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Meeting the needs

Handling and preparation of hazardous infusions and drugs

Closed system devices and new technologies have been proven to be safer, more cost effective and easier to use, providing protection to healthcare workers during preparation, transport, administration or disposal of hazardous drugs

Sheila Inwood RN Director International Medical Affairs, CareFusion Clinical Nurse Specialist Vascular Access NHS, UK

“It may seem a strange principle to enunciate as the very first requirement in a Hospital that it should do the sick no harm.” [1859]

This well-known quote by Florence Nightingale has been taken to heart by all healthcare professionals across the globe for some considerable time. Perhaps what has not been so apparent is that this principle should also include healthcare facilities, and employers of healthcare professionals providing under a duty of care the safest environment and equipment available to protect not only their patients but their healthcare workers as well. A patient’s safety should not be protected or guaranteed by sacrificing either the safety of the healthcare professionals caring for them or the environment in which they work. Every day, thousands of pharmacists, nurses, physicians and other caregivers may encounter a serious threat to their own physical and reproductive health, often without even realizing it. While the hazardous nature of chemotherapy, antivirals, antibiotics, hormones and other drugs is well established, it is estimated that millions of healthcare workers continue to be exposed to these substances each year.1 Traces of hazardous drugs have been found on floors and counters in hospital pharmacies, and on chairs and table tops at the patient bedside.2–4

multiple studies have detected hazardous drugs in the urine of workers who handled them and also in the urine of workers who did not.5–11

In the workplace, occupational exposure may occur where control measures either fail or are not in place. Exposure may be through skin contact, skin absorption, inhalation of aerosols and drug particles, ingestion and needle stick injuries resulting from the preparation and handling of hazardous drugs and infusions.

More ominously,

Needlestick, sharps injury On May 11th 2013, EC Directive 2010/32 will be transposed into EU Member State law. Healthcare professionals, whether at the bedside or in the pharmacy, if they have not already done so, will need to ensure that they follow the Directive by, amongst others, “eliminating the unnecessary use of sharps by implementing changes in practice and on the basis of the results of the risk assessment, providing medical devices incorporating safety-engineered

protection mechanisms”. Assessment of risk can be an ambiguous undertaking for facilities and healthcare professionals, as they are obliged to reduce or eliminate unexpected, unintended outcomes. Templates and matrix systems exist to help establish which risks can be eliminated or reduced. The Health and Safety Executive is the UK’s national independent watchdog for work-related health, safety and illness. They are an independent regulator and act in the public interest to reduce work-related death and serious injury across Great Britain’s workplaces. They have a series of templates that enable a more systematic approach to the assessment of risk. ● Step 1 Identify the hazards ● Step 2 Decide who might be harmed and how

● Step 3 Evaluate the risks and decide on precautions 9

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