Chemotherapy, which shrinks tumors and kills malignant cells, is extremely toxic. If you are a nurse taking care of a patient on chemotherapy, you must protect yourself by wearing personal protective equipment (PPE) and by practicing universal precautions. Universal precautions, or guidelines that protect health care providers from exposure to harmful substances, indicate the use of PPE when preparing chemotherapy or when coming in contact with the bodily fluids of patients on chemotherapy.
Personal Protective Equipment (PPE)
PPE includes chemosafety gloves, chemosafety gowns and absorbent pads. Chemosafety gloves are thick, disposable latex gloves. Latex prohibits penetration of fluids from either side; chemotherapy spills will not soak through the glove and damage your skin, just as perspiration will not evaporate but remains trapped inside the glove. Chemosafety gowns, which are waterproof and disposable, close from the back to prevent chemotherapy spills from splashing onto your clothes. Absorbent pads cover counter surfaces during chemotherapy preparation and absorbs leaks before they puddle.
Handling Chemotherapy IV Bags
When preparing IV chemotherapy, place an absorbent pad on the counter, don gown and double glove. Putting on the second pair of gloves may be a challenge due to friction, so go one size larger. Wearing two pairs of gloves ensures protection in case one glove tears. Keep your gown and gloves on until you are done hooking up the chemotherapy bag to the patient. When the infusion is complete, don gown and double glove again and discard the empty IV bag in a red biohazard bag.
Handling Bodily Fluids
Chemotherapy may still be toxic when it is excreted from the body through urine, stool, and emesis, or vomit. When coming in contact with bodily fluids, always wear chemosafety gown and gloves. Wear one pair of gloves or two, whichever makes you comfortable. You can always leave a box of gloves in the patient's room and change your gloves if they become soiled. Flush the toilet twice after dumping any urine, stool or vomit. If the patient vomits in bed, remove the linens without touching the emesis, then place the sheets in a large plastic trash bag and seal tightly-this will prevent the contents from falling out. Place the bag in the dirty linen cart.
How Long to Implement Precautions
Continue using PPE for 48 hours after the patient has completed his chemotherapy; after that, you can simply wear one pair of gloves, no gown and flush the toilet just once.