Hazardous Material Handling and Disposition (Chemo, Radioactive) for Certified Perioperative Nurse (CNOR)

Hazardous Material Handling and Disposition (Chemo, Radioactive)

Guidelines:

• Hazardous material = environmental harm
• PPE is key!
• Use PPE to prevent exposure to hazardous materials
• Contain wastes properly per EPA guidelines
• Refer to safety data sheets for hazardous chemicals information

Considerations:

• The health care organization must provide PPE and education for employees who handle chemicals in the workplace
• PPE includes gowns, gloves, masks, and eye protection
• Hand hygiene:
  • Before contact
  • Immediately after gloves are removed
  • Between patient contacts
  • When otherwise indicated to avoid transfer of microorganisms to other patients or environments
• Hazardous Material containers should be:
  • labeled or color coded
  • warning labels affixed to containers of

Nurse’s role:

• PPE is key!
• Use PPE appropriately!
  • Select gown and mask type according to the task and degree of exposure
  • Gown should fully cover torso from neck to knees and arms to the end of wrists and wrap around back
  • Maintain coverage of the gown cuff by the glove
  • Clean, non sterile gowns should be worn any time activities are likely to generate sprays or splashes
  • Gloves should be worn when handling hazardous materials
  • Mask, eye protection, face shields should be worn any time activities are likely to generate sprays or splashes
• Know where to go for more information
  • OSHA
  • EPA
  • CDC
  • AORN

Pitfalls:

• Perioperative nurses frequently fail to use PPE correctly
  • High risk during PPE removal
  • Self-contamination with potential pathogens or harmful chemicals
  • Remove PPE in a sequence that prevents contamination
  • After removal, discard and perform hand hygiene

Examples:

• Professional and Regulatory Standards:
  • Advancement of Medical Instrumentation (AAMI)
  • Association for Professionals in Infection Control (APIC)
  • American National Standards Institute (ANSI)
  • ASTM International Standards
    • The level of protection provided by isolation or surgical gown may be on product label as ANSI/AAMI PB70 barrier performance levels and associated test methods. Higher barrier levels provide more protection to the wearer
    • The level of protection provided by the surgical mask may be determined by the ASTM barrier level as stated on the product label, with higher barrier levels providing more protection
    • APIC Guidelines for infection control practice
    • AORN Guidelines for perioperative nursing practice

Linchpins (Key Points):

• PPE is key
• EPA guidelines for waste disposal, environmental safety
• OSHA Universal precautions, worker safety
• CDC Standard precautions, patient safety