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High rate of nurses exposed to chemotherapy drugs
Friese CR. BMJ Qual Saf. 2011;doi:10.1136/bmjqs-2011-000178.
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As many as 16.9% of nurses responding to a survey conducted by the University of Michigan said their skin or eyes had been exposed to chemotherapy drugs within the previous 12 months.
Exposure to antineoplastic drugs such as cyclophosphamide, ifosfamide, paclitaxel and methotrexate have been associated with immediate nervous system effects, acute and long-term reproductive effects and increased risk for hematological malignancies. Researchers found that the likelihood of exposure declined when nurses reported having adequate staffing and resources (OR=0.35; 95% CI, 0.17-0.73) and when nurses reported that chemotherapy doses were verified by two nurses frequently or very frequently (OR=0.17; 95% CI, 0.05-0.59).
Researchers surveyed 1,339 nurses; and 402 responded (30.4%). Of those, 242 reported at least one exposure to a chemotherapeutic agent.
Compared with nurses who were not exposed, nurses who had been exposed reported poorer scores on several Practice Environment Scale of the Nursing Work Index subscales, including participation in practice affairs and staffing (3.16 vs. 2.73 on a five-point scale) and resource adequacy subscales (3.61 vs. 3.01).
Additionally, exposed nurses reported an average assignment of 11.1 patients per shift compared with 8.43 patients per shift for nurses who were not exposed. Researchers said after adjusting for nurse characteristics and workload, respondents who reported favorable working conditions had a significantly lower risk for exposure compared with nurses who reported unfavorable or mixed working conditions (OR=0.44; 95% CI, 0.21-0.92).
Overall, chemotherapy doses were verified by two or more nurses on a frequent or very frequent basis 94.5% of the time but only 82.9% of time for nurses exposed to chemotherapy compared with 96.9% of nurses not exposed. After adjusting for nurse characteristics and nursing workloads, frequent or very frequent use of chemotherapy verification was associated with a significant reduction in risk for exposure (OR=0.21; 95% CI, 0.07-0.61).
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