医疗机构细胞毒性药物职业暴露风险防控指南

Guideline for the prevention and control of occupational exposure risks to cytotoxic drugs in medical institutions

为医疗机构提供细胞毒性药物职业暴露风险防控策略,提高医务人员的防护意识,降低医务人员发生潜在的职业暴露风险,制定《医疗机构细胞毒性药物职业暴露风险防控指南》。依据《世界卫生组织指南制定手册》方法,收集细胞毒性药物从配送到医院开始到其进入医院后在运输、接收、储存、脱包、调剂、成品使用、废物处理各个环节存在的暴露风险问题,采用德尔菲法构建临床问题,采用循证研究方法形成相关证据体后,按照推荐分级的评价、制定与评估(GRADE)方法进行质量评价,并再次通过专家共识法对推荐意见及证据级别达成共识。将工程控制、行政控制和个人防护设备3个不同等级管控相结合,通过分级管控的方式,最终确定了37个临床问题,共形成36条推荐意见,旨在为医疗机构制定细胞毒性药物分级防控措施提供参考与补充。

To provide prevention and control strategies of occupational exposure risks to cytotoxic drug in medical institutions,improve the awareness of protection among medical staff,and reduce potential occupational exposure risks,the Guidelines for the Prevention and Control of Occupational Exposure Risk to Cytotoxic Drugs in Medical Institutions is developed.Based on the World Health Organization Guidelines Development Manual,the exposure risk issues of the cytotoxic drug collected from the time that it entered the hospital to the several stages after delivery to hospital,such as transportation,receipt,storage,unpacking,dispensing,use of finished products,and waste disposal.Delphi method is used to construct identification of clinical issues,and evidence-based research method is used to develop relevant evidence.Quality evaluation is conducted by using the recommended GRADE method.The consensus is reached on the recommendation opinions and evidence levels through expert consensus method.By combining engineering controls,administrative controls and personal protective equipment at different levels,a graded control approach is established.A total of 37 clinical issues are identified,resulting in 36 recommendations.This guideline provides reference and supplementation for the formulation of cytotoxic drug prevention and control measures in medical institutions.