Chemotherapy is a type of cancer treatment that uses one or more anti-cancer drugs as part of a standardized chemotherapy regimen. The study in this article sought to confirm whether the current NIOSH PPE and the hospital chemotherapy exposures control policies were being observed in actual clinical practice, which was the primary purpose of the study. This was achieved by conducting some questionnaire interview on the observations and nurses' self-assessment, on the way these clinical officers were carrying themselves on and off duty. Also, it sought to establish how they conducted the whole process and how they discarded the used materials like gloves after the procedure. It also looks at the effect of their behaviors to other people, their patients and themselves.
According to McDiarmid, Rogers & Oliver (2014), if the necessary control policies were not observed, there could be adverse effects on the patients and the nurses. It also implies that nurses themselves can cause the consequences in case of ignorance of the required behavior and control policies. This article was to bring out the new safety policies that should be observed by all the chemotherapy cites and the nurses that carry out the whole process and to counter the effect in case of negligence
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In this article the research questions were; are the research policies set by the NIOSH PPE and hospital adhered to? What are the effects in case the nurses ignore the policies? What group can be affected in case of ignorance of the policies? According to research done in this article, we find that some of the nurses adhere to the policies set though others do not. This was done using two assessments. The first was an assessment of observations of handling, administering and disposing of chemotherapy materials. Second, was to obtain self-assessment of nurses' adherence to PPE and institutional policies.
The investigators used checklists that mimicked the NIOSH guidelines and institution policies, and after matching factors from the two used criteria checklists, we find that not all components of safe chemotherapy handling procedures were observed as recorded on the nurse skill checklist. In the case of self-assessment adherence, the investigators discovered that using chemotherapy approved gown and disposing of contaminated equipment, disconnection and disposal scored 100%. According to the article, OSHA uses hierarchy to rank the findings from least effective to the most effective, and we find that PPE was the least effective followed by the work practice control administrative control, engineering control and elimination of hazard.
For the nurses' adherence to safe handling practices, the study reveals that the investigators used mixed method design as a form of research method, which involved collecting and analyzing and integrating quantitative and qualitative research. The quantitative aspect of this research was used when the investigators measured attitude behaviors and performance instruments of the nurses, specifically micro ethnography (Matsumura & Maeda, 2015). While the qualitative element was used alongside questionnaires in gathering information from nurses, quantitively focuses on the group like the ones working on hospital oncology unit and others from ambulatory oncology. When the quantitative and qualitative behaviors were compared, it was revealed that double gloving, gowning and properly discarding chemotherapy were carried out with greater frequency than what nurses perceived in the questionnaire.
In this article, the sample size was appropriate as the investigators used different types of nurses with different experiences to come into a conclusion. Appropriate sample size can produce accurate results. According to me the sample size used in this article was adequate since the investigators had to use the different information which gotten from different personalities.
Medical institution and review board conducted and approved the data in this article. According to the article, different nurses were presented with questionnaires during the research process. Interviews were also employed in acquiring information from these nurses. The institution considered every information that they got from their investigations and this improved the accuracy of their findings, though there were some gaps in that they conducted since they used the same nurses for the different investigation.
The main focus of the article was on the Adherence to safe handling guidelines by healthcare workers who administer the antineoplastic drug. The result of this research points out the new knowledge on the observation and adherence of the chemotherapy control policies that should not be ignored by the nurses while administering and after administering chemotherapy (Bioano, Steege & Sweeney, 2014). It was reported that nurses are double gloved when administering chemotherapy agents at a very higher rate, while on the other side of the observation group, adherence rate did not match the information about nurses who completed self-assessment. This article to some extent did not answer the research questions because there were relatively contradictory summaries on the article.
Summary
Of 22 observations of nurses performing usual care in chemotherapy administration, the investigator found out that not all components of safe chemotherapy handling were observed and recorded on the nurse skill checklist. In order to ensure full adherence to chemotherapy control policies, many things need to be done rather than just looking at the observations and self-assessment of nurses. Nurses intervention and quality monitoring can improve adherence to these policies. According to my point of view, the practice will be highly warranted by improving the proposed strategies from this investigation. For instance, quality monitoring, competency evaluation and training education revision will help improve full adherence to these policies (McDiarmid & Presson, 1996). This can be applied to both the institution and the nurses themselves hence the evidence I found is strong enough to suggest a change in practice. It is critical for the practitioners to observe set policies to ensure safety and responsibility in the handling of chemotherapy cases.
References
Bioano, J.M., Steege, A.L., & Sweeney, M.H. (2014). Adherence to safe handling guidelines by health care workers who administer antineoplastic drugs. Journal of Occupational and Environmental Hygiene, 11, 728–740. doi:10.1080/15459624.2014.916809
Matsumura, Y., & Maeda, H. (2015). A new concept for macromolecular therapeutics in cancer chemotherapy: mechanism of tumoritropic accumulation of proteins and the antitumor agent smancs. Cancer research, 46(12 Part 1), 6387-6392.
McDiarmid, M.A., & Presson, A.C. (1996). Controlling occupational exposure to hazardous drugs. American Journal of Health-System Pharmacy, 53, 1669–1685.
McDiarmid, M.A., Rogers, B., & Oliver, M.S. (2014). Chromosomal effects of non-alkylating drug exposure in oncology personnel. Environmental and Molecular Mutagenesis, 55, 369–374. doi:10.1002/em.21852
