Giving Methotrexate in an OB setting-Nurse safety?

[FLOBRN]

We are going to start giving Methotrexate on our Ob unit for ectopic pregnacies. I have found much information on the medication of course but nothing on the safety for the nurse aspect. When giving it IM or PO, do you need any special safety precautions other than regular non sterile gloves as for any IM or PO med?

thanks

FLOBRN

[OCNRN63, RN]

You should be wearing chemo-protective gear, including chemo gloves and gown if you're giving it IM. Plain gloves are not appropriate. You should also have a second nurse verify right drug, dose, route, etc. Our chemo is always double checked, even injections.

In our facility, OB is not allowed to give MTX for ectopics. They have to come down to outpatient oncology, because none of the staff in OB have taken the ONS chemo-provider course. Pretty tough requirements, I know, but that's what was decided.

[nursie_pants]

To dovetail on OCNRN63's response, make sure you also do some teaching with the patient/family about chemo in the pt's bodily fluids for about 72 hours following chemo administration. That means no family member's handling of vomit/urine/etc and the use of condoms as a barrier method. Also, close the toilet lid before flushing x 2. If the patient is staying in an in-patient setting, make sure staff also follows those safety protocols as well (chemo gown/gloves and a sign on the door).

[mzjennx, BSN, RN]

At our facility MTX needs to be given by a chemo certified/trained nurse with ONS so they have the Chemotherapy Provider Card. Double check with your facility if that is the case. like what OCNRN63 said need to be in chemo clothes like the chemo gown, gloves, eye wear. and like nursie_pants said, teaching teaching teaching. chemo is everywhere so be safe!!!