GUIDELINES FOR SAFE HANDLING OF CYTOTOXIC DRUGS

BASILDON AND THURROCK HOSPITAL GUIDELINES (Revised Feb 2001)

 1.                   Prescriptions for all cytotoxic drugs must be signed by a Consultant – or experienced specialist registrar.

2.                   Only those persons who have received appropriate training should reconstitute or administer cytotoxic drugs.

3.                   Reconstitution of cytotoxic materials should be undertaken by the pharmacy department only.  No out of hours chemotherapy should be prepared – except at the discretion of a Consultant.

4.                   The handling of cytotoxic drugs during the early stages of pregnancy should be avoided.

5.                   Packages must be labelled with the appropriate warnings concerning the precautions to be taken during storage, administration and disposal.

6.                   Protective clothing and gloves should always be worn.  Where there is a risk of aerosol exposure then goggles and a face mask should be worn.

7.                   Oral cytotoxic tablets should not be touched, always wear latex gloves.  Mechanical counter should not be used as contamination can occur.

8.                   Liquid formulations should be dispensed in an outer wrapping which would contain the liquid in the event of a leakage.

9.                   Solutions should be issued in such a form that manipulation on the ward, other than administration, is reduced to a minimum. 

10.               Staff with a history of allergies should not be involved in handling of cytotoxic agents until clearance has been obtained from the appropriate staff health department.

11.               Clearly identified containers must be used for the collection of materials for destruction.

12.               Normally, all IV and intrathecal chemotherapy will be administered by trained staff on a designated haematology/oncology unit.  In exceptional cases, chemotherapy may be administered with the agreement of the haematology staff outside of this setting, ie in the Intensive Care Unit in an emergency, or at the discretion of another consultant who accepts responsibility for their patient.