Document Type


Publication Date


Publication Title

WIN Conference 2023


california; fullerton; sjmc


Infusion Nurses’ Personal Protective Equipment Use While Handling Chemotherapy Drugs Purpose: To describe perceived barriers, perceived risks, interpersonal influence (modeling and norms), perceived conflict of interest, and organizational influences and select demographics related to Personal Protective Equipment (PPE) use for out-patient, oncology infusion nurses. Background: The proper use of PPE should be common practice among nurses who administer chemotherapy. However, despite training and education, many studies have demonstrated that infusion nurses’ PPE adherence is as low as 50%. Improper PPE use can increase exposure to chemotherapy and has potential adverse health effects including fertility issues and risks of cancer. Few studies have examined if certain nurse demographics impact proper PPE use. Methods: This descriptive correlational, cross sectional research design used purposeful sampling to recruit infusion nurses from 4 clinic sites. In June and July 2022, infusion nurses received a one-time survey consisting of the valid and reliable Revised Hazardous Drug Handling Questionnaire (51 questions) and 12 demographic questions; data was captured in REDCap. The 5 subcategories included 1) perceived barriers, 2) perceived risks, 3) interpersonal influence of modeling and norms, 4) perceived conflict of interest, and 5) organizational influences with scales ranging from (1 = strongly disagree to 5 = strongly agree). Pearson r correlations was done using SPSS version 26. Results: Out of the possible 56 nurses, 32 responded (57%).Statistically significant correlations between demographics and subcategories included nurses age and interpersonal influences of norms (r = .552; p < .001) and organizational influences (r =.419; p < .05.); years of total nursing experience and interpersonal influences of norms (r = .617; p < .001), modeling (r = .412; p < .05), and organizational influences (r =422; p < .05). The years of oncology nursing experience only correlated with interpersonal influences of norms (r = .435; p < .05). Larger patient caseload correlated with perceived barriers (.428; p < .05) and conflict of interest (r = .416; p < .05) with negative correlation to organizational influences (r = -.418; p < .05). PPE adherence is low with 62% of participants agreeing or strongly agreeing that “others around me don’t use PPE”. Most nurses did not use PPE because they were uncomfortable (55%) or too hot (71%). Knowledge gap of adverse health risks were identified when 26% felt that they were “not worried about future negative health effects from chemotherapy exposure.” Also, 34% of the nurses felt that “wearing PPE makes my patients worry” and 21% felt that it made patients “feel uncomfortable.” Implications: This study found higher PPE non-compliance (62%) compared to previous literature (50%). Nurse age (younger), years of experience (fewer), and caseload (higher) increased risky PPE behavior. PPE education targeting perceived barriers, and the impact of modeling appropriate behaviors should be reinforced to both nurses and patients. Organizational influences of workplace safety climate could be improved with collaboration of more experienced nurses. Future research should include a multifaceted approach addressing the PPE itself, the infusion clinics culture and acceptability, and nurse knowledge.

Clinical Institute