Evaluating the knowledge, attitude, and practice of oncology nurses towards the safe handling of anti-neoplastic drugs
DOI:
https://doi.org/10.18203/2320-6012.ijrms20251614Keywords:
Knowledge, Attitude, Practices, Nurses, Safe handling, Cytotoxic drugsAbstract
Background: Safe handling of anti-neoplastic drugs (ADs) is critical for oncology nurses due to the potential health risks of occupational exposure. Occupational exposure to antineoplastic agents and safe handling of cytotoxic drugs (CDs) had gained a high concern among oncology nursing staff due to their potential health risks. This study evaluates the knowledge, attitude and practices (KAP) of oncology nurses towards the safe handling of these drugs at King Abdullah Medical City, Makkah, Saudi Arabia.
Methods: A cross-sectional survey was conducted among 88 oncology nurses across oncology, hematology, and chemotherapy units using a validated questionnaire.
Results: Results showed that nurses demonstrated good knowledge regarding cytotoxicity, correct use of personal protective equipment (PPE), and waste disposal methods but reported gaps in the use of biological safety cabinets (BSC). Attitudes reflected adherence to safety guidelines but highlighted challenges during work overload. Practices revealed strengths in BSC usage but weaknesses in consistent PPE use and incident reporting. A strong correlation was observed among KAP variables and safe handling practices.
Conclusions: The safe handling of cytotoxic medications is a crucial feature, and nurses can avoid issues for both themselves and their patients. Overall, the nurses reported good practices for handling CDs safely, however a significant number of the nurses still have fair and negative habits. Effective actions are required to improve the procedures followed by oncology nurses when handling cytotoxic medications safely.
Metrics
References
Boiano JM, Steege AL, Sweeney MH. Adherence to safe handling guidelines by health care workers who administer antineoplastic drugs. J Occupational Environmental Hygiene. 2014;11(11):728-40. DOI: https://doi.org/10.1080/15459624.2014.916809
Mistry M, Parkin DM, Ahmad AS, Sasieni P. Cancer incidence in the United Kingdom: projections to the year 2030. Br J Cancer. 2011;105:1795-803. DOI: https://doi.org/10.1038/bjc.2011.430
Occupational Health and Safety Administration (OSHA): OSHA technical manual: controlling occupational exposure to hazardous drugs, Section VI Chapter 2. OSHA. 1999.
Alehashem M, Baniasadi S. Safe Handling of Anti-Neoplastic Drugs in the University Hospitals: A Descriptive Survey Study Among Oncology Nurses. Int J Cancer Manag. 2018;11(2):e6482. DOI: https://doi.org/10.5812/ijcm.6482
Nouri A, Seyed Javadi M, Iranijam E, Aghamohammadi M. Improving nurses’ performance in the safe handling of antineoplastic agents: A quasi-experimental study. BMC Nursing. 2021;20(1):247. DOI: https://doi.org/10.1186/s12912-021-00771-4
Mahdy NE, Rahman A, Hassan HA. Cytotoxic drugs safety guidelines: Its effect on awareness and safe handling practices of oncology nurses. IOSR J Nurs Heal Sci. 2017;6(03):22-33. DOI: https://doi.org/10.9790/1959-0603032233
Orujlu S, Zali M, Zamanzadeh V, Esfahani A, Hajaghazadeh M. Knowledge, attitude, and practice of oncology nurses of East Azerbaijan hospitals about handling antineoplastic drugs. J Prevent Med. 2021;8(2):71-9.
Rao I, Cheema PK. Antineoplastic Drugs-Knowledge, Attitude and Safe Handling practice of Nurses’ at Cancer Hospital. Int J Nursing Educat Res. 2020;8(1):1-5. DOI: https://doi.org/10.5958/2454-2660.2020.00001.0
Al-Atiyyat NM, Banifawaz AZ. Oncology nurses’ knowledge, practice, and confidence toward chemotherapy-induced peripheral neuropathy in Jordan. Saudi Med J. 2018;39(11):1158-63. DOI: https://doi.org/10.15537/smj.2018.11.23303
Asefa S, Aga F, Dinegde NG, Demie TG. Knowledge and Practices on the Safe Handling of Cytotoxic Drugs Among Oncology Nurses Working at Tertiary Teaching Hospitals in Addis Ababa, Ethiopia. Drug Healthcare Patient Safety. 2021;13:71-80. DOI: https://doi.org/10.2147/DHPS.S289025
Chen HC, Lu ZYJ, Lee SH. Nurses’ Experiences in Safe Handling of Chemotherapeutic Agents: The Taiwan Case. Cancer Nursing. 2016;39(5):E29-38. DOI: https://doi.org/10.1097/NCC.0000000000000314
Waheida SM, Abd-El GSI, Atia G. Evaluation of handling practices of oncology nurses during chemotherapy preparation and administration in Menoufia oncology hospital. Int J Novel Res Healthcare Nursing. 2018;2(3):107-19.
Simegn W, Dagnew B, Dagne H. Knowledge and associated factors towards cytotoxic drug handling among University of Gondar Comprehensive Specialized Hospital health professionals, institutional-based cross-sectional study. Environmental Health Preventive Med. 2020;25:11. DOI: https://doi.org/10.1186/s12199-020-00850-z
Esmail DH, Qadir CS, Mahmood EK, Osman GA, Omar YB. Safe Handling Knowledge and Practices of Chemotherapy among Oncology Nurses in Erbil City. Kufa J Nursing Sci. 2016;6(1):10. DOI: https://doi.org/10.36321/kjns.vi20161.2623
Nwagbo ES, Ilesanmi E, Ohaeri B, Oluwatosin OA. Knowledge of chemotherapy and occupational safety measures among nurses in oncology units. J Clin Sci. 2023;14(3):31. DOI: https://doi.org/10.4103/jcls.jcls_88_16
Abdullah DAH, Rasheed OH. Nursing Staff Knowledge regarding Safe Chemotherapy Administration at Oncology Center in Kirkuk City. Kirkuk University J Scientific Studies. 2018;13(1)20. DOI: https://doi.org/10.32894/kujss.2018.142401
Friese CR, Wong M, Fauer A, Mendelsohn-Victor K, Polovich M, McCullagh MC. Hazardous Drug Exposure: Case Report Analysis from a Prospective, Multisite Study of Oncology Nurses’ Exposure in Ambulatory Settings. Clin J Oncol Nursing. 2020;24(3):249-55. DOI: https://doi.org/10.1188/20.CJON.249-255
Polit DF, Beck CT. Nursing Research: Principles and Methods. Lippincott Williams and Wilkins, Philadelphia. 2004.
Ha Z, Sm S, Rm ES, Wm S. Knowledge, attitudes and practices of safe handling of cytotoxic drugs among oncology nurses in Tanta university hospitals. Egypt J Occupational Med. 2019;43(1):75-92. DOI: https://doi.org/10.21608/ejom.2019.25119
Turk M, Davas A, Ciceklioglu M, Sacaklioglu F, Mercan T. Knowledge, attitude and safe behaviour of nurses handling cytotoxic anticancer drugs in Ege University Hospital. Asian Pacific J Cancer Prevent. 2004;5(2):164-8.
Sheikh YA. Knowledge and practice on safe handling of cytotoxic drugs among health care workers at Kenyatta National Hospital. Thesis, University of Nairobi. 2016.
Elshamy K, El-Hadidi M, El-Roby M, Fouda M. Health hazards among oncology nurses exposed to chemotherapy drugs. Afr J Haematol Oncol. 2010;1(3):70-8.
Kyprianou M, Kapsou M, Raftopoulos V, Soteriades ES. Knowledge, attitudes and beliefs of Cypriot nurses on the handling of antineoplastic agents. Europ J Oncol Nursing. 2010;14(4):278-82. DOI: https://doi.org/10.1016/j.ejon.2010.01.025
Chaudhary R, Karn BK. Chemotherapy-Knowledge and Handling Practice of Nurses Working in a Medical University of Nepal. J Cancer Therapy. 2012;3(1):110-4. DOI: https://doi.org/10.4236/jct.2012.31014
Ben-Ami S, Shaham J, Rabin S, Melzer A, Ribak J. The influence of nurses’ knowledge, attitudes, and health beliefs on their safe behavior with cytotoxic drugs in Israel. Cancer Nursing. 2001;24(3):192-200. DOI: https://doi.org/10.1097/00002820-200106000-00005
Keat CH, Sooaid NS, Yun CY, Sriraman M. Improving safety-related knowledge, attitude and practices of nurses handling cytotoxic anticancer drug: Pharmacists’ experience in a general hospital, Malaysia. Asian Pacific J Cancer Prevention. 32013;14(1):69-73. DOI: https://doi.org/10.7314/APJCP.2013.14.1.69
Khan N, Khowaja KZA, Ali TS. Assessment of knowledge, skill and attitude of oncology nurses in chemotherapy administration in tertiary hospital Pakistan. Open J Nursing. 2012;2(2):97-103. DOI: https://doi.org/10.4236/ojn.2012.22015