Date of Publication


Project Team

Faculty Advisor: Stuart Whtitney EdD, CNL, RN Site Advisor: Elsa Fennelly, BSN, RN


Purpose: Healthcare workers are potentially exposed to hazardous drugs (HDs) in the workplace, especially with chemotherapeutics used in oncologic treatment. Exposure to HDs increases the risk of adverse health effects. Personal protective equipment (PPE) as one control to prevent exposure. A Northeast academic medical center required implementation of annual competencies on HDs to comply with national standards detailed in United States Pharmacopeia (USP) Chapter 800. This project sought to evaluate the effectiveness of this HD competency and evaluate the PPE practices of healthcare workers who are frequently involved with HDs

Methods: A hands-on HD annual competency was developed for nurses and nursing assistants involved in patient care on an inpatient oncology unit to demonstrate staff follow appropriate PPE protocols for handling HDs and HD contaminated excreta. A follow-up voluntary survey using multiple choice, Likert scale questions, and qualitative responses was conducted to evaluate PPE practices on the job based on self-report.

Results: All eligible staff members completed the hands-on annual competency successfully (n=71). Twenty-one staff members completed the voluntary survey. Staff demonstrated a high degree of knowledge and self-efficacy for PPE use but reported significantly lower rates of PPE use with handling HD contaminated excreta than demonstrated in the hands-on competency (p<0.01), and less use of labels, disposable pads, and touching the IV pump with gloves during administration (p<0.05).

Conclusion: This project demonstrated a successful hands-on competency to assess HD administration and HD excreta handling, but more research is needed to better understand the self- reported lower compliance with established policies and procedures for handling HD infusions and contaminated excreta in practice.

Keywords: Hazardous drugs, oncology, PPE, chemotherapy, nursing

Document Type



Occupational and Environmental Health Nursing