ABSTRACT
Oncology nursing assistants (NAs) provide intimate personal care for cancer patients, increasing their risk for exposure to hazardous drugs in patients' bodily fluid. Their knowledge and comfort with safe handling is paramount to protect staff and the environment from a potential hazardous drug contamination. However, since the COVID-19 pandemic, inpatient NAs at our National Cancer Institute (NCI) Designated Comprehensive Cancer Center only received safe handling education via our online education system. The COVID-related change in educating staff precipitated a knowledge gap for NAs with safe handling guidelines. Furthermore, nursing staff rarely communicated safe handling precautions for patients on oral medications or outpatient IV chemotherapy. The communication breakdown from nurses to NA placed an undue exposure risk to NAs, who are an integral part of the oncology care team. The purpose of this quality improvement project was to provide comprehensive didactic and hands-on training to NAs on our medical oncology unit to improve staff knowledge, comfort and communication with safe handling precautions. Eighteen NAs completed an anonymous survey to determine baseline knowledge of and comfort level with safe handling. The seven-question survey was developed by the unit safe handling champion and Clinical Nurse Specialist to assess knowledge, comfort and communication of safe handling precautions. Mandatory education included didactic and hands-on review of safe handling guidelines such as: communication of chemotherapy precautions;donning and doffing;proper disposal of wastes, contaminated linen and personal protective equipment;and chemotherapy spill response. NA comfort level was assessed using a single item Likert scale ranging from 1 (not at all comfortable) to 5 (very comfortable). NA communication was assessed using two multiple select questions addressing peer to peer communication and precaution signs in rooms. Four questions assessed NA knowledge of location and use of PPE, waste disposal and duration of safe handling precautions. Three month reassessment showed comfort level improved from average 2.6 to 4.3. Thirty-eight percent of initial responders stated they never received communication about safe handling precautions, which decreased to 0% after education. NA knowledge also improved across all four questions. NAs are responsible for disposal of potentially contaminated bodily fluids. Lack of communication and knowledge of safe handling practices places undue exposure risk to staff and environment. Ensuring proper NA training improves engagement and empowers oncology nursing assistants to improve knowledge, communication and comfort with safe handling guidelines.