn if splashing is likely to adhere to PPE recommendations when handling the body fluids of patients who have received HDs within the past 48 hours (Polovich & Olsen, 2018; U.S. Pharmacopeial Convention, 2020). 

Consider reviewing the following additional resources:

Toolkit for Safe Handling of Hazardous Drugs for Nurses in Oncology

Safe Handling Basics

References:

National Institute for Occupational Safety and Health. (2023). Managing hazardous drug exposures: Information for healthcare settings. (DHHS [NIOSH] Publication No. 2023-130). Retrieved from https://doi.org/10.26616/NIOSHPUB2023130.

Polovich, M., & Olsen, M. (2018). Safe handling of hazardous drugs (3rd ed.). Pittsburgh, PA: Oncology Nursing Society. 

United States Pharmacopeial Convention. (2020). USP General Chapter <800>: Hazardous drugs—Handling in healthcare settings.