Safe Handling

Recommendations for the safe handling of oral agents:

• Unit dose packaging is preferred for oral hazardous drugs. Packaging should be opened carefully, and the nurse should avoid touching the tablet or capsule. Drug should be placed directly into a medicine cup for administration.  All waste should be discarded in the appropriate chemotherapy waste container.
• Any manipulation of oral drugs, such as crushing, breaking, or mixing tablets with food or fluids should be performed in a biologic safety cabinet designed for hazardous drug preparation.
• Personal protective equipment:
  • Gloves approved for chemotherapy administration should be worn when working with all oral therapies.
  • Gown and face shield should be worn if there is a potential for sprays, aerosols or splattering of the agent is possible (such as with liquid HDs.)
  • Protect the work area with a plastic-backed absorbent pad if necessary.
• PPE should be used to prevent potential exposure to blood or body fluids following oral therapy administration. Because oral agents are not 100% bioavailable, a portion of the drug may remain in the gut and is excreted through patients’ stools. Depending on the activity of patients’ gastrointestinal systems, precautions may be needed beyond the standard 48 hours after treatment has stopped.

Reference:  Polovich, M. (2011). Safe Handling of Hazardous Drugs. Pittsburgh, PA: Oncology Nursing Society. pp. 34, 37.