If healthcare facilities genuinely want to protect their people from the harmful effects of hazardous drug exposure, they must go beyond the basics of NIOSH. In the second installment of our webinar series, we discussed why it's important to go beyond the NIOSH list and offered some tips based on what your peers are doing to protect their people.
Tip #1: Don’t Wait on NIOSH – Stay Ahead with Newly Approved Drugs
Here's something that might surprise you: while NIOSH 2024 lists 238 hazardous drugs, healthcare facilities are tracking over 600 in Rhazdrugs! Why? If we had waited the six years it has taken NIOSH to publish an updated list, our healthcare workers would have been tragically exposed to many new hazardous drugs.
Here’s step-by-step how we review and add new drugs to the Rhazdrugs database:
Through this process and client collaboration, we've successfully added 473 new medications into the Rhazdrugs database since 2016.
The numbers don’t lie, and they indeed are evidence that you must go beyond even the NIOSH 2024 list if your organization’s mission is to keep your healthcare workers protected from exposure to hazardous drugs.
Tip #2: Consider Monoclonal Antibodies (Even if NIOSH Doesn’t)
The real game-changers come from how facilities handle tricky situations. Take monoclonal antibodies, for instance. While they might not technically be “hazardous” by NIOSH standards, competent healthcare teams aren't taking chances – they're creating a Group 3 for "potentially hazardous drugs not reviewed by NIOSH" to list their monoclonal antibodies. This allows them to have specific procedures and precautions in place for handling these drugs, even if they are not officially classified as hazardous by NIOSH. Something we thought was smart: facilities that list their obsolete drugs in Group 3.
Perhaps even trickier is tracking drugs that patients bring into your facility. Look at your institutional practice to see if the pharmacy unit is dosing the medications patients bring in, especially if a nurse is administering them. If the medications have hazardous properties, include them in your hazardous drugs list. Remember: Protect your people.
Tip #3: What about BCG? Keep Biologics and Gene Therapies on Your List
What about biologics and gene therapies? Some facilities are taking a bold approach by putting these agents right into Table 1 classifications.
We shared an illustration of one client’s BCG preparation in light of the fact that NIOSH has removed BCG from the list. This client is keeping it on their list. Here, you can see their preparation table or handling guides for BCG. Notice with this client that they actually have used the editor to create a Table 3 “non-classified, not reviewed by NIOSH.” They’ve determined this is a critical drug and decided to include this information in Rhazdrugs for all of their healthcare workers.
Tip #4: Maintain a Separate Reproductive Risk Category
Another interesting twist – many places aren't backing down on reproductive hazards despite recent NIOSH changes. In the same way that NIOSH 2016 included a Group 3 for reproductive risk, clients are continuing to segregate those primarily reproductive risk drugs out because they have specific handling information for those drugs. Facilities want to alert and protect staff in that reproductive category: breastfeeding, pregnant, or trying to conceive.
Tip #5: Prepare for the Unexpected – Including Illicit Drugs
Perhaps the most innovative development? Some facilities are getting ahead of the curve by developing specific protocols for handling illicit drugs and including them in a Table 3.
This particular client was concerned that their staff would encounter these items in the pockets or clothing of people who come in the door. This is particularly true in an emergency department or clinic, where people may come in and must be disrobed to be examined. This client wants their staff to know how to protect themselves if they have needles or these products in their pockets.
The bottom line? We’re working with healthcare facilities that aren't just checking boxes – they're leveraging Rhazdrugs to create a hazardous drug safety management tool that actually works for their teams. By carefully reviewing package inserts, adding newly approved drugs, and setting up notification systems for new drugs, we’re helping clients put their staff safety first.
It's clear that when it comes to hazardous drug management, the bare minimum just won't cut it anymore. And honestly? That's why we’re here- to help you protect your people.
If you have additional questions or want to schedule a demo, check out our calendar. We hope to hear from you!