Since chemotherapy agents have been around in the 1950s there have been studies to find out the effect on the health care workers, particularly the pharmacists who make the drugs and nurses who administer the drugs to the patients. I will be focusing my research on the nurses who administer the chemotherapy drugs to the patients. Chemotherapy falls under the hazardous drug category due to the low levels of exposure nurses are exposed to while administering chemotherapy.
The first study on oncology nurses and risks of chemotherapy exposure where done in the late 1970s when mutagenic changes were discovered in the urine of nurses who administered chemotherapy. The first set of guidelines for the safe handling of chemotherapy was made around 1985 by the American Society of Health System Pharmacists (ASHP) and shortly after Occupational Safety and Health Administration (OSHA) and the Oncology Nursing Society (ONS) followed suite. Chemotherapy drugs are also defined as hazardous drugs according to the ONS and many other organizations.
The sources of contamination from chemotherapy don’t just come from the obvious route such as administering it to the patient, but can come from contamination of the outside of the chemotherapy containers, patient excretion, and improper disposal of chemotherapy equipment. Even in trace amounts contamination and exposure to chemotherapy drugs are dangerous. This is why it’s important to have separate bathroom facilities for patients who are receiving chemotherapy and for visitors/staff members.
How is the problem handled by the institution, unit, and staff?
I am currently doing my clinical at UMH 12 South which is a bariatric floor. I have had patient’s with skin cancer, bladder cancer, kidney cancer, etc. A majority of the patients I have had do not receive chemotherapy treatments but the ones who have; it has been PO chemotherapy medications where a nurse from the oncology floor comes and administers the chemo. I have noticed that some nurses just wear chemotherapy gloves while giving meds. From previous research: gloves, a gown, a facial shield, and goggles are needed. On my first day of clinical one nurse put on the personal protection equipment (PPE) and said, “I am just wearing this to show you what we’re supposed to do” but then they don’t regularly use all the PPE required. When discussing the PPE while administering chemo some nurses even said they “don’t work in an NCLEX hospital”. This made me want to see what the exact protocol is at UMH for handling chemotherapy drugs and why these precautions are in place.
According to the Policy and Procedures UMHC/Sylvester, in the Chemotherapy and Biotherapy Standards and Policies Code 1321 (2012), before administering chemotherapy nurses must have the following PPE available:
Powder free disposable gloves used for handling chemotherapeutic agents, disposable lint free gown with solid front and long sleeves with tight cuffs and back closure, eye and face protection...