Hospitals & Services
These procedures are the standards expected when handling Cytotoxic or Biotherapy for all staff within the CDHB. Any staff involved in Cytotoxic or Biotherapy management should be familiar with all procedures.
They will be reviewed by the Canterbury Regional Cancer and Haematology Service Clinical Nurse Specialists and Nurse Educators.
If you have any queries please contact one of us, contact details are on the Our Staff page. Please note website currently under RV - July 2018
The CDHB has adopted antineoplastic drug administration procedures developed by eviQ (add link). While these procedures cover all key aspects of administration, they DO NOT always reflect clinical practice within the Canterbury Regional Blood and Cancer Service.
Therefore critical notes have been developed to highlight practice differences. If you are unsure, please discuss with the senior nurses in your area.
Critical Notes - Must be used in conjunction with the procedures
Written consent must be obtained if the cytotoxic drug, being administered, is part of cancer treatment. This must be sighted prior to administration. All other areas, refer to CDHB & local area consent policy for requirements. (???link to our consent and CDHB consent).
You must don the following Personal Protective Equipment (PPE) when handling any cytotoxic drugs that are administered as solutions.
In some circumstances ie risk of cytotoxic drug splash/spill, you may consider/prefer to also don face protection (ie masks, visor, safety glasses) for cytotoxic drug administration.
All cytotoxic infusion bags must be pierced in a container, on a trolley that has been lined with a plastic back sheet.
Oral cytotoxic drugs being administered to inpatients should be identified on e-meds. They also may come from pharmacy with a purple 'cytotoxic' label on them. Chemotherapy gloves should be used when handling this medication.
IV LEUR ANTINEOPLASTIC DRUG ADMINISTRATION
CVAD ANTINEOPLASTIC DRUG ADMINISTRATION
As per the CDHB CVAD policy, all medications infused via a CVAD must be administered using an infusion pump. This includes cytotoxic drugs.
IM/SC ANTINEOPLASTIC DRUG ADMINISTRATION
Cytotoxic medication can be administered using the 'air sandwhich' technique Subcutaneous Administration of Cytotoxic Medication using the Air Sandwich Technique
ORAL ANTINEOPLASTIC DRUG ADMINISTRATION
Flare Reaction Procedure
Cytotoxic spill kits are no longer available from Christchurch Hospital Pharmacy. Every area administering any cytotoxic medication should have a spill kit on hand. For non-cancer areas and in an emergency spill kits may be obtained from Ward 26. These kits are now fully disposable.
Spill Management Procedure
Spill Management Flowchart
Cytotoxic Spill Kit Label 2016
CAUTION Cytotoxic Spill Sign
Infusion Related Reactions
Infusion Related Reactions Guidance
Serious Infusion Reaction Flow Chart
Mild-moderate Infusion Related Reaction Flow Chart
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