PURPOSE/ OBJECTIVES: To describe how nurses from a local Oncology Nursing Society (ONS) Chapter Implement Occupational Safety and Health Administration (OSHA) guidelines for handling cytotoxic drugs (CDs) in their individual practices and to identify barriers to implementing these guidelines. DESIGN: Mailed survey. SETTING: ONS chapter in a large midwestern city. SAMPLE: 103 nurses, 83 of whom handle CDs. Mean years in oncology nursing was 7.5. METHODS: Mailed survey consisting of 48 questions on seven topics, as well as demographic questions. MAIN RESEARCH VARIABLES: Roles in preparation and administration of CDs, management spills, patient care, and use of protective equipment in patient and family education practices; barriers to use of protective practices. FINDINGS: Subjects used some protective equipment when preparing and administering CDs, but the type of equipment and its frequency of use did not specifically meet OSHA Guidelines. Rates of compliance with guidelines were better for management of spills and disposal of equipment. Verbal instructions for patients and families were employed but very few provided written instructions or explanations. Barriers to using protective equipment included a lack of time, problems with availability, and concerns about patient reactions. CONCLUSIONS: Barriers must be overcome and better safe-handling practices incorporated into practice to ensure the safety of nurses. More education is needed for family members who come into contact with patients receiving CDs. IMPLICATIONS FOR NURSING PRACTICE: Future research to document the extent of the problem, including stratification of responses according to the quantity and frequency with which a nurse administers CDs. Better, and perhaps more frequent, staff and family education efforts are needed.
PURPOSE/ OBJECTIVES: To describe how nurses from a local Oncology Nursing Society (ONS) Chapter Implement Occupational Safety and Health Administration (OSHA) guidelines for handling cytotoxic drugs (CDs) in their individual practices and to identify barriers to implementing these guidelines. DESIGN: Mailed survey. SETTING: ONS chapter in a large midwestern city. SAMPLE: 103 nurses, 83 of whom handle CDs. Mean years in oncology nursing was 7.5. METHODS: Mailed survey consisting of 48 questions on seven topics, as well as demographic questions. MAIN RESEARCH VARIABLES: Roles in preparation and administration of CDs, management spills, patient care, and use of protective equipment in patient and family education practices; barriers to use of protective practices. FINDINGS: Subjects used some protective equipment when preparing and administering CDs, but the type of equipment and its frequency of use did not specifically meet OSHA Guidelines. Rates of compliance with guidelines were better for management of spills and disposal of equipment. Verbal instructions for patients and families were employed but very few provided written instructions or explanations. Barriers to using protective equipment included a lack of time, problems with availability, and concerns about patient reactions. CONCLUSIONS: Barriers must be overcome and better safe-handling practices incorporated into practice to ensure the safety of nurses. More education is needed for family members who come into contact with patients receiving CDs. IMPLICATIONS FOR NURSING PRACTICE: Future research to document the extent of the problem, including stratification of responses according to the quantity and frequency with which a nurse administers CDs. Better, and perhaps more frequent, staff and family education efforts are needed.