Knowledge and Practices on the Safe Handling of Cytotoxic Drugs Among Oncology Nurses Working at Tertiary Teaching Hospitals in Addis Ababa, Ethiopia

Abstract

Background

Cytotoxic drugs (CDs) administration and occupational exposure is a worldwide concern. Inappropriate handling may cause toxic residues to infiltrate hospital environments and patient care areas, and can even be traced to patients’ homes. Hence, the study sought to assess knowledge and practices on the safe handling of cytotoxic drugs Among Oncology Nurses at Tertiary Teaching Hospitals in Addis Ababa, Ethiopia.

Methods

The researchers conducted a hospital-based cross-sectional study among 77 nurses from April 1–30, 2019. Purposive sampling was used in recruiting the respondents. Structured questionnaires were filled through self-administered interviewing. Data were analyzed using SPSS version 23 software. Multiple linear regression was performed to see the association between dependent variables and independent variables at a p-value of less than 0.05.

Results

Mean score of knowledge and practice of nurses was 7.82±2.22 out of 15 and 22.1±5.50 out of 40 respectively. Nearly 69% of nurses reported the lack of training program on the handling of CDs at their workplaces and the use of Personal Protective Equipment (PPE) remains suboptimal as none used all of PPE. Nurses who had not heard about CDs had an average knowledge score of 0.33 points lower than nurses who had heard about CDs (p ≤ 0.01). Nurses who have scored higher knowledge points had 0.33 points more practice score of safe CD handling than those who had lower knowledge score (p < 0.05) and also married nurses had average safe CDs handling practice score 0.27 points lower than their counterparts (p < 0.05).

Conclusion

Nurses’ knowledge and practice of safe handling of cytotoxic drugs are inadequate. Nurses who have scored higher knowledge points and are married were more likely to practice safe CD handling. Provision of proper PPE and training regarding the handling of CDs for Oncology Nurses are recommended and chemotherapy safety protocol and guidelines should be established.

Keywords:

• cytotoxic drugs
• safe handling
• knowledge
• practice
• oncology nurses
• Ethiopia

Abbreviations

BSC, Biological Safety Cabinet; CDs, Cytotoxic Drugs; DNA, Deoxyribonucleic Acid; GLOBOCAN, Global Cancer Incidence Mortality and Prevalence; HCWs, Health Care Workers; HD, Hazardous Drug; PPE, Personal Protective Equipment; SPHMMC, Saint Paul Hospital Millennium Medical College; TASH, Tikur Anbesa Specialized Hospital.

Data Sharing Statement

Data will be shared upon reasonable request from the corresponding author.

Ethical Approval

Ethical clearance was obtained from institutional review boards of both Addis Ababa University, College of Health Sciences, School of Nursing and Midwifery, and St. Paul’s Hospital Millennium Medical College. Above all, this study was carried out according to the Helsinki Declaration of Ethical Principles for Research. Besides, the School of Nursing and Midwifery of Tikur Anbessa Specialized Hospital (TASH), Addis Ababa University, wrote a support letter for both hospitals. After obtaining permission from the two hospitals, the data collection was started. The patient’s identifiers, such as name, were not used in the research report or any other to maintain patient confidentiality.

Acknowledgments

The authors are indebted to Addis Ababa University for approval of the ethical clearance, the Tikur Anbessa Specialized Hospital (TASH), and St. Paul’s Hospital Millennium Medical College for permitting us to collect data. The authors also forward their gratitude to data collectors, supervisors, and study participants.

Author Contributions

All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.

Disclosure

This manuscript and the data within it and the tables were derived from an original thesis of SA, which was for the fulfillment of the Master’s program, not a degree by publication. The full thesis work (preprint) was archived in the institutional electronic repository of Addis Ababa University (http://etd.aau.edu.et/bitstream/handle/123456789/21434/Selamawit%20asefa.pdf?sequence=1&isAllowed=y). Any journal publication of the manuscript derived from this thesis does not violate the policy of Addis Ababa University and it has no role in the publication. The authors declare that they have no other potential conflicts of interest for this work.

Additional information

Funding

There was no specific funding obtained for this study.