Department of Nursing Clinical Competencies

Title : Cytotoxic Agents Spill Management Employee Name:__________________________ Employee No.___________________________ Date :__________________________________ Can demonstrate competence during the management of a cytotoxic spill, and is able to integrate knowledge from the reference material with clinical practice. 1. NUR02.109 - Cytotoxic agents, Spill Management 2. Otto, S (2001) Oncology Nursing, (4th Edition) Mosby: St. Louis 3. PRG10.307, 309, 310, 311, 313 and 351. Criteria Inform the Site manager Secures and opens cytotoxic spill kit. Displays spill sign near area. If the spill is out of control, calls for help in restricting access to the spill area. The RN Dress with: chemotherapy gloves Long sleeved chemotherapy gown safety glasses respirator mask (if powder spill) spill towels cytotoxic plastic waste bag shoe coverings Places absorbent towels/ pads over the spill. If the spill involves a powder, the nurse carefully place a big absorbent pad over the powder, ensuring minimal dust production, then carefully wet the pad so that the powder dissolves and is absorbed by the mat. The RN Scoops up any broken glass and places it in a puncture proof disposal sharp container and detach the scraper from the scoop and discard it with other clean up material. If the spill is on a patient or staff member, remove the contaminated clothing and immediately wash the skin with copious amounts of soap and water for a minimum of five (5) minutes. Wash mucous membranes and/or eyes with copious amounts of water or isotonic eye wash for at least five (15) minutes. Place the linen in a water soluble bag, then in yellow plastic bag then in linen hamper. The RN use a strong alkaline detergent solution (with a pH 10) to clean the spill three times beginning with the least contaminated finishing with the most contaminated area. Rinse with plain water and dry with absorbent towels or Met Unmet Comment

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pads. Places all contaminated materials, towels, and absorbent towel/pad in Chemotherapy waste bag. Removes PPE, start with outer layer gloves, gown, inner gloves and places in chemo waste bag. Wash hands thoroughly with soap and water. Seal the chemo waste bag and place in a puncture proof container designated for HD waste. Document the spill in the patients record if patient was exposed and inform the physician. An Incident Report (MSD-MedAdmin.F10) must be filled out and brought to EHS / ER for the physician comments in the appropriate space. The completed copy must be brought to the Nursing Office. The exposed employee must, after initial treatment, go to Employee Health Department if the cytotoxic agent came in contact with their skin or directly to Emergency Room (ER) if the cytotoxic agent came in contact with their eyes. Ensure that the spill kit is replenished and maintained.

Competency performance level :NR = Needs Review C = Competent A total of 80% is required to achieve competency Outcome :________________________ Assessor : ________________________ Employee No. :____________________ Signature : ________________________