Nurses Need a Comprehensive Approach for Hazardous Drug Handling


In an interview with Oncology Nursing News, Christopher R. Friese, PhD, RN, AOCN, FAAN, discussed his study, and though the results were not what he expected, Friese still emphasized the need for proper education for oncology nurses.

Hazardous drug handling is an important issue for oncology nurses that requires a comprehensive approach, according to Christopher R. Friese, PhD, RN, AOCN, FAAN.

Friese, director of the Center for Improving Patient and Population Health and Elizabeth Tone Hosmer Professor of Nursing, Health Management and Policy at the University of Michigan, recently conducted a study about an educational intervention about drug handling. In an interview with Oncology Nursing News, he discussed his study, and though the results were not what he expected, Friese still emphasized the need for proper education for oncology nurses.

Can you briefly explain your study, its findings, and why it was important to conduct?

Our team sought to improve nurses’ handling of chemotherapy by delivering an educational intervention with quarterly reminders and tailored messages. We used a cluster, randomized-controlled trial design with 12 cancer centers and 257 nurses.

We found that our educational intervention, compared with a static control intervention, did not result in improved use of personal protective equipment (PPE) among nurses who handle chemotherapy in ambulatory oncology settings. This research is important because nurses who handle hazardous drugs are at increased risk for adverse health effects, summarized below. Yet despite these hazards, protective equipment use remains low.

What are some of the greatest risks for nurses when it comes to handling drugs to treat cancer?

The National Institute for Occupational Safety and Health (NIOSH) has concluded that hazardous drug exposure can cause both acute and chronic health effects, which can include skin rashes, reproductive problems, leukemia, and other rare cancers.

Do you feel that more can be done to improve nurses’ education — and practice – when it comes to hazardous drug handling?

Based on our findings, we advocate for a comprehensive approach to tackling this pervasive problem. This includes cancer centers using the latest equipment and devices to reduce the likelihood of exposure, engaged leaders to support staff in adopting safer drug handling practices, reviewing policies and procedures to be sure they are consistent with professional guidelines, and exploring ways to make it easier for clinicians to wear personal protective equipment each and every time they handle a hazardous drug. I also encourage workers exposed to hazardous drugs to complete their institution's incident report and seek care from an occupational health provider.

Are there any other implications for further research or next steps regarding your study?

Despite these disappointing results, we have generated important data to show that hazardous drug handling remains an important issue. Our team is currently analyzing data on drug spills that were reported during the study and exploring potential biomarkers of adverse health effects in our study sample.

Is there anything else you’d like to mention?

We are applying the findings of our study to a new National Cancer Institute-funded training program on chemotherapy safety for nurses and pharmacists. The Multi-Professional Oncology Safety and Simulation Training (MOSST) program is offered free of charge for the next two years. For more information and to apply, go to

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