Improving safety-related knowledge, attitude and practices of nurses handling cytotoxic anticancer drug: pharmacists' experience in a general hospital, Malaysia

Asian Pac J Cancer Prev. 2013;14(1):69-73. doi: 10.7314/apjcp.2013.14.1.69.

Abstract

Background: An increasing trend of cytotoxic drug use, mainly in cancer treatment, has increased the occupational exposure among the nurses. This study aimed to assess the change of nurses' safety-related knowledge as well as attitude levels and subsequently to assess the change of cytotoxic drug handling practices in wards after a series of pharmacist-based interventions.

Materials and methods: This prospective interventional study with a before and after design requested a single group of 96 nurses in 15 wards actively providing chemotherapy to answer a self-administered questionnaire. A performance checklist was then used to determine the compliance of all these wards with the recommended safety measures. The first and second assessments took 2 months respectively with a 9-month intervention period. Pharmacist-based interventions included a series of technical, educational and administrative support measures consisting of the initiation of closed-system cytotoxic drug reconstitution (CDR) services, courses, training workshops and guideline updates.

Results: The mean age of nurses was 32.2∓6.19 years. Most of them were female (93.8%) and married (72.9%). The mean knowledge score of nurses was significantly increased from 45.5∓10.52 to 73.4∓8.88 out of 100 (p<0.001) at the end of the second assessment. Overall, the mean practice score among the wards was improved from 7.6∓5.51 to 15.3∓2.55 out of 20 (p<0.001).

Conclusions: The pharmacist-based interventions improved the knowledge, attitude and safe practices of nurses in cytotoxic drug handling. Further assessment may help to confirm the sustainability of the improved practices.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Antineoplastic Agents / toxicity*
  • Attitude of Health Personnel*
  • Female
  • Guideline Adherence
  • Hazardous Substances / toxicity*
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Malaysia
  • Male
  • Neoplasms / drug therapy
  • Neoplasms / nursing*
  • Occupational Exposure / adverse effects
  • Occupational Exposure / prevention & control*
  • Occupational Health
  • Oncology Nursing / education*
  • Oncology Nursing / standards
  • Pharmacy Service, Hospital
  • Practice Guidelines as Topic
  • Practice Patterns, Nurses'
  • Statistics, Nonparametric
  • Workplace / standards

Substances

  • Antineoplastic Agents
  • Hazardous Substances