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Canterbury DHB Canterbury Regional Cancer and Blood (CRCB) Service SC and IM Administration of Chemotherapy Procedure Intramuscular (IM) and Subcutaneous (SC) Administration of Cytotoxic Medications and Biotherapies Procedure Purpose To ensure the safe administration of either IM or SC cytotoxic medications and biotherapies Audience/Scope Registered Nurses who have completed a minimum of the safe handling and waste management SLP and the level one oral, IM, SC cytotoxic administration training package Associated Documents • • • • • CDHB Manual, Volume 12 – IM and SC drug administration policies CDHB Manual, Volume 12 – Cytotoxic policy CDHB Cytotoxic and Biotherapies Website Haematology Red Book Cytotoxic waste and spill management procedures Equipment Dedicated trolley for chemotherapy and biotherapy administration Spill Kit Personal protective equipment – long sleeve impermeable gown and purple nitrile gloves Plastic backed sheet Disposable container Chlorhexidine 2%/alcohol 70% wipes Small cytotoxic sharps container Small cytotoxic waste bag Pressure pad (dressing) Appropriate needle for administration Procedure Issue Date: September 2012 Authorised by: Nursing Director CRCBS Document owners: senior nursing group CRCBS Page 1 of 2 Canterbury DHB Canterbury Regional Cancer and Blood (CRCB) Service SC and IM Administration of Chemotherapy Procedure If this is the first dose of the medication, keep the patient for 30 minutes post administration to assess for adverse reaction. For subsequent treatments, prior to administering the medication assess the patient for toxicities/side effects. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Wash your hands Collect equipment Lay plastic backed sheet on trolley Place foil container on trolley Don PPE Remove syringe from bag Place in disposable container Check drugs as per checking procedure Remove gloves Proceed to patient, check consent, adverse reaction history and identification 11. Wash hands 12. Don nitrile gloves 13. Administer drug as per your local policy For IM administration see the CDHB, Volume 12; Fluid and Medication Management – Intramuscular Injections Policy http://www.cdhb.govt.nz/cdhbpolicies/documents/vol12/4710-intramuscularinjections.pdf For SC administration see the CDHB, Volume 12; Fluid and Medication Management – Subcutaneous Injection Policy http://www.cdhb.govt.nz/cdhbpolicies/documents/vol12/4714-subcutaneous-fluid.pdf 14. Dispose of equipment in appropriate waste container 15. Ensure chemotherapy prescription is signed 16. Document procedure and any adverse events in the clinical notes Issue Date: September 2012 Authorised by: Nursing Director CRCBS Document owners: senior nursing group CRCBS Page 2 of 2