Some of these practices include but are not limited to, donning of personal protective equipment such as a disposable gown, gloves, masks and the utilization of a closed-system drug transfer device.
The key safe handling is to protect the health care worker throughout the three phases of contact with the hazardous drugs.
[3] However, a Cochrane review published in 2018 that synthesized all available controlled studies found no evidence of a closed-system drug transfer device offering an additional decrease in contamination or exposure to safe handling practices alone.
[4] It has been determined that current personal protective equipment (PPE) does not provide adequate protection against workers handling hazardous drugs - NIOSH states that “... measurable concentrations of some hazardous drugs have been documented in the urine of health care workers who prepared or administered them − even after safety precautions had been employed.”[1] Further, NIOSH recommends that institutions should "consider using devices such as closed-system transfer devices.
[1] Other guidelines outline that "As other products become available, they should meet the definition of a closed system drug transfer device established by NIOSH and should be required to demonstrate their effectiveness in independent studies".