| Sumario: | In 2018 Oncology nursing clinical specialists (ONCS) reviewed the USP800 Guidelines-hazardous drug (HD) list from NIOSH. The expanded administration of Group 2 and 3 HD was identified as an emergent priority for teammate safety. The ONCS advocated and received strong nursing leadership support. In 2019 a team was formed to develop an HD safety initiative. The purpose was to improve teammate knowledge and just in time resources to decrease HD exposure risks for all teammates across the HD trajectory. Standardized safety processes- yellow for Group 1-High Risk HD (HRHD) and pink for Groups 2 & 3-Low Risk HD (LRHD). Color allow for quick visual identification of HD medication labels, IV line and bag stickers, and precautionary door signage (PDS). The ONCS created the PDS with input from other departments and applied the health literacy concepts-simplistic language, large photos, which enabled application of appropriate hospital specific personal protective equipment (PPE). The laminated PDS allows precaution start/stop dates to be modified. The back of the PDS includes just in time quick views of: the level of risk, pre/post administration safety and spill management. ONCS interventions utilized ONS HD standards. The adoption of a broader definition of HD fertility risk for both males and females. The use of closed system transfer device for all HD administration. Established safety processes for all crushed/split oral HD. The use of a gown in the PPE for all HD. Expanded HD spill kit to include a decontamination wipe and power air purifying respirator designed for vaporization safety. The ONCS developed computer-based learning (CBL) modules with application questions for all clinical and non-clinical teammates. Then conducted interactive sessions throughout the system to reinforce application of the content and to answer questions. Teammates expressed appreciation of the new knowledge and interventions supported by the institutions culture of safety designed to protect them. The ONCS are greatly encouraged by the critical thinking demonstrated during discussions as they assess, analyze and apply safety principles. Historically, healthcare initiatives have focused on patient-safety. Our initiative brought attention to potential teammate safety risks associated with HD exposure. Safety initiatives may change, but it is essential to support all nurses in the provision of safe care for themselves, coworkers and the patient.
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