Assessing the Workplace for Antineoplastic Drug Exposure

Jackie Gambrell, RN, BSN, OCN

Oncology Nurse Navigator

Oncology Multidisciplinary Center

Cancer Treatment Center

Greenville Hospital System University Medical Center

South Carolina Magnet ConferenceApril 28, 2006

Discussion Topics• Drug Exposure in the Workplace

• Regulating Agencies and Drug-Handling Guidelines

• Assessing Work Practice Environments

• Improving Compliance – SOLVE

• Promoting Practice Change

• Questions and Answers

©

Drug Exposure In the Workplace

• Evidence of Exposure Risks

• Factors Affecting Worker Exposure– Drug Handling– Potential for Absorption– Safety Equipment– PPE

• Measuring Policy Compliance

Regulating Agencies Providing Guidelines

OSHA Publication #8-1.1

NIOSH Publication No. 2004-165

Chemotherapy and Biotherapy Guidelines

Guidelines for Handling Hazardous Drugs

Workplace Environment

PatientOutcomes

Compliance Reporting

WorkerSafety

Compliance Training and Awareness

Implementing Workplace Compliance

• Situation Assessment

• Order the Investigation

• Live Evidence Collection

• Verify the Analysis

• Effective Corrective Action

©

(S) Situation Assessment

• Find chronic problems • The cost approach problem selection method• The impact / effort problem selection method

(O) Organize The Investigation

• The formal analysis team

• The informal analysis team

• The individual problem solver

(L) Live Evidence Collection

• (F) Find and interview people• (A) Act quickly to begin the investigation• (C) Collect physical evidence• (T) Track time and position• (S) Search for cause and effect relationships

(V) Verified Analysis

• Problem definition• Problem analysis

• Root cause discovery• Logic tree examples• Site specific practice

(E) Effective Corrective Action

• Actions to eliminate root cause• Management review and approval

• Engineering• Procedures and training• Planning, scheduling and execution• Tracking for success

The Key to SOLVE Success!

•Valued

•Effective

•Fully Integrated into the workplace

TEAMWORK

©

Investigational Model For Assessing Non-Compliance

*Source:

Summary

• Preventing Hazardous Drug Exposure

• Implementing State, Federal and Organizational Guidelines

• Assessing your Organization

• Improving your Workplace Compliance

• Using a Proven Process such as SOLVE©

Questions and Answers

Jackie Gambrell, RN, BSN, OCN

Oncology Nurse Navigator

Oncology Multidisciplinary Center

Cancer Treatment Center

Greenville Hospital System University Medical Center