chemotherapy safety at home, spill kit procedure, answers to questions for everyday living situations

1. 1
QUESTIONS & ANSWERS FOR PATIENTS & FAMILIES RECEIVING
CHEMOTHERAPY IN THE HOME
MOST chemotherapy drugs are safe. However, SOME chemotherapy drugs are “Cytotoxic” and
known to cause DNA damage.
Chemotherapy drugs are excreted in urine and feces.
The drug remains active after each chemotherapy treatment for an average of 24-48 hours,
depending on the chemotherapy drugs used.
It is important to take steps to prevent unnecessary exposure of chemotherapy drugs to your
family and caregivers in the home.
The following questions, answers and safety tips will assure safe chemotherapy treatment at
home for you and your family:
1. Is it safe for family members to have contact with the person receiving treatment during
chemotherapy?
YES!
 Eating together, enjoying favorite activities, hugging, and kissing are all safe.
2. Is it safe for family members to use the same toilet as the person receiving the
chemotherapy treatment?
YES!
 As long as any chemotherapy waste is cleaned from the toilet, sharing is safe.
 Close the toilet lid and flush the toilet twice.

2. 2
QUESTIONS & ANSWERS FOR PATIENTS & FAMILIES RECEIVING
CHEMOTHERAPY IN THE HOME
3. What if the person (including a baby or child not yet potty trained) receiving
chemotherapy does not have control of their BLADDER OR BOWELS?
 Use a disposable, plastic-backed pad, diaper, or sheet to absorb urine or stool.
 Change immediately when soiled, and wash skin with soap and water.
 If the person has an ostomy or wears a diaper, the person taking care of the ostomy or
diaper should wear gloves when emptying or change the bags.
Discard disposable ostomy supplies in the chemotherapy waste container.
4. What if the person receiving chemotherapy uses a BEDPAN, URINAL OR COMMODE?
 The caregiver should wear gloves when emptying body wastes.
 Rinse the container with water after each use, and wash it with soap and water at least
once/day.
5. What if person receiving chemotherapy at home vomits?
 The caregiver should when emptying the basin.
 Rinse the container with water after each use, and wash it with soap and water at least
once/day.
6. Is it safe to be sexually active during chemotherapy treatment?
 Ask your doctor or nurse this question.
 It is possible that traces of chemotherapy may be present in vaginal fluid and
semen for up to 48 hours after treatment.
 Special precautions may be necessary.

3. 3
QUESTIONS & ANSWERS FOR PATIENTS & FAMILIES RECEIVING
CHEMOTHERAPY IN THE HOME
7. How should the chemotherapy treatment equipment and supplies be stored at home?
 Store equipment and supplies in a safe place out of reach of children and pets.
 Do NOT store chemotherapy medication (IV and/or ORAL) in the bathroom, as high
humidity may damage the drug.
 Check the medication labels to see if the chemotherapy should be kept in the
refrigerator or away from light.
 Keep chemotherapy/hazardous waste bucket out of reach or children/pets.
 Keep CHEMO SPILL KIT in an EASILY ACCESSIBLE location while receiving IV
chemotherapy administration at home.
8. Is it safe to dispose of chemotherapy supplies and equipment in the trash?
NO!
 Chemotherapy waste is hazardous and should be handled separately.
 The person receiving chemotherapy in the home should have received a special
waste container for the chemotherapy and equipment (discussed above) that is labeled
“Hazardous Waste” or “Chemotherapy”.
 Used syringes, needles, tubing, bags, cassettes, and vials are all disposed of in this
special waste container.
9. Can I travel with my chemotherapy?
YES!
 Usually traveling is not a problem. However, because some chemotherapy medication
requires special storage, you may need to make special arrangements.
 Check with your nurse, doctor, or pharmacy supplier for further information.
 Regardless of your means of travel (airplane, car, etc.), always seal your
chemotherapy medication in a PLASTIC bag.
+

4. 4
QUESTIONS & ANSWERS FOR PATIENTS & FAMILIES RECEIVING
CHEMOTHERAPY IN THE HOME
What if the CHEMOTHERAPY MEDICATION LEAKS OR SPILLS?
=
A spill kit is provided to any person receiving IV chemotherapy at home.
Always keep your spill kit in an easy to reach place while receiving IV
Chemotherapy at home.
In the event of a Chemotherapy Spill or Leak:
FOLLOW THIS PROCEDURE
1. Do NOT touch the spill with unprotected hands.
2. Open the spill kit and put on both pairs of gloves.
3. If the chemotherapy is leaking from (med bag, IV Tubing, etc.), and you have a catheter or an
implanted port in place;
 Before cleaning the spill, disconnect the catheter from the tubing and flush your catheter or
port.
4. Put on the gown (closes in the back), face shield, and respirator/mask.
5. Use spill pillows to contain spill-place around the puddle to form a “V”.
6. Use the absorbent sheets to blot up as much of the drug as possible.
7. Place contaminated clean-up materials directly into the plastic bag contained in the kit. Do NOT
lay them on unprotected surfaces.

5. 5
QUESTIONS & ANSWERS FOR PATIENTS & FAMILIES RECEIVING
CHEMOTHERAPY IN THE HOME
8. Use the scoop and brush to collect any broken glass, sweeping toward the V’d spill pillows, and
dispose of the glass in the box of the kit.
9. While still wearing the protective gear, wash the area with dishwashing or
laundry detergent and warm water, using disposable rags or paper towels, and place
them in the plastic bag with other waste.
10. Rinse the area with clean water and dispose of the towels in
the same plastic bag.
11. Remove gloves, face shield, respirator/mask, and gown and
place them in the plastic bag.
12. Put all contaminated materials, including the spill kit box, into the second large plastic bag and seal
and label the bag with the hazardous waste label in the kit.
13. Wash your hands with soap and water.
14. Call your home health nurse, clinic, home infusion pharmacy,
and/or your provider’s office promptly to report the spill.
15. Plans need to be made to replace the spilled chemotherapy so that treatment can be completed.
16. Arrangements will be made to have the waste material picked up or have you bring it to an area
that accepts hazardous waste for proper disposal.
17. If the spill occurs on sheets or clothing, wash the items in hot water, separate from other laundry.

6. 6
QUESTIONS & ANSWERS FOR PATIENTS & FAMILIES RECEIVING
CHEMOTHERAPY IN THE HOME
YOUR HOMECARE NURSE
AND
YOUR HOMECARE CHEMOTHERAPY MEDICATION SUPPLIER (PHARMACY)
With
ALL CHEMOTHERAPY LEAKS AND/OR SPILLS
Additional information may be found on the following websites:
www.CytotoxicSafety.org/problem-chemo-drugs
www.Cytotoxicsafety.org/cytotoxic-chemicals-findings-fact
www.cytotoxicsafey.org/osha-niosh-joint-commission
www.cytotoxicsafety.org/protect-the-environment

7. 7
QUESTIONS & ANSWERS FOR PATIENTS & FAMILIES RECEIVING
CHEMOTHERAPY IN THE HOME
Safe Handling of Chemotherapy Medications in the
Home
REVIEWED
PATIENT PCG NA
1. Handling Chemotherapy Medications
 Wash your hands before and after handling hazardous drugs.
 Wear disposable nitrile gloves (not latex) when handling any
type of hazardous drugs. Do not use torn or punctured
gloves.
 Place a plastic-backed, absorbent pad under the work area if
changing pump cassettes, tubing, or when handling
hazardous drugs.
 Check intravenous (I.V.) connections regularly to make sure
that they are secure.
 Check infusion pump regularly to make sure it is infusing
without difficulty.
 Discard any used gloves in a plastic bag; Tie or seal the
plastic bag and place in your household trash bag for
disposal.
2. Storing Chemotherapy Medications PATIENT PCG NA
 Your nurse will tell you about special storage instructions.
 Keep all drugs out of the reach of children and pets.
 If the drug needs refrigeration, do not place it in or near the
freezer, and separate it from other foods (for example, uses a
crisper bin or places the medication in a container).
3. Accidental Chemotherapy Medication Drug Spills: PATIENT PCG NA

8. 8
QUESTIONS & ANSWERS FOR PATIENTS & FAMILIES RECEIVING
CHEMOTHERAPY IN THE HOME
If you suspect a leak or spill of the hazardous drug, immediately
stop the infusion pump and use clamps to clamp the catheter line.
4. Skin Care for Accidental Splashes PATIENT PCG NA
 Hazardous drugs spilled on your skin may cause
irritation.
 Wash the area thoroughly with soap and water, dry the
area, and contact your doctor.
 Observe the skin for the next 7 days.
 If redness or skin irritation occurs, contact your doctor.
 If the drug splashes into your eye, flush the eye with tap
water for at least 15 minutes and contact your doctor.
5. Disposing of Body Waste While You Take Chemotherapy
Medications:
PATIENT PCG NA
 You may use the bathroom as usual.
 Wash your hands with soap and water after using the
toilet.
 Toilets should be double-flushed with the lid down each
time they are used while actively receiving the treatment
and for 48 hours after receiving hazardous drugs.
 All caregivers must wear nitrile gloves when handling
your sweat soaked linens and clothing or your blood,
urine, stool, or vomitus for 48 hours after you receive
hazardous drugs.

9. 9
QUESTIONS & ANSWERS FOR PATIENTS & FAMILIES RECEIVING
CHEMOTHERAPY IN THE HOME
 After using any devices for bodily waste, thoroughly wash
your hands and the devices with soap and water.
 Diapers should continue to be placed in “zip-lock” plastic
bags for disposal for 48 hours after receiving hazardous
drugs.
 I /WE have discussed the above information with a health care provider and have had any/all questions
answered to my/our satisfaction.
 I understand that although most chemotherapy medication treatments are safe, safety precautions need to
be followed to protect myself and those around me.
Patient (or PCG) Signature: __________________________________________Date: ______________
Educator Signature: ________________________________________________Date: ________________