Improving Safety-Related Knowledge, Attitude and Practices of Nurses Handling Cytotoxic Anticancer Drug: Pharmacists’ Experience in a General Hospital, Malaysia


Background: An increasing trend of cytotoxic drug use, mainly in cancer treatment, has increased theoccupational exposure among the nurses. This study aimed to assess the change of nurses’ safety-related knowledgeas well as attitude levels and subsequently to assess the change of cytotoxic drug handling practices in wards aftera series of pharmacist-based interventions. Materials and
Methods: This prospective interventional study witha before and after design requested a single group of 96 nurses in 15 wards actively providing chemotherapy toanswer a self-administered questionnaire. A performance checklist was then used to determine the complianceof all these wards with the recommended safety measures. The first and second assessments took 2 monthsrespectively with a 9-month intervention period. Pharmacist-based interventions included a series of technical,educational and administrative support measures consisting of the initiation of closed-system cytotoxic drugreconstitution (CDR) services, courses, training workshops and guideline updates.
Results: The mean age ofnurses was 32.2±6.19 years. Most of them were female (93.8%) and married (72.9%). The mean knowledge scoreof nurses was significantly increased from 45.5±10.52 to 73.4±8.88 out of 100 (p<0.001) at the end of the secondassessment. Overall, the mean practice score among the wards was improved from 7.6±5.51 to 15.3±2.55 outof 20 (p<0.001).
Conclusions: The pharmacist-based interventions improved the knowledge, attitude and safepractices of nurses in cytotoxic drug handling. Further assessment may help to confirm the sustainability of theimproved practices.