Safety at home for patients on chemotherapy
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Patients can have chemotherapy in different ways.
- Intravenous (IV) chemotherapy is given into the patient’s vein, and goes straight into their blood.
- Oral chemotherapy is given by mouth, as tablets, capsules or liquids that the patient swallows.
There are important safety measures that you should take while caring for patients who are having chemotherapy.
You also need to educate your patients, and their families and carers, about safety.
This section explains:
- how to protect yourself, and your patients’ families and carers, from chemotherapy drugs
- how to support patients who are taking oral chemotherapy at home
- what equipment you may need, like gloves and spill kits.
Bush medicine could cause problems for patients having cancer treatment.
Your patient should check with their doctor before using bush medicine.
Safety information for all chemotherapy patients
Chemotherapy drugs kill cancer cells but can also damage normal cells. Each time your patient has chemotherapy, it can take up to seven days for the chemotherapy drugs to leave the body. During these seven days, chemotherapy drugs can be in the patient’s body fluids or waste products, including:
- urine (wee)
- vomit (spew)
- saliva (spit)
- vaginal secretions
- stool/faeces (poo).
If you accidentally touch any of these fluids, some of the chemotherapy drug could get into your body through your skin.
You, and your patient’s family and carers, need to take special care to stay safe for the first seven days after each chemotherapy treatment. The following information explains how to do this.
Women who are pregnant or breastfeeding should not touch:
- chemotherapy medication
- body fluids (wee, vomit, etc.) of someone having chemotherapy
- any bedding, clothing, or cleaning cloths with the above body fluids on them.
Educate your patient
About cleaning up spills
- If there is a spill of any body fluids (e.g. poo, wee, spew), put on rubber gloves and use a disposable cloth to clean up the spill straight away.
- Place the cloth in a plastic bag and tie it closed; then place that plastic bag into another plastic bag and tie it closed—this is called ‘double-bagging’.
- The plastic bag can then be placed in the normal household rubbish.
- Towels, linen or clothing that have body fluids on them should be machine washed separately in a hot or cold wash, on the longest washing cycle. They can then be dried outside.
- If there is a spill of body fluids on a bench top or floor, wear rubber gloves and wash it off with lots of water and detergent.
About feeling sick and vomiting
- It is a good idea to keep a plastic bowl or bag (without holes in it) handy for this.
- A bowl used for vomiting, should not be used for anything else.
- Wash the bowl out after each use.
- Throw it away at the end of the chemotherapy treatment.
About going to the toilet
- After going to the toilet, close the lid, and flush the toilet on full flush. This is so that fluids from the toilet don’t splash out.
- Men should sit down when using the toilet so there is no splashing.
About having sex
Your patient and their partner should always wear condoms when having sex in the first seven days after chemotherapy treatment. This is because low amounts of chemotherapy drugs may be passed in the semen or vaginal secretions.
Safety information for patients taking oral chemotherapy at home
You may need to care for patients taking oral chemotherapy at home. The patient may have to take tablets, capsules or liquid medicine. The information below explains how to do this safely.
Make sure your patient knows how to take their oral chemotherapy drugs
- Most patients will have a written plan, telling them when to take their tablets. It’s a good idea for you to go through this with them to make sure they have understood this information.
- Make sure the patient knows they must take the oral chemotherapy exactly as their doctor or pharmacist has told them to. This includes taking it on the right day, at the right time, and with or without food, as directed.
Check that your patient knows how to store their oral chemotherapy drugs safely
It is important that your patient:
- keeps the chemotherapy drugs in their original packaging
- stores any chemotherapy drugs (tablets or liquids) as the doctor or pharmacist tells them to stores them safely away from children or animals.
Educate your patient
How to handle oral chemotherapy drugs safely
- Your patient can handle the oral chemotherapy drugs because the treatment is for them.
- After taking the drugs, they should wash their hands before touching anything else.
You, and the patient’s family or carers:
- You, and the patient’s family or carers, should never touch chemotherapy medicine with your bare hands.
- This is because some of the chemotherapy drug could be absorbed into your body through your skin.
- Sometimes you, or someone else, will need to touch chemotherapy drugs to help the patient to take them.
- You should always wear a pair of rubber gloves to touch or handle chemotherapy drugs.
- Wash your hands after taking off the gloves.
How to take oral chemotherapy drugs safely
Your patient should:
- take the chemotherapy exactly as directed by their doctor or pharmacist (e.g. this may be with food or on an empty stomach)—it will say on the medicine label on the bottle
- swallow the chemotherapy tablets or capsules whole—never crush, cut, chew or bite tablets, and do not open capsules
- wash their hands after handling the chemotherapy tablet or capsule.
Note: If the patient cannot swallow the tablets, talk to the doctor straight away.
Important things to know
What if my patient vomits after taking the chemotherapy?
- If your patient vomits straight after taking a dose of oral chemotherapy, they should not take a replacement dose but contact the treatment team for further advice.
- If they have been given anti-sickness tablets to stop nausea and vomiting, they should take this medicine as the doctor or pharmacist has instructed, even if they do not feel sick.
- If they have taken the anti-sickness medication and it does not stop them from vomiting, speak with the doctor about what to do.
- Make a note to tell the doctor or nurse from the treatment team about any missed or vomited doses.
What if my patient forgets to take their chemotherapy tablets?
- If your patient forgets to take a chemotherapy dose, they should take the next dose at the normal time, as prescribed.
- Refer to the eviQ patient information sheet that they may have been given for further information. If the patient is unsure about what to do, speak with the doctor or clinic staff on the next working day.
What if my patient has finished chemotherapy treatment but has some tablets left?
Leftover chemotherapy capsules or tablets should be returned to the cancer clinic or pharmacy.
If your patient is having chemotherapy treatment in hospital, they may see nursing staff wearing protective
equipment. This is necessary for some types of chemotherapy administration. It is nothing to be frightened of.
The best gloves to use are nitrile gloves, which are made from synthetic rubber and are resistant to chemotherapy. If you or your patient don’t have nitrile gloves, you can use:
- two pairs of disposable gloves, or
- a thick pair of rubber gloves that can be bought from the supermarket.
Whichever gloves you use, they should only be used for cleaning up spills, or for handling chemotherapy medication.
Home-made spill kit
If your patient does not have a spill kit provided by the hospital, it is a good idea for them to keep a kit at home to clean up spills. It should include:
- incontinence pad/’inco sheet’ or disposable cloths
- plastic apron
- vomit bag/bowl
- plastic bags.
- Be careful when removing gloves.
- Do not touch the outside of the gloves with your bare hands.
- Wash your hands after removing gloves.
- If using re-useable gloves, these gloves should be stored separately in a sealed plastic bag and thrown away at the end of treatment.