Since chemotherapy agents have been around in the 1950s there have been studies to find out the effect on the health care workers, particularly the pharmacists who make the drugs and nurses who administer the drugs to the patients. I will be focusing my research on the nurses who administer the chemotherapy drugs to the patients. Chemotherapy falls under the hazardous drug category due to the low levels of exposure nurses are exposed to while administering chemotherapy.
The first study on oncology nurses and risks of chemotherapy exposure where done in the late 1970s when mutagenic changes were discovered in the urine of nurses who administered chemotherapy. The first set of guidelines for the safe handling of chemotherapy was made around 1985 by the American Society of Health System Pharmacists (ASHP) and shortly after Occupational Safety and Health Administration (OSHA) and the Oncology Nursing Society (ONS) followed suite. Chemotherapy drugs are also defined as hazardous drugs according to the ONS and many other organizations.
The sources of contamination from chemotherapy don’t just come from the obvious route such as administering it to the patient, but can come from contamination of the outside of the chemotherapy containers, patient excretion, and improper disposal of chemotherapy equipment. Even in trace amounts contamination and exposure to chemotherapy drugs are dangerous. This is why it’s important to have separate bathroom facilities for patients who are receiving chemotherapy and for visitors/staff members.
How is the problem handled by the institution, unit, and staff?
I am currently doing my clinical at UMH 12 South which is a bariatric floor. I have had patient’s with skin cancer, bladder cancer, kidney cancer...
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OSHA targets high-risk workplaces for possible inspections. (2013). PPS Alert for Long - Term Care, 16(6), 1-5. Retrieved from http://search.proquest.com/docview/1352761916?accountid=14585
Research, evidence-based practice, and clinical Improvement/Innovation posters. (2013). Association of Operating Room Nurses.AORN Journal, 97(6), 654-72. doi:http://dx.doi.org/10.1016/j.aorn.2013.04.004
Study links workplace chemical exposures to miscarriages among nurses: data suggests that exposure to chemotherapy drugs and sterilizing agents puts nurses at risk. (2012, April). Briefings on Hospital Safety, 20(4), 4+. Retrieved from http://go.galegroup.com/ps/i.do?id=GALE%7CA288538633&v=2.1&u=miami_richter&it=r&p=AONE&sw=w&asid=9cca539712ab06be526003982a559021
University of Miami Health System. Plan for the provision of patient care (2013). Pg. 17
Hinkle, J., Cheever, K., & , (2012). Textbook of medical-surgical nursing. (13 ed., pp. 586-588). Philadelphia: Wolters Kluwer Health
Overall, I retain three goals for this clinical day: Safely and efficently administer medication, enhance my nursing/CNA skills, and determine how to implement infection control into a health care setting. This week reflects my assigned time to administer medication in a health care setting for the first time, with a resident who retains nearly twenty medications. I except this experience will be a great learning experience, but it will also subsist slightly stressful. With the assistance of my FOR, my goal is to administer all of my resident 's medications without complications. To ensure that medication safety, I will perform the six medication rights and three checks prior to administration. Along with medication administration, a goal
Ignatavicius, D. D., & Workman, M. L. (2013). Care of Intraoperative Patients. Medical-surgical nursing: patient-centered collaborative care (7th ed.). St. Louis: Elsevier.
(AC 1.1, 2.1) Jane may be uncertain about the side effects of chemotherapy and radiotherapy. This is the time when the oncology nurse will use her specialist knowledge, will answer all questions that Jane is not sure and even if she does not know the answer she will find out by working with other team members. Based on the nurse’s oncology knowledge and experience her communication skills will make Jane and her family think positively about treatment; not only at the beginning of cancer treatment but also during and at the end however it turns out.
Nielsen, Ronald P. OSHA Regulations And Guidelines : A Guide For Health Care Providers. Albany, NY: Delmar,
When performing evidence based practice research, the Iowa Model uses a team or individual approach to assist nurses in the journey to quality care. The Iowa Model begins by offering a process of selecting a proper clinical topic, which is often a recurring problematic issue (Polit & Beck, 2012). This topic is formulated as a question to improve a technique or procedure. Once the researcher determines that an ample amount of reported investigation exists on the desired question, information may be gathered and presented for approval (Polit & Beck, 2012). The research may lead to a gradual change in nursing practice.
...ause harmful side effects when mixed with the drugs that are a part of cancer treatment (Gillison).
Evidence-based practice integrates best current evidence with clinical expertise and patient/family preferences and values for the delivery of optimal health care (qsen.org). Like most medical professions, nursing is a constantly changing field. With new studies being done and as we learn more about different diseases it is crucial for the nurse to continue to learn even after becoming an RN. Using evidence-based practice methods are a great way for nurses and other medical professionals learn new information and to stay up to date on new ways to practice that can be used to better assess
Talbert, JeanAnne Johnson. "Substance Abuse Among Nurses." Clinical Journal Of Oncology Nursing 13.1 (2009): 17-19. Academic Search Complete. Web. 8 Dec. 2013
Cyclophosphamide is an alkylating agent used in the treatment of lymphoma, carcinomas and sarcomas in dogs. It is increasingly being used in ‘metronomic’ chemotherapy protocols.[1] Cyclophosphamide is a prodrug that requires oxidation in the liver to form the active metabolites which are in turn are converted to phosphoramide mustard and acrolein.[2] Phosphoramide mustard causes DNA damage and acrolein has inflammatory effects. Like many chemotherapy agents, cyclophosphamide may cause myelosuppression, gastrointestinal upset and alopecia; however, unlike most chemotherapy agents, it also carries the risk of sterile haemorrhagic cystitis (SHC). This leads to haemorrhage and fibrosis of the bladder epithelium.[3, 4] The mechanism with which cyclophosphamide
Davenport, Joan M., Stacy Estridge, and Dolores M. Zygmont. Medical-surgical nursing. 2nd ed. Upper Saddle River, N.J.: Pearson Prentice Hall, 2008, 66-88.
While chemotherapy is beneficial at curing or helping a disease such as cancer, it can has a negative effect on a person’s body too.
Brunner, L.S. & Suddarth, D. S Textbook of Medical- Surgical Nursing, 1988 6th ed. J. B. Lippincott Company, Philadelphia
Karch, A. M. (2013). 2013 Lippincott's Nursing Drug Guide. New York: Lippincott Williams & Wilkins.
Firstly, nurses are expected to practice evidence-based health care hence a mastery of information about the essential and safe dose of drugs for a patient is very important for a nurse. Consequently, it could be the determinant between the life and the death of the patient. Pharmacology is a discipline which is mandatory for the nurse to excel in to be efficient in discharging his/her duties. Understanding which drug to use, the right dosage, the expected side effects which may occur and the contra-indications of the various drugs are key in the preservation of