Safety Management Status among Nurses Handling Anticancer Drugs: Nurse Awareness and Performance Following Safety Regulations

Influences Shaping Clinicians' Monoclonal Antibody and Immune Checkpoint Inhibitor Preparation and Administration Management Practices: A Systematic Review

OBJECTIVES

In 30 years, monoclonal antibodies (mAbs) and immune checkpoint inhibitors (ICPIs) have enhanced cancer survival and quality of life. Limited knowledge exists regarding the long-term risks of repeated exposure, especially for cancer nurses, who prepare and administer them. This systematic review aimed to identify influences shaping clinicians' awareness and practices in the safe preparation and administration of mAbs and ICPIs.

DATA SOURCES

This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases CINAHL, EMBASE, Joanna Briggs Institute, OVID, MEDLINE, and Cochrane were searched. Eligibility and risk of bias were assessed by four reviewers.

RESULTS

Of 7301 identified studies, 481 duplicates were removed, and 6673 were excluded after title and abstract review. A full-text review was conducted on 147 studies; six studies were included. A narrative synthesis generated two themes: (1) ambiguity contributes to variation in handling practices and (2) continuing professional development (CPD) is vital but hard to implement without evidence.

CONCLUSION

Lack of evidence regarding long-term risks and consensus creates uncertainty about the hazardous nature of unconjugated mAbs and ICPIs. Resulting in varied risk reduction strategies during preparation and administration, and inconsistent CPD. Protecting the long-term health of clinicians necessitates consensus on risk reduction strategies. This will be challenging without compelling evidence or international agreement on their hazardous classification.

IMPLICATIONS FOR NURSING PRACTICE

In nursing, policy gaps and inconsistent CPD related to unconjugated mAbs and ICPIs may expose nurses to risks. Understanding the educational needs of nurses and global standardized guidelines are urgently needed.

Improving nurses' performance in the safe handling of antineoplastic agents: a quasi-experimental study

Background

The safe and standard handling of antineoplastic drugs can reduce the effects of occupational exposure and promote safe behaviors in nurses. Thus, the present study aimed to determine the effects ofstandard guidelines education on the safe handling of antineoplastic drugs among oncologynurses in Ardabil, Iran.

Methods

Thequasi-experimental study with a one-group pretest-posttest design was performed among 32 nursesworking in the oncology wards of two educational hospitals in Ardabil city, during 2020. Allthe nurses in the wards who met the inclusion criteria participated in the study. The data were collectedby usinga demographic information form and nurses’knowledge assessment questionnaire regardingthe standard guidelines for working with antineoplastic drugs, and a standard checklist for examiningtheir performance in this regard. Subsequently, they were analyzed by descriptive (mean and standard deviation) and inferential statistics (t-test)and Pearson’s correlation coefficient) in SPSS 22.

Results

The mean and standard deviation of the knowledge and performance scores of the oncology nurses was59.56±6.41and 18.96±2.54 respectively, which changed to 66±4.82 and 32.03±2.45 respectively three months after training. The results of the t-test represented a statistically significant difference between the level of knowledge and performance before and after the intervention (P=0.001).

Conclusions

Based on the results, the standard guidelines education improved the nurses’ knowledge and performance on the safe handling of antineoplastic drugs in the chemotherapy wards. Therefore, it is advised to increase the awareness of the oncology nurses in this regard in the planning and policy-making ofhealthcare centers.

Riscos ocupacionais e intervenções que promovem segurança para a equipe de enfermagem oncológica

Resumo Objetivo: analisar as evidências científicas relacionadas aos riscos ocupacionais e às intervenções que promovem segurança no trabalho para a equipe de enfermagem oncológica. Métodos: revisão de literatura realizada nas bases de dados MEDLINE, Web of Science, Scopus, LILACS, IBECS e BDENF. Resultados: a busca identificou 17 estudos primários, publicados em inglês, no período de 2008 a 2017. Dentre os fatores que configuram riscos ocupacionais, destacam-se: o déficit no conhecimento; a pouca disponibilidade de equipamentos de proteção individual para manuseio dos medicamentos antineoplásicos; o estresse; e a ansiedade. Quanto às intervenções que promovem a segurança, evidenciam-se: a manutenção do ambiente laboral favorável ao desempenho da assistência; a disponibilidade de insumos; o bom relacionamento interpessoal; a organização do trabalho; o dimensionamento profissional adequado; o conhecimento, a disponibilidade e o incentivo ao uso dos equipamentos de proteção; e a compreensão dos riscos ocupacionais aos quais os profissionais estão expostos. Conclusão: o estudo possibilitou a identificação de fatores associados à atividade laboral que comprometem a saúde da equipe de enfermagem oncológica, demonstrando a necessidade de intervenções voltadas para a melhoria das relações interprofissionais, a capacitação dos profissionais e o oferecimento de um ambiente de trabalho seguro e condições organizacionais que promovam a saúde dos trabalhadores.

Korean nurses' adherence to safety guidelines for chemotherapy administration

PURPOSE

Nurses are at risk from handling chemotherapeutic agents. This study aimed to determine adherence to safety guidelines for chemotherapy administration by Korean nurses and to examine the relationship between the hospital safety climate and nurses' adherence to safety guidelines.

METHOD

A descriptive, correlational design with a cross-sectional survey using data from the Korea Nurses' Health Study. For this study, participants included 872 female nurses who had administered chemotherapeutic agents to patients in the last 30 days.

RESULTS

Only a quarter of the participants had high adherence to the safety guidelines, while the majority had moderate to low adherence. The absence of job hindrances and feedback/training - two sub-factors of the hospital safety climate - enhanced the likeliness for nurses to comply with the safety guidelines by almost 1.3 and 1.7 times, respectively.

CONCLUSION

The results imply that the hospital safety climate, particularly feedback/training, and the absence of job hindrances are significantly correlated with adherence to the safety guidelines for chemotherapy administration. Therefore, organisational and policy support is needed to improve the hospital safety climate.