Hazardous Drug Safety in The Hospital and At Home for the Caregiver
There are many things you need to know
when you care for someone who is getting
hazardous drug treatments. It is important
for caregivers to avoid direct contact with
hazardous drugs and the patient’s body
What is a hazardous drug?
Hazardous drugs are drugs used to treat
patients with cancer, problems with the
immune system, and some viral infections.
These drugs are known to cause harmful
changes in normal cells in the body. As a
result, caretakers need to avoid any contact
with the drugs.
How would I come into contact with
You may breathe in the drug when it is
being drawn into a syringe or you break or
crush an oral pill. Contact can also occur by
touching the urine, vomit, stool, and sexual
fluids of someone getting treatment. The
drug may be in these body fluids for 48
hours after each dose.
Why do hospital staff take more
Hospital staff will take extra precaution
when handling these drugs and body wastes.
They may gown, double glove, and at times,
wear face shields or masks. They will
dispose of the waste in special plastic bags.
They will take extra precaution when
handling soiled linens. These special
precautions are because hospital workers
have exposure from many persons.
What do I need to do to protect myself
from drug exposure?
Family members and caregivers need to take
extra care to prevent exposure. For your
safety, follow the guidelines below when
caring for someone during treatment and for
48 hours after each dose.
o Wear gloves when handling any
o Wear gloves when handling any
body fluid (urine, vomit, and stool).
o Wear gloves when helping with
toileting. Close the toilet lid and
flush. Flush twice if the toilet is one
with low volume or low pressure.
o Wear gloves when you handle soiled
linens. Hold the linens away from
your body. Put it in a washing
machine or plastic bag as soon as
you can. Don’t put any other
laundry in the washing machine with
the soiled linens. Wash in hot water
with detergent through two full wash
and rinse cycles.
o When cleaning body fluids off
surfaces or carpeting, wear gloves
and use paper towels to wash the
spots with soap and water. Rinse
o Wash your hands with soap and
water after taking off your gloves
once care tasks are completed.
How do I dispose of soiled waste?
Soiled items such as gloves, paper towels,
incontinence pads and diapers should be
thrown out in a plastic garbage bag. Throw
in the garbage right away.
Do I need to take special precautions if I
am breastfeeding, pregnant, or trying to
As well as gloves you should wear a
protective disposable gown. If possible,
select another caregiver to handle the
medicine or contaminated waste.
Where should hazardous drugs be stored
in the home?
Keep all hazardous drugs and items used
with the drugs away from children and pets.
Keep the drug in its original, labeled
container. Store the drug as directed on the
label. For instance, the drug may need to be
stored in the refrigerator or out of light.
How do I care for someone who wears a
Wear gloves while cleaning the patient’s
perineal skin with soap and water. Apply a
moisture barrier to the perineal and
perirectal area after urination and stooling.
Follow the instructions above for how to
handle soiled items.
How should I break or crush a hazardous
drug in pill form?
Before you break or crush a pill, talk to your
pharmacist to determine if it is safe to break
or crush the pill. If it is okay to break a pill,
put on gloves. Use a pill splicer inside a
small plastic bag. The pill splicer should be
stored in the sealed plastic bag. If it is okay
to crush a pill, put on gloves. If a mask is
available, wear it. Then, place the pill in a
small plastic bag and seal it. Crush the pill
with the back of a spoon. Pour it into a
small pill cup. The area should be washed
with soap and water.
Where do I dispose of any unused
Unused hazardous oral drugs should be
taken to a MedDrop box in your area for
disposal. To find your local MedDrop ask
your local pharmacist or check the Internet.
You will need to put the pill bottles in
ziplock bag and drop them in the drop box.
Note: Do not dispose of any supplies used
for injections or infusions in the drop box.
This includes needles and syringes.
What do I do if I get hazardous drugs on
my skin or eyes?
Any skin contact with a hazardous drug or
body waste should be washed at once with
soap and water. Rinse and pat dry. If the
drug splashes in your eye, keep the eye open
and rinse it right away with fast running
lukewarm tap water for 15 minutes. You
should call the regional Poison Control
Center in your area.
Poison Control Center
What do I do if there is a drug spill?
If you spill a liquid hazardous drug in the
home, put on gloves. Use paper towel to
wipe up the spill. Cleanse the area where the
spill occurred with soap and water. Place all
items used to clean up the spill in a plastic
garbage bag. Throw them in the garbage
right away. Once care tasks are completed,
remove gloves and wash your hands with
soap and water.
If you are giving an intravenous hazardous
drug in the home, you will receive special
instructions. You will be told how to give
the drug and dispose of the equipment. You
will receive a special plastic container to
dispose of such items as syringes, vials etc.
You will receive a “Spill Kit” and
instructions on how to use. Before giving
the drug, review the directions for giving the
drug, disposal, and use of the Spill Kit.
Follow the directions closely. Contact your
home care provider if you do not understand
the instructions or a drug spill occurs.
If a drug spill does occur take these actions.
o Protect others by making sure no one touches the medicine.
o Open the spill kit. Follow the instructions.
o Protect yourself by wearing the protective items in the kit.
o Place everything you used to clean up the spill in the special hazard bag. Do not throw
the bag in the regular trash. Do not leave the bag where children or pets may open or
o Call your home care nurse about the spill and disposal of hazard material.
Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 6/2017 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#7286.