Should You Wear a Gown to Disconnect Chemo?
The short answer is yes—guidelines from ONS, National Institute of Occupational Safety and Health (NIOSH), Occupational Safety and Health Administration, and U.S. Pharmacopia (USP) all call for nurses to always wear appropriate personal protective equipment (PPE) when at risk for exposure, including disconnecting a patient’s chemotherapy.
Wearing a gown and other PPE isn’t just good practice—it protects nurses at one of many touchpoints during chemotherapy administration and patient care where healthcare providers are at risk for exposure to hazardous drugs (https://www.ons.org/sites/default/files/2018-06/ONS_Safe_Handling_Toolkit_0.pdf).
Antineoplastic drug exposure (https://www.cdc.gov/niosh/topics/hazdrug/antineoplastic.html), especially over prolonged periods of time, is associated with increased risk for reproductive issues, fetal damage, kidney and liver damage, and cancer. Using proper PPE during chemotherapy administration is an essential component of oncology nursing practice—minimizing exposure to keep healthcare professionals safe.
When and Where PPE Is Required
As centers across the country prepare for USP <800> implementation, many are increasing their focus on using proper PPE. Although the chapter itself doesn’t go into detail about all the situations where nurses should be using PPE, national guidelines have established the finer points to help demystify the process and keep healthcare providers safe.
According to ONS’s 2018 safe handling toolkit (https://www.ons.org/sites/default/files/2018-06/ONS_Safe_Handling_Toolkit_0.pdf), nurses should wear PPE during the following encounters with hazardous drugs:
- Receipt, storage, and transport
- Drug compounding
- Administration
- Handling body fluids following administration
- Deactivation or decontamination
- Cleaning and disinfecting
- Spill management
- Waste disposal
Tips for Safe PPE Practice
Using proper PPE doesn’t just protect administering nurses from exposure; it can also cut down on cross contamination that can affect other staff, family members, and even patients. Consider the following tips for safe PPE practice (https://www.ons.org/sites/default/files/2018-06/ONS_Safe_Handling_Toolkit_0.pdf):
- Do not touch anything else if your gloves are contaminated.
- Before using, inspect all PPE for damage or tears.
- Never reuse any disposable PPE, including gloves, gowns, shoe covers, or any other applicable pieces.
- Change gloves after 30 minutes or if damaged or contaminated.
- Gowns are intended for one-time, single use only and should be changed when leaving the handling area, after a spill or splash, or after two to three hours of continuous use.
- Remove shoe covers when leaving handling areas.
- Eyeglasses shouldn’t be the sole means of eye protection—use goggles with side shields or a face shield.
- Dispose of all PPE in a hazardous waste container after use.
- For reusable PPE like respirators, eye, and face protection, decontaminate and clean after use and properly dispose of the cleaning materials.
Regardless of whether your state enforces national standards like USP <800>, adherence to appropriate PPE and safe handling practice has a tangible impact on the safety of an institution. From the front desk to the administering nurse to maintenance and custodial staff—and everywhere in between—proper PPE can help protect everyone in practice.
Learn more about proper safe handling with ONS’s safe handling toolkit online (https://www.ons.org/clinical-practice-resources/toolkit-safe-handling-hazardous-drugs-nurses-oncology).