Minimizing Staff Exposure to Antineoplastic Agents 
During Intravesical Therapy

Abstract

Exposure to chemotherapy is a daily risk for nurses in oncology infusion centers. Although significant advances have been made in developing systems to make IV administration of antineoplastic agents safer, less attention has been given to developing systems to minimize exposure risk during instillation of intravesical chemotherapy. This article describes the use of a closed system developed at a comprehensive cancer center and compares it to two closed systems reported in the literature. At a Glance • Safe handling of biohazard medications is important for all healthcare workers involved in the administration of antineoplastic agents. • Nurses need to advocate for use of chemotherapy administration systems that minimize exposure to staff and patients. • Infrequently performed procedures need to be supported by clearly specified procedural steps that are readily accessible to the nurse.

Current evidence of education and safety requirements for the nursing administration of chemotherapy: An integrative review

“…The selected studies do provide information relevant to the current research question. However the case studies were mainly the presentation of a small practice changes within a cancer care area (Ashley et al, 2011;Beaver & Magnan, 2015;Coyle, Griffie, & Czaplewski, 2014;Gonzalez, 2013;Hydzik, 2009;Looper et al, 2015;Menonna-Quinn, 2013;Muehlbauer, Parr, & Perkins, 2013;Sheridan-Leos, 2007;Sheridan-Leos, Schulmeister, & Hartranft, 2006;Turner & Stephenson, 2015).…”

“…See Table 2 for a summary of studies. (Ashley et al, 2011;Beaver & Magnan, 2015;Boiano et al, 2014;Bonnabry et al, 2006;Coyle et al, 2014;Gonzalez, 2013;Hydzik, 2009;Markert, Thierry, Kleber, Behrens, & Engelhardt, 2009;Sheridan-Leos, 2007;Villarini et al, 2011) Process safeguards Standardised orders, electronic orders, barcode Protocols, guidelines and audits Quiet zone, time out, speak outloud checks between nurses…”

“…Organisations' need to have a process for risk assessment and identification to direct the development of guidelines and policies to guide practice. Institutional practices such as audits, the use of closed systems, standardised assessment and flow tools help ensure safe practices are adhered to during all aspects of chemotherapy administration (Beaver & Magnan, 2015;Coyle et al, 2014;Gonzalez, 2013).…”

“…Nurses need to become advocates for patient safety at all levels, including organisational and health service delivery levels. To improve safety for the patient, nurse and environment in regards to administration of chemotherapy, a closed system was considered best practice (Beaver & Magnan, 2015). Standardised orders and barcodes also reduced medication errors and should be implemented within clinical practice where possible.…”