Effects of organizational safety practices and perceived safety climate on PPE usage, engineering controls, and adverse events involving liquid antineoplastic drugs among nurses.
Antineoplastic drugs pose risks to the healthcare workers who handle them. This fact notwithstanding, adherence to safe handling guidelines remains inconsistent and often poor. This study examined the effects of pertinent organizational safety practices and perceived safety climate on the use of personal protective equipment, engineering controls, and adverse events (spill/leak or skin contact) involving liquid antineoplastic drugs. Data for this study came from the 2011 National Institute for Occupational Safety and Health (NIOSH) Health and Safety Practices Survey of Healthcare Workers which included a sample of approximately 1,800 nurses who had administered liquid antineoplastic drugs during the past seven days. Regression modeling was used to examine predictors of personal protective equipment use, engineering controls, and adverse events involving antineoplastic drugs. Approximately 14% of nurses reported experiencing an adverse event while administering antineoplastic drugs during the previous week. Usage of recommended engineering controls and personal protective equipment was quite variable. Usage of both was better in non-profit and government settings, when workers were more familiar with safe handling guidelines, and when perceived management commitment to safety was higher. Usage was poorer in the absence of specific safety handling procedures. The odds of adverse events increased with number of antineoplastic drugs treatments and when antineoplastic drugs were administered more days of the week. The odds of such events were significantly lower when the use of engineering controls and personal protective equipment was greater and when more precautionary measures were in place. Greater levels of management commitment to safety and perceived risk were also related to lower odds of adverse events. These results point to the value of implementing a comprehensive health and safety program that utilizes available hazard controls and effectively communicates and demonstrates the importance of safe handling practices. Such actions also contribute to creating a positive safety climate.
a Department of Health Promotion and Behavior, College of Public Health , University of Georgia , Athens , Georgia.
David M
DM
DeJoy
b Department of Applied Health Science, School of Public Health , Indiana University , Bloomington , Indiana.
Todd D
TD
Smith
c Department of Epidemiology and Biostatistics, College of Public Health , University of Georgia , Athens , Georgia.
Henok
H
Woldu
d Department of Health Promotion and Physical Education , Kennesaw State University , Marietta , Georgia.
Mari-Amanda
MA
Dyal
e Division of Surveillance, Hazard Evaluations and Field Studies , National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention , Cincinnati , Ohio.
Andrea L
0000-0001-5665-2559
AL
Steege
e Division of Surveillance, Hazard Evaluations and Field Studies , National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention , Cincinnati , Ohio.
James M
0000-0003-2738-4588
JM
Boiano
D000293:Adolescent; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D009726:Nurses; D016273:Occupational Exposure / Q000517:prevention & control* / Q000706:statistics & numerical data; D015279:Organizational Culture; D000067393:Personal Protective Equipment / Q000706:statistics & numerical data*; D011481:Protective Clothing / Q000706:statistics & numerical data; D017751:Safety Management; D011795:Surveys and Questionnaires
D000970:Antineoplastic Agents
Antineoplastic drug administration; hazardous drugs; healthcare workers; organizational factors; safe handling practices; safety climate