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Introduction
Nurses working in oncology units may not realize the negative impact of their practice on their health. The problem is evident since many caregivers do not adhere to safety recommendations aimed to prevent occupational exposure. The article by Colvin, Karius, and Albert (2016) investigates the topic and proves the acuteness of the issue. The purpose of this paper is to assess the contribution of the article to the problem of nurses adherence to chemotherapy safe-handling guidelines by analyzing its research design, sampling, data collection methods, limitations, and findings. It also aims to prove that caregivers adherence to the use of protective equipment can eliminate adverse health outcomes.
Research Question
Nurses working in chemotherapy units are at significant risk for occupational exposure. To avoid adverse outcomes for caregivers, the National Institute for Occupational Safety and Health (NIOSH) and hospitals develop chemotherapy safe-handling guideline recommendations. The aim of the study is to investigate the level of nurses adherence to these policies based on direct observation and caregivers self-assessment.
The trend that could have affected this question is that many healthcare providers do not follow the safety guidelines (Boiano, Steege, & Sweeney, 2014). For example, many nurses do not wear double gloves, as is suggested by the NIOSH. The article presents the analysis and discussion of the problem, as well as presents the information about the risks for caregivers based on the statistical data about their adherence to safe-handling recommendations.
Research Design
The research used the mixed-methods design, utilizing the perspective and comparative approaches to investigation. The strength of the first approach is that it allows for measuring several types of behavior at the same time. The comparative study is beneficial as it provides an opportunity for evaluation of nurses self-perceptions compared to the actual results. The limitation of the approaches is the risk of bias of the observers.
The choice of the mixed-methods may be determined by the authors decision to observe the differences between nurses perspectives on their actions and their actual adherence to safety recommendations (Colvin et al., 2016). The findings of such a study may stress the significance of caregivers awareness of the precautionary measures while working in oncology units.
Sample Size
The study was performed at Cleveland Clinic and utilized two methods, including observation and questionnaire. The goal of the first one was to observe the actions of at least fifteen nurses with three or more years of experience in oncology nursing (Colvin et al., 2016). Thirty-three ambulatory oncology nurses, whose task was to deliver IV chemotherapy agents, participated in the questionnaire component of the study (Colvin et al., 2016).
It included fifteen yes-no questions along with a set of nine open questions. The sample size and the number of participants were adequate to the intent of the study as it allowed for the detailed analysis of individuals responses and behavior. However, the difference in the number of nurses for each study methods does not allow for comparison between the nurses answers and their actual adherence to safety recommendations.
Data Collection Methods
The data was collected by the principal investigator and three observers. Each of the individuals involved in the research had knowledge about oncology nursing and the NIOSH recommendations. Ethical considerations were addressed as the observers were unknown to the assessed nurses and the information was collected confidentially. For questionnaires, envelopes were provided to caregivers to ensure their anonymity. The data collection methods are appropriate to the study design and purposes.
Limitations of the Study
The possible limitations of the study are its small sample sizes for both of the research methods. Moreover, the authors did not consider the fact that one nurse could have been assessed by different observers more than one time. To overcome these limitations in subsequent studies, the authors may perform research in bigger medical institutions to allow for a larger number of participants. It is also possible to develop a data collection system for each observer to avoid the assessment of the same caregivers. Limitations are important to list within a study as they should be considered during the analysis of the findings and provide the basis for improvement for future investigations on the topic.
Findings
The findings of the study support the research question and prove that nurses show a lack of adherence to safety guidelines. The results reveal that of 22 recommendations, all of the nurses followed only three, which are the disposal of gloves, hand hygiene, and appropriate discard of the chemotherapy bag (Colvin et al., 2016). Seven items had less than a 50% adherence rate (Colvin et al., 2016). It is unclear whether they include the assessment of the same nurses by different observers, therefore, the credibility of the findings is questionable.
Summary
The lack of nurses adherence to safety guideline recommendations remains an acute problem. The study shows that caregivers perform only a limited number of protection interventions, which may result in adverse health effects. The findings reveal that the research question is relevant and timely as the problem should be addressed and eliminated.
The possible implementation of the study into practice is the development of training programs for nurses to enhance their awareness of the risks associated with occupational exposure to chemotherapy medications. The evidence provided by the authors is strong enough to suggest this changes as it shows that none of the nurses complied with all of the NIOSHs recommendations. With the improvement of nurses adherence, the risks associated with their work may be decreased significantly.
References
Boiano, 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(11), 728-740. Web.
Colvin, C. M., Karius, D., & Albert, N. M. (2016). Nurse adherence to safe-handling practices: Observation versus self-assessment. Clinical Journal of Oncology Nursing, 20(6), 617-622. Web.
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