Chemotherapy-Handling Practices of Outpatient and Office-Based Oncology Nurses

Martin, Susan; Larson, Elaine

doi:10.1188/03.onf.575-581

Cited by 64 publications

(52 citation statements)

References 9 publications

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“…The percent of respondents participating in a medical surveillance program (19%) was markedly lower than reported (46%, 47%) in previous surveys. (24,27) …”

Section: Discussionmentioning

confidence: 99%

Adherence to Safe Handling Guidelines by Health Care Workers Who Administer Antineoplastic Drugs

Boiano

Steege

Sweeney

2014

Journal of Occupational and Environmental Hygiene

100

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The toxicity of antineoplastic drugs is well documented. Many are known or suspected human carcinogens where no safe exposure level exists. Authoritative guidelines developed by professional practice organizations and federal agencies for the safe handling of these hazardous drugs have been available for nearly three decades. As a means of evaluating the extent of use of primary prevention practices such as engineering, administrative and work practice controls, personal protective equipment (PPE), and barriers to using PPE, the National Institute for Safety and Health (NIOSH) conducted a web survey of health care workers in 2011. The study population primarily included members of professional practice organizations representing health care occupations which routinely use or come in contact with selected chemical agents. All respondents who indicated that they administered antineoplastic drugs in the past week were eligible to complete a hazard module addressing self-reported health and safety practices on this topic. Most (98%) of the 2069 respondents of this module were nurses. Working primarily in hospitals, outpatient care centers, and physician offices, respondents reported that they had collectively administered over 90 specific antineoplastic drugs in the past week, with carboplatin, cyclophosphamide, and paclitaxel the most common. Examples of activities which increase exposure risk, expressed as percent of respondents, included: failure to wear nonabsorbent gown with closed front and tight cuffs (42%); intravenous (I.V.) tubing primed with antineoplastic drug by respondent (6%) or by pharmacy (12%); potentially contaminated clothing taken home (12%); spill or leak of antineoplastic drug during administration (12%); failure to wear chemotherapy gloves (12%); and lack of hazard awareness training (4%). The most common reason for not wearing gloves or gowns was “skin exposure was minimal”; 4% of respondents, however, reported skin contact during handling and administration. Despite the longstanding availability of safe handling guidance, recommended practices are not always followed, underscoring the importance of training and education for employers and workers.

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“…The percent of respondents participating in a medical surveillance program (19%) was markedly lower than reported (46%, 47%) in previous surveys. (24,27) …”

Section: Discussionmentioning

confidence: 99%

Adherence to Safe Handling Guidelines by Health Care Workers Who Administer Antineoplastic Drugs

Boiano

Steege

Sweeney

2014

Journal of Occupational and Environmental Hygiene

100

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“…The ability of the toothbrush to remove plaque is consistently better and more clinically useful than foam swabs. [8][9][10][11][12][13][14] Grap et al 5 found that toothbrushing was not routinely performed and that sponge toothettes were used more often than toothbrushes were used for patients receiving mechanical ventilation. Antimicrobial chlorhexidine gluconate has been tested as a potential strategy for preventing VAP in several studies.…”

mentioning

confidence: 99%

“…Antimicrobial chlorhexidine gluconate has been tested as a potential strategy for preventing VAP in several studies. [10][11][12][13][14] When our study was done, no published studies had demonstrated a definitive link between chlorhexidine use and decreased VAP rates for critically ill patients. Recent studies [15][16][17] show a reduction in VAP rates when chlorhexidine is used, but the role of chlorhexidine in preventing VAP in critically ill patients remains unclear.…”

mentioning

confidence: 99%

Oral Care Practices for Orally Intubated Critically Ill Adults

Feider

Mitchell

Bridges

2010

American Journal of Critical Care

121

110

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Background Ventilator-associated pneumonia is a major threat to patients receiving mechanical ventilation in hospitals. Oral care is a nursing intervention that may help prevent ventilator-associated pneumonia.Objectives To describe oral care practices performed by critical care nurses for orally intubated critically ill patients and compare these practices with recommendations for oral care in the 2005 AACN Procedure Manual for Critical Care and the guidelines from the Centers for Disease Control and Prevention.Methods A descriptive, cross-sectional design with a 31-item Web-based survey was used to describe oral care practices reported by 347 randomly selected members of the American Association of Critical-Care Nurses.Results Oral care was performed every 2 (50%) or 4 (42%) hours, usually with foam swabs (97%). Oral care was reported as a high priority (47%). Nurses with 7 years or more of critical care experience performed oral care more often (P=.008) than did less experienced nurses. Nurses with a bachelor’s degree in nursing used foam swabs (P=.001), suctioned the mouth before the endotracheal tube (P=.02), and suctioned after oral care (P<.001) more often than other nurses. Nurses whose units had an oral care policy (72%) reported that the policy indicated using a toothbrush (63%), using toothpaste (40%), brushing with a foam swab (90%), using chlorhexidine gluconate oral rinse (49%), suctioning the oral cavity (84%), and assessing the oral cavity (73%). Oral care practices and policies differed for all those items.Conclusions Survey results indicate that discrepancies exist between reported practices and policies. Oral care policies appear to be present, but not well used.

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“…It is further suggested that the use of other equipment has improved, but remains under-compliant with OSHA guidelines. 73 Another recent study done in Israel examined the influence of the nurses' knowledge, attitudes and health beliefs on their behavior regarding safety measures. In general, nurses in this study did not fully comply with their facility's regulations for the safe handling of HD partly due to an education deficit.…”

Section: Practices Of Hcws Handling Hdsmentioning

confidence: 99%

“…[55][56][57][58][59][60][61][62][63][64][65][66][67] Findings from studies dating back to the 1980s are alarming given the knowledge offered by today's 20/20 hindsight regarding the risk these agents pose. In general, in that era when practice guidelines were first being developed and implemented, gloves were the most commonly used PPE, but even their use was comparatively low.…”

Section: Practices Of Hcws Handling Hdsmentioning

confidence: 99%