Asian Oncol Nurs.  2018 Dec;18(4):206-213. 10.5388/aon.2018.18.4.206.

Safe Handling of Cytotoxic Drugs and Use of Personal Protective Equipment among Nurses at a Regional Cancer Center

• Kim SM
• Hong SO
• Chung HS
• Park JY

• KMID: 2431003
• DOI: http://doi.org/10.5388/aon.2018.18.4.206

Abstract

PURPOSE
This purpose of this study was to identify the level of safe-handling of cytotoxic drugs and use of PPE (Personal Protective Equipment) among nurses at a regional cancer center in South Korea.
METHODS
This was a cross-sectional descriptive study. The participants were 131 nurses who care for cancer patients undergoing chemotherapy. Demographic information, safe-handling of cytotoxic drugs and use of PPE were collected using questionnaires from May 7 to 25, 2018.
RESULTS
Response rate was 98.4%. The mean age of the nurses was 28.2±4.4 years and their clinical nursing experience was 4.34±3.93 years. The mean scores out of 5 for the participants' safe handling of cytotoxic drugs was 3.73± 0.43. In use of PPE, the mean score of wearing gloves, masks, and gowns were 3.89±.77, 3.06±1.04, and 2.34±0.98, respectively. The main reason for not wearing PPE was "˜too busy' (62.8%). The level of safe-handling of cytotoxic drugs was not significantly different according to any variables, but the use of PPE was significantly different according to age (p=.021).
CONCLUSION
The findings showed that nurses had exposure to cytotoxic drugs in the processes of preparation, administration, cleaning of spills, and handling of patient waste. Education programs and continuous monitoring are needed to improve the use of PPE among nurses and trigger the appropriate motivation for consistent personal protection.

Keyword

Drug therapy; Safety; Personal Protective Equipment; Cancer hospital; Nurses

MeSH Terms

Cancer Care Facilities
Drug Therapy
Education
Humans
Korea
Masks
Motivation
Nursing
Personal Protective Equipment*

Reference

1. Ministry of Health and Welfare (KR). Operation guidelines for regional cancer centers [Internet]. Accessed September 20, 2018. Available from:http://www.mohw.go.kr/react/jb/sjb030301vw.jsp?PAR_MENU_ID=03&MENU_ID=032901&CONT_SEQ=336833&page=1.

2. Korean Statistical Information Service (KR). Deaths and death rates by cause [Internet]. Accessed September 20, 2018. Available from: http://kosis.kr/statisticsList/statisticsListIndex.do?menuId=M_01_01&vwcd=MT_ZTITLE&parmTabId=M_01_01#SelectStatsBoxDiv.

3. Sung YH, Hwang MS, Yi YH. Oncology advanced nurses' use of outcome indicators and perception of outcome evaluation. J Korean Acad Nurs Adm. 2012; 18:189–201.

4. Oh BJ, Lee MN, Kang HS, Kim KS, Kim HO, Seol ME, et al. Development and analysis of job description for Korean oncology APN. J Korean Oncol Nurs. 2006; 6:3–14.

5. Kim BK, Lee SL, Youn JH, Kim SM, Kim MH. Nurses' knowledge, compliance and exposure experiences with cytotoxic drugs in a university hospital. Glob Health Nurs. 2016; 6:11–19.

6. United States Department of Labor. OSHA technical manual, TED 1-0.15A, Sec VI: chapter 2 - controlling occupational exposure to hazardous drugs [Internet]. Accessed July 4, 2017. Available from: https://www.osha.gov/dts/osta/otm/otm_vi/otm_vi_2.html.

7. National Institute for Occupational Safety and Health (US). Workplace solutions: personal protective equipment for health care workers who work with hazardous drugs [Internet]. Accessed July 4, 2017. Available from: https://www.cdc.gov/niosh/docs/wp-solutions/2009-106/pdfs/2009-106.pdf?id=10.26616/NIOSHPUB2009106.

8. National Institute for Occupational Safety and Health (US). Workplace solutions: safe handling of hazardous drugs for veterinary healthcare workers [Internet]. Accessed July 4, 2017. Available from: https://www.cdc.gov/niosh/docs/wp-solutions/2010-150/pdfs/2010-150.pdf.

9. Lawson CC, Rocheleau CM, Whelan EA, Lividoti Hibert EN, Grajewski B, Spiegelman D, et al. Occupational exposures among nurses and risk of spontaneous abortion. Am J Obstet Gynecol. 2012; 206:327.e1–327.e8.

10. Choi JS, Kim YH, Gong SH, Jun MH, Park JS, Kim MJ. Level of knowledge and compliance on guidelines for safe handling of cytotoxic drugs by career and work units in clinical nurses. Clin Nurs Res. 2004; 9:6–17.

11. Nixon S, Schulmeister L. Safe handling of hazardous drugs: are you protected? Clin J Oncol Nurs. 2009; 13:433–439.

12. Polovich M, Martin S. Nurses' use of hazardous drug-handling precautions and awareness of national safety guidelines. Oncol Nurs Forum. 2011; 38:718–726.

13. Korean Oncology Nursing Society. Safe handling guideline of cytotoxic drugs: chemotherapy. Asian Oncol Nurs. 2008; 8:178–190.

14. Korea Occupational Safety & Health Agency. Health management guidelines for chemical exposure of medical workers [Internet]. Accessed July 4, 2017. Available from: http://www.kosha.or.kr/www/boardView.do?contentId=3585&menuId=4828&boardType=A4.

15. Korea Institute for Healthcare Accreditation. Guideline for healthcare accreditation Ver 2.0 [Internet]. Accessed July 4, 2018. Available from: http://www.koiha.kr/member/kr/board/establish/establish_BoardList.do.

16. Yun JH, Park JY. Oncology nurses' knowledge of safety guidelines and compliance with safe handling of antineoplastic agent in a tertiary hospital. Asian Oncol Nurs. 2016; 16:251–260.

17. Park SJ. Nurses' compliance with safety guidelines for use of antineoplastic drug, observable symptoms and stress from occupational exposure [dissertation]. Busan: Catholic Univ. of Pusan;2017.

18. Kim MJ, Jun MH, Choi JS, Park JS. Cognition and practice of safe handling of cytotoxic drugs in university hospital nurses. Asian Oncol Nurs. 2004; 4:154–165.

19. Jeong KW, Lee BY, Kwon MS, Jang JH. Safety management status among nurses handling anticancer drugs: nurse awareness and performance following safety regulations. Asian Pac J Cancer Prev. 2015; 16:3203–3211.

20. Callahan A, Ames NJ, Manning ML, Touchton-Leonard K, Yang L, Wallen R. Factors influencing nurses' use of hazardous drug safe handling precautions. Oncol Nurs Forum. 2016; 43:342–349.

21. Polovich M, Clark PC. Factors influencing oncology nurses' use of hazardous drug safe-handling precautions. Oncol Nurs Forum. 2012; 39:E299–E309.