Episode 330: Stay Up to Date on Safe Handling of Hazardous Drugs

“The reality is that we are responsible for creating a culture of safety together for everybody in the clinical area. We have to think not only about ourselves and our personal risk, but how exposure to these hazardous drugs persists in the work environment for everybody. And we have to be part of the solution for everybody, even if it’s not something that we’re personally really worried about being exposed to,” AnnMarie Walton, PhD, MPH, RN, OCN^®, CHES, FAAN, associate professor at Duke University School of Nursing in Durham, NC, told Lenise Taylor, MN, RN, AOCNS^®, BMTCN^®, oncology clinical specialist at ONS, during a conversation about updates to the fourth edition of Safe Handling of Hazardous Drugs, one of ONS’s book publications.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0 

Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by September 20, 2026. AnnMarie Walton serves in a compensated consultant role with Splashblocker LLC and as a compensated speaker for BD. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning outcome: Learner will report an increase in knowledge related to safe handling of hazardous drugs. 

Episode Notes

• Complete this evaluation for free NCPD. 
• Oncology Nursing Podcast™ episodes:
  • Episode 325: What Changed in the 2024 ASCO/ONS Antineoplastic Administration Safety Standards
  • Episode 308: Hazardous Drugs and Hazardous Waste: Personal, Patient, and Environmental Safety
• ONS Voice articles:
  • Hazardous Drug Surface Contamination Prevails, Despite More Diligent PPE
  • Strategies to Promote Safe Medication Administration Practices
• ONS books:
  • Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)
  • Safe Handling of Hazardous Drugs (fourth edition)
• ONS courses:
  • ONS/ONCC Chemotherapy Immunotherapy Certificate™
  • Safe Handling Basics
• Clinical Journal of Oncology Nursing articles:
  • Environmental Risk Factors: The Role of Oncology Nurses in Assessing and Reducing the Risk for Exposure
  • Oral Chemotherapy: A Home Safety Educational Framework for Healthcare Providers, Patients, and Caregivers
  • Oral Chemotherapy: An Evidence-Based Practice Change for Safe Handling of Patient Waste
  • Personal Protective Equipment Use and Surface Contamination With Antineoplastic Drugs: The Impact of the COVID-19 Pandemic
• Oncology Nursing Forum articles:
  • Factors Influencing Nurses’ Use of Hazardous Drug Safe Handling Precautions
  • Randomized Controlled Trial of an Intervention to Improve Nurses’ Hazardous Drug Handling
• ONS Learning Library: Safe Handling of Hazardous Drugs
• Joint ONS and Hematology/Oncology Pharmacy Association position statement: Ensuring Healthcare Worker Safety When Handling Hazardous Drugs
• ONS Voice video: Hazardous Drug Surface Contamination—The Science Behind the Study

To discuss the information in this episode with other oncology nurses, visit the ONS Communities. 

To find resources for creating an Oncology Nursing Podcast™ Club in your chapter or nursing community, visit the ONS Podcast Library.

To provide feedback or otherwise reach ONS about the podcast, email [email protected].

Highlights From This Episode

“We know that this book is used in practice sites across the country and increasingly around the world, and we have the privilege of answering lots of questions of ONS’s members routinely. And we’ve also been part of writing guidance documents for ONS. And so, we utilized, as well, some of those questions that have come to us, and we know what people want to know more about. So we’ve made sure that we’ve developed a book that would be the most helpful in clinical practice settings.” TS 2:42

“We ensured that the book was in alignment with all of the most recent organizational position statements, standards, and recommendations. And there have been some big ones between the publication of the third and fourth book. So USP 800 is one that everyone knows about, and that became enforceable in November of 2023. … The ONS/HOPA [Hematology/Oncology Pharmacy Association] position statement, which was most recently updated in 2022, was also folded into this book. NIOSH [National Institute for Occupational Safety and Health] came out with two new guidance documents in 2023, and I had the opportunity to serve as a reviewer on one and a contributor to the other. Those two NIOSH guidelines have been folded into this book And then the ONS Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice, which MiKaela Olsen was a lead editor on and I was an author for, have also been folded into this text.” TS 7:01

“We’ve understood the NIOSH hierarchy of controls for years, and if we look at that hierarchy, it tells us that PPE is important but also the least effective when it comes to controlling exposure. And what’s slightly more effective is administrative controls, which are things like changes in our practices, more education, and training. And then even more powerful than administrative controls are engineering controls, and these are your closed-system transfer devices, for example, that are really important in minimizing exposure.” TS 10:31

“[Toilet pluming] is a place that I, for better or worse, spend a lot of time. And I have a colleague, Tom Connor from NIH [National Institutes of Health], who likes to joke when people ask him about his work. He says, ‘Oh, it’s in the toilet.’ And so I’m going to steal that from him and say a lot of my research is in the toilet, too.” TS 13:16

“I feel like people don’t know how contaminated toilets are and how contaminated floors are. And I’ve already told you my tip about leaving your work shoes outside. But I think if people were more aware that the toilets and the floors are often the most contaminated places on a unit, there would be more attention paid to people who are coming into contact with those surfaces and bear a lot of the exposure risk.” TS 22:51