Chemotherapy-Knowledge and Handling Practice of Nurses Working in a Medical University of Nepal

Abstract

Background: Many antineoplastic agents are known to be teratogenic and mutagenic to humans. Nurses are the main groups that are exposed to these drugs in hospital setting. Generally, the occupational activities that pose to greatest risk of exposure are the preparation and administration of antineoplastic agents, cleaning of chemotherapy spills, and handling of patient excreta. Objective: The objectives of this study were to evaluate the knowledge of nurse regarding the way of exposure of Cytotoxic Drugs (CDs) and to determine the current patterns of use of personal protective equipments while handling antineoplastic chemotherapeutic agents. Methods: An analytic cross sectional study was carried out at BPKIHS Dharan. The study was carried out on 125 nurses. The random sampling technique was used to select the study subjects using structured and semi-structured questionnaire. Collected data were analyzed using descriptive and inferential statistics. Result: More than 92% of participants reported usually wearing gloves during chemotherapy handling; 6% reported using laboratory coats as protective garments. Usual use of face and respiratory protection was less than 5%. Chemotherapy was reported to be prepared in nursing station where there are no laminar airflow hoods in 100% of work settings. None of the subjects have reportedly provided any type of medical monitoring. Conclusion: Use and availability of gloves have increased but personal protective equipment like protective garments, face and respiratory protective, when handling chemotherapy have decreased and medical monitoring of exposed employees still is neither widely practiced nor consistent with Occupational Safety and Health Administration (OSHA) guidelines

Safe Handling of Anti-Neoplastic Drugs in the University Hospitals: A Descriptive Survey Study Among Oncology Nurses

“…As reported in the previous studies, participating in training programs significantly enhance the nurse's knowledge (16)(17)(18). The current study also showed a significant difference between knowledge scores of trained and untrained nurses regarding work in oncology ward.…”

“…U n c o r r e c t e d P r o o f score (17). Overall practice score was relatively appropriate, showing that oncology nurses may follow guideline instructions.…”

Cytotoxic Drugs Safety Guidelines: Its Effect on Awareness and Safe Handling Practices of Oncology Nurses

“…These finding are contradicted with Elshamy et al, (2010) [20] and Chaudhary and Karn, (2012) [14] who reported that fewer nurses mentioned that there are nursing care guidelines for procedures for dealing with patients receiving CDs as well as presence of in-service training programs. Also, Kyprianou, et al, (2010) [6] stated that most of the nurses were aware of the potential hazards of handling antineoplastic agents despite not having received specialized training on safe handling practices and they did not receive annual medical surveillance as a result of handling antineoplastic agents in their study that titled "Knowledge, attitudes and beliefs of Cypriot nurses on the handling of antineoplastic agents".…”

“…This result is contradicted with Chaudhary and Karn, (2012) [14] who reported that no significant differences were found in the frequency of risky behaviors in working environment regarding CDs and none of the nurses were using the four protective equipments necessary during the handling of CDs in their study that titled "chemotherapy-knowledge and handling practice of nurses working in a medical university of Nepal". But in accordance with Bolbol, Hassan, El-Naggar and Zaitoun, (2016) [18] who reported that there is significant improvement in studied nurses' attitude and practice after intervention regarding the use of personal protective equipment during handling patients' waste and cleaning up spills.…”

“…The responses for the positive attitude statements were on a five-likert scale where 5=strongly agree, 4=agree, 3=neutral (undecided), 2=disagree, 1=strongly disagree. [13,14] to assess the factors that affect oncology nurses' use of cytotoxic anticancer drugs safe handling practices. It included 18 statements which were grouped into 5 subgroups as follow: safe handling awareness of cytotoxic drugs (3 items), adequacy of equipments (5 items), working environment (2 items), workload (5 items), and administrative (3 items).…”