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MEDTECH The shift towards home healthcare has been accelerated by the COVID-19 pandemic, and the application of NIOSH principles to this setting is becoming increasingly vital.
The recent release of the 2023 National Institute for Occupational Safety and Health (NIOSH) document and the impending implementation of USP Chapter <800> have sparked renewed interest in assessing the risk of hazardous drugs in healthcare settings. This focus is now extending to home healthcare, particularly for chemotherapy, where the risk assessment must include not only healthcare workers but also patients and family members.
Key Points:
- Rapid Increase in Home Delivery of Chemotherapy: The Penn Center for Cancer Care Innovation scaled up from 39 patients in March 2020 to 310 patients by the end of April that year.
- Identifying People at Risk: This includes home health nurses, family members, and patients. Proper training, personal protective equipment (PPE), and spill kits are essential.
- Hazardous Drugs in the Home: Common hazardous drugs administered in the home include IV, oral, and topical forms. Awareness of exposures and proper handling is crucial.
- Assessing the Risk: Consideration of exposure form, route of administration, and patient condition is vital. A 12-step tool for assessing home care hazardous drug exposure risk is provided.
- Risks to Healthcare Professionals: Proper education, PPE, and disposal methods are required.
- Patient Risks and Responsibilities: Includes proper storage, administration, personal hygiene, and awareness of potential contamination.
- Caregiver Risks and Responsibilities: Caregivers must be informed about proper storage, administration, and cleanup.
- Risks to Bystanders: Family members and other bystanders may be exposed through absorption, inhalation, or ingestion.
- Pet Care and Concerns: Limiting exposure to pets is essential, as they may be at risk from licking the skin of the patient or chewing through chemotherapy lines.
Additional Points:
- Chemotherapy Spills and Leaks: Proper protocols and spill kits are necessary.
- Disposal of Hazardous Drugs: Proper disposal methods must be followed, including the use of specific containers and disposal locations.
- Home Spill Kits: Infusion pharmacies should provide spill kits or patients should assemble their own.
Conclusion:
- The adaptation of NIOSH Hazardous Drug Assessment principles to home healthcare is a complex and essential process. It requires careful consideration of various risks and the implementation of proper protocols, training, and equipment. Ensuring the safety of healthcare professionals, patients, family members, and even pets is paramount in this growing field of healthcare.
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Did You Know?
The number of home health agencies has been steadily decreasing over the past few years. In 2020, there were 9,378 agencies, compared to 9,893 in 2019 and 10,852 in 2014.
