Our passion for protecting healthcare workers and patients stems from deeply personal experiences. In 2000, we tragically lost my paternal grandmother to a preventable medical error—a devastating reminder of what's at stake. Meanwhile, my maternal grandmother dedicated 40 years of her life to nursing. This family legacy drives our mission every day: to protect dedicated healthcare professionals like my grandmother Maggie while preventing other families from experiencing the loss we felt with my other grandmother Billie. Our commitment isn't just professional—it's profoundly personal.
Working with our clients, I’ve become extremely passionate about nurses' role in the planning and implementation of Rhazdrugs and how their employers protect them from hazardous drug exposure.
In this webinar, we not only were fortunate enough to share stories from one of our clients, but we also had the honor of welcoming an invaluable resource, the woman who literally wrote the book on hazardous drugs, Dr. AnnMarie Walton, the co-editor of ONS Safe Handling of Hazardous Drugs book. Dr. Walton focuses on understanding and minimizing occupational and environmental exposure to hazardous drugs - especially when it comes to nursing assistants, environmental services workers (EVS), and health unit coordinators, who might not receive the same standardized education and training that nurses and pharmacists get annually.
This first story may shock you, or it may be all too familiar.
A nurse in Texas was preparing to administer a hazardous drug, but she didn’t know how to handle it safely. Because the healthcare system she worked for didn’t have Rhazdrugs or an easily accessible safe handling resource, she did what many of us do—she Googled it. Unfortunately, Dr. Google provided incorrect and unsafe handling information, meaning this nurse was probably exposed to the hazardous drug.
Sound familiar?
We believe it should be fast and simple to access necessary safe handling and disposal information. We also believe nurses play a vital role in how this information is stored and shared and should have a seat at the table when hazardous drug communications are being planned and implemented.
Here are some best practices on how to involve nurses in hazardous drug safety planning:
1. Include Nurses in Planning
Nurses and other stakeholders want to be involved in the hazardous drugs work group. Here, we share our client’s work group agenda, which she used during user group meetings with three different groups of frontline nurses.
2. Beyond the NIOSH List
Nurses come into contact with hazardous drugs that are not on the formulary. Do you have investigational drugs on your hazardous drugs list? Do you have illicit drugs on your list? Nurses, nursing aides, and environmental services (EVS) need to know how to handle these substances, whether or not they are on NIOSH.
3. Optimize the EHR
“Shorter is better.” - Nurse at Scripps Health
Nurses shared that they don’t have time to read through a wall of text, nor do they want to. Time is of the essence and nurses want safe handling and disposal protocols in an easily digestible format.
Here’s a look at the Patient Activities tab before and after nurses requested concise labeling, for instance, to identify whether a drug is anti-neoplastic or not. This clear labeling system makes it easier for nurses to answer questions about whether a medication is a chemotherapy drug.
BEFORE:
AFTER:
4. Seek Ongoing Feedback -
Once your Rhazdrugs implementation is complete, continue requesting feedback and be open to ongoing improvements based on nursing’s input.
In fact, the nurses’ feedback was passed onto the Rpharmy team and thanks to them, Rhazdrugs now includes a “consent required” field as shown in this screenshot.
5. Provide training materials
One of our clients has an oncology clinical practice support nurse on their hazardous drug committee, which has resulted in thorough materials in terms nurses easily recognize and focused on items pertinent to nurses.
Here’s an example of a training slide created by an informatics team at a health system. They present this at their quarterly Epic education training.
Dr. Walton also explained how critical it is that all nurses are trained on and are practicing the latest safety protocols because nursing assistants and other nurses often model the actions taken by experienced nurses.
In her research, she found that some nurses are still double flushing, which has been found to actually increase the amount of aerosolized particles of antineoplastic drug contamination in the bathroom (check out her article on that here). Some nurses are still using the antiquated method of ‘flush and rush’ where a nurse holds his/her breath, flushes and runs out of the bathroom.
Access to Rhazdrugs for even those healthcare workers who do not need access to the EHR can help prevent these dangerous practices from continuing.
6. Think Beyond Nurses
What about the people who don't have access to your EHR but who could potentially be exposed to hazardous drugs like nursing assistants and EVS? What about those healthcare workers like physical therapists and respiratory therapists who are caring for patients taking a hazardous drug that lingers in their system for 48 to 72 hours after administration?
Providing mobile access to Rhazdrugs or your hazardous drugs safety information through a website or QR code can protect healthcare workers without access to the EHR.
Some of our clients even print out relevant sections, like the patient care activities, for workers without EHR access. This is also helpful in protecting caregivers or a patient’s family who may be handling a patient's bodily fluids after a hazardous drug administration.
With Rhazdrugs we are able to see the most viewed hazardous drugs. Our list contained drugs that have been in use for at least 40 years, some nearly 70 years. This means that for decades, people like you, pharmacists, nurses, and other healthcare workers have been handling and disposing of these drugs. They’ve always been hazardous but the law requiring identification and safe handling of these drugs, USP <800>, didn’t go into effect until 2023. 🤯
If you have more questions about how to involve nurses in your Rhazdrugs build, implementation or even ongoing efforts, we’re always here to help. We can even put you in touch with other clients of ours who generously will share their best practices. Contact us anytime: info@rpharmy.com
***If you are a Rpharmy customer - either Rhazdrugs or Formweb - you can access these webinar presentations within your editor.
