Glove Selection During a Hazardous Drug Transfer
You are preparing to transfer a hazardous drug from a vial to a syringe using a closed-system transfer device. The drug is a known irritant and suspected carcinogen. You have nitrile exam gloves (not chemotherapy-rated), a gown, and a face shield. A coworker suggests double-gloving with the nitrile exam gloves will be 'good enough' because the transfer device is closed. The transfer will take about 10 minutes. You notice a small tear at the cuff of one nitrile glove.
1. Are the nitrile exam gloves appropriate? What PPE corrections do you make before starting?
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No. For hazardous drug handling, you need chemotherapy-rated gloves (tested for permeability to hazardous drugs), typically worn as double gloves. Standard nitrile exam gloves are not validated for chemotherapy permeation. The torn cuff glove must be discarded. Before starting, obtain chemo-rated gloves, double-glove, ensure the gown is a appropriate barrier gown, and keep the face shield. The closed-system device reduces but does not eliminate exposure risk, so glove selection still matters.
2. What do you do if a splash occurs on your glove during the transfer?
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Stop, remove the contaminated outer glove without touching the inside, discard it in the hazardous waste container, and replace it. If the inner glove or skin is contaminated, wash the area with soap and water and follow the facility's exposure protocol. Document the incident. Continue only after PPE is intact.