Patterns of chemotherapy exposure and adherence to safety practices among nurses: A pilot descriptive study

Dania M. Abu-Alhaija , Hanan Al-Faraj , Walaa R. Almallah , Gordon L. Gillespie

Journal of Nursing Education and Practice ›› 2026, Vol. 16 ›› Issue (7) : 45 -52.

PDF (365KB)
Journal of Nursing Education and Practice ›› 2026, Vol. 16 ›› Issue (7) :45 -52. DOI: 10.63564/jnep.v16n7p45
ORIGINAL RESEARCH
research-article
Patterns of chemotherapy exposure and adherence to safety practices among nurses: A pilot descriptive study
Author information +
History +
PDF (365KB)

Abstract

Objective The aim of the study was to describe the patterns of exposure to chemotherapy and adherence to chemotherapy safe handling practices among oncology nurses.

Methods A cross-sectional survey design was employed. Oncology nurse participants completed online surveys assessing nurses' demographics, exposure patterns, and their chemotherapy handling practices.

Results Participants were recruited from two medical centers in the Midwest region in the United States and social media. One hundred and twenty-three nurses completed the surveys. The study findings indicate that nurses are exposed to chemotherapy through various routes, and their use of personal protective equipment (PPE) and chemotherapy-specific equipment is less than the recommended standards. Twenty-one participants (18.1%) experienced chemotherapy exposure, primarily through skin. The participants followed safe chemotherapy handling guidelines 54.5% of the time. The adherence level was lowest during chemotherapy preparation (43.5% of the time) and highest during chemotherapy administration (63.2% of the time). Engineering control equipment (i.e., closed system transfer devices) was used most of the time during chemotherapy preparation and administration. Among PPE, chemotherapy-specific gloves and gowns were used most frequently across all handling procedures, while eye and respiratory protective equipment were used least frequently.

Conclusions This study highlights the necessity of developing interventions to enhance adherence to safe chemotherapy handling guidelines among nurses at the individual and institutional levels and to address any potential barriers to adherence. Future research is needed to investigate organizational factors and individual factors and their relationships with the patterns of adherence to handling guidelines.

Keywords

Adherence / Antineoplastic agents / Chemotherapy / Hazardous drugs / Nurses / Occupational health

Cite this article

Download citation ▾
Dania M. Abu-Alhaija, Hanan Al-Faraj, Walaa R. Almallah, Gordon L. Gillespie. Patterns of chemotherapy exposure and adherence to safety practices among nurses: A pilot descriptive study. Journal of Nursing Education and Practice, 2026, 16 (7) : 45-52 DOI:10.63564/jnep.v16n7p45

登录浏览全文

4963

注册一个新账户 忘记密码

References

[1]

Centers for Disease Control and Prevention. Cancer treatments. 2023. Available from:https://www.cdc.gov/cancer-survivors/patients/treatments.html?CDC_AAref_Val=https://www.cdc.gov/cancer/survivors/patients/treatments.htm

[2]

Muehlbauer PM. Chemotherapy administration in non-oncology settings. Pittsburgh (PA): Oncology Nursing Society; 2012. Available from: https://www.ons.org/04-2012/chemotherapy-administration-non-oncology-settings

[3]

National Institute for Occupational Safety and Health, Hodson L, Ovesen J, et al. Managing hazardous drug exposures:Information for healthcare settings. United States: Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, DHHS (NIOSH). Publication No. 2023-130; 2023. https://doi.org/10.26616/NIOSHPUB2023130

[4]

Nejat N, Mehrabi F. The occupational hazards of exposure to antineoplastic and chemotherapy drugs in nurses. A systematic review. Iran J of Cancer Care. 2022; 1(3): 20-8. https://doi.org/10.29252/ijca.1.3.20

[5]

DeJoy DM, Smith TD, Woldu H, et al. Effects of organizational safety practices and perceived safety climate on PPE usage, engineering controls and adverse events involving liquid antineoplastic drugs among nurses. J Occup Environ Hyg. 2017; 14(7): 485-93. PMid:28326998 https://doi.org/10.1080/15459624.2017.1285496

[6]

Friese CR, Wong M, Fauer A, et al. Hazardous drug exposure: Case report analysis From a prospective, multisite study of oncology nurses’ exposure in ambulatory settings. Clin J Oncol Nurs. 2020; 24(3): 249-55. PMid:32441682 https://doi.org/10.1188/20.CJON.249-255

[7]

Occupational Safety and Health Administration. Controlling occupational exposure to hazardous drugs. 2016. Available from: https://www.osha.gov/hazardous-drugs/controlling-occex

[8]

United States Pharmacopeial Convention. USP general chapter <800> Hazardous drugs -handling in healthcare settings. 2020. Available from: https://www.usp.org/compounding/general-chapter-hazardous-drugs-handling-healthcare

[9]

Menonna-Quinn D, Polovich M, Marshall B. Personal protective equipment: evaluating usage among inpatient and outpatient oncology nurses. Clin J Oncol Nurs. 2019; 23(3): 260-5.

[10]

He B, Mendelsohn-Victor K, McCullagh MC, et al. Personal protective equipment use and hazardous drug spills among ambulatory oncology nurses. Oncol Nurs Forum. 2017; 44(1): 60-5. PMid:28067030 https://doi.org/10.1188/17.ONF.60-65

[11]

Abu-Alhaija DM, Al-Faraj H, Miller ET, et al. Factors and strategies influencing chemotherapy safety among oncology nurses: A qualitative descriptive study. J Infus Nurs. 2025; 48(1): 17-24. PMid:39760874 https://doi.org/10.1097/NAN.0000000000000567

[12]

Von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007; 370(9596): 1453-7. PMid:18064739 https://doi.org/10.1016/S0140-6736(07)61602-X

[13]

Oudat Q, Bakas T. Merits and pitfalls of social media as a platform for recruitment of study participants. J Med Internet Res. 2023; 25: e47705. PMid:37819692 https://doi.org/10.2196/47705

[14]

Harris PA, Taylor R, Minor BL, et al. The REDCap consortium: Building an international community of software platform partners. J Biomed Inform. 2019; 95: 103208. PMid:31078660 https://doi.org/10.1016/j.jbi.2019.103208

[15]

Martin S, Larson E. Chemotherapy-handling practices of outpatient and office-based oncology nurses. Oncol Nurs Forum. 2003; 30(4): 575-81. PMid:12861318 https://doi.org/10.1188/03.ONF.575-581

[16]

Polovich M, Clark PC. Factors influencing oncology nurses’ use of hazardous drug safe-handling precautions. Oncol Nurs Forum. 2012; 39(3): E299-E309. PMid:22543401 https://doi.org/10.1188/12.ONF.E299-E309

[17]

IBM Corp. IBM SPSS statistics for Windows (version 28). IBM Corp; 2021.

[18]

Friese CR, Himes-Ferris L, Frasier MN, et al. Structures and processes of care in ambulatory oncology settings and nurse-reported exposure to chemotherapy. BMJ Qual Saf. 2012; 21(9): 753-9. PMid:21846769 https://doi.org/10.1136/bmjqs-2011-000178

[19]

Abu-Alhaija D, Miller E, Shaughnessy E, et al. Psychometric testing of the Oncology Nurses Health Behaviors Determinants Scale: A cross-sectional study. Semin Oncol Nurs. 2023; 39(6): 151515. PMid:37880012 https://doi.org/10.1016/j.soncn.2023.151515

[20]

Boiano JM, Steege AL, Sweeney MH. Adherence to safe handling guidelines by health care workers who administer antineoplastic drugs. J Occup Environ Hyg. 2014; 11(11): 728-40. PMid:24766408 https://doi.org/10.1080/15459624.2014.916809

[21]

Boiano JM, Steege AL, Sweeney MH. Adherence to precautionary guidelines for compounding antineoplastic drugs: A survey of nurses and pharmacy practitioners. J Occup Environ Hyg. 2015; 12(9): 588-602. PMid:25897702 https://doi.org/10.1080/15459624.2015.1029610

[22]

Abu-Alhaija D, Bakas T, Shaughnessy E, et al. The factors that influence chemotherapy exposure among nurses: An integrative review. Workplace Health Saf. 2023; 71(5): 212-27. PMid:36703295 https://doi.org/10.1177/21650799221140583

PDF (365KB)

0

Accesses

0

Citation

Detail

Sections
Recommended

/