Date of Award

4-1-2015

Degree Type

Dissertation

Degree Name

Nursing (D.N.P.)

Department

College of Nursing

First Advisor

Ruth Ann Brintnall

Second Advisor

Cynthia Coviak

Third Advisor

Terri Bacon-Baguley

Fourth Advisor

Wendy Koopman

Abstract

The purpose of this project was to explore nursing practice perceptions regarding the safe-administration of outpatient chemotherapy and establish whether a knowledge deficit existed in an ambulatory care setting. Although recommendations for chemotherapy administration exist they are not mandatory and data suggests that contamination may still be occurring, due in part to inconsistent nursing compliance. To provide a foundation for instituting safety improvements in the administration of chemotherapy, a mailed survey was distributed to a population of 68 oncology nurses in an outpatient setting to explore the disparity between evidence-based recommendations and actual implementation.

The Chemotherapy Handling Questionnaire previously developed by Dr. Martha Polovich was utilized for the purposes of this project. The questionnaire included scales that measured knowledge, barriers to using personal protective equipment, perceived risks of exposure, self-efficacy, the climate of workplace safety, conflict of interest and interpersonal influences. Each of the survey scales were scored and Spearman‟s Correlation Coefficients were calculated for data analysis. Project findings suggest that despite high levels of exposure knowledge and moderate levels of self-efficacy for the use of personal protective equipment, total precaution use of outpatient oncology nurses was still low.

This safety improvement project has multiple implications for future research. Nurse perceptions suggest that personal motivation for compliance with safe-handling standards needs to be revisited. Additionally, chemotherapy administration procedures need to be assessed to determine which barriers to safety can be minimized or eradicated and how treatment volume may be reduced or organized to improve outcomes and decrease the risk for unnecessary chemotherapy exposure. Qualitative survey comments urge organizational leaders to ensure that appropriate personal protective equipment (PPE) is readily available to nursing staff, open lines of communication regarding chemotherapy safety and compliance expectations are present, and implications for work policy changes exist.

This project explored nursing knowledge and perceptions of the safe administration of chemotherapy in outpatient settings of a multi-site clinic using the Chemotherapy Handling Questionnaire. The review of this cohort's perceptions suggests a need for ongoing evaluation of the workplace environment, in order to support a climate of safety and foster a culture that supports the well-being of nurses, in addition to their patients and the greater public.

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