COSA 2014* Chemotherapy services, safety hierarchy – What you need to know (#248)
Background
A multiplicity of documents identifies the potential risk for occupational exposure to chemotherapy as a hazardous substance which has led to a plethora of regulatory standards and guidance documents.
Regulations outline a hierarchy of control measures to be implemented in order of rank from most effective to least effective to manage risk in relation to the handling of hazardous substances and related waste. If the risk is unable to be eliminated, it must be minimised so far as is reasonably practicable (State of Queensland 2011).
Aims
To provide an impartial consistent documented review including recommendations, to assist with identifying how a facility is meeting legislative requirements and best practice standards with regard to the supply, administration and safe handling of hazardous substances (namely chemotherapy) and related waste.
Methods
The review requires access to local policies and procedures related to chemotherapy management.
The process involves a site visit which includes meeting with Workplace Health and Safety, Pharmacy, Waste Management and nursing representatives and a walk around the facility. Subsequent recommendations provide practical assistance to enable a current service to measure its compliance or support facilities planning to establish chemotherapy services.
The review is structured around the hierarchy of control measures from state and territory regulations:
- Elimination
- Substitution
- Isolation
- Engineering controls
- Administrative Controls
- Personal Protective Equipment
Results
Recommendations become the responsibility of the facility’s Workplace Health and Safety team. Completed reviews have highlighted ongoing work is necessary related to who requires training, training content and the most appropriate training delivery method.
Conclusions
The review provides facilities the means to deliver a chemotherapy service that has optimal control measures.
Regardless of location, size or level of complexity, meeting the education requirements is the greatest challenge. Central Integrated Regional Cancer Service is undertaking to formulate an education requirement hierarchy.
