Korean nurses' adherence to safety guidelines for chemotherapy administration

Impact of low- and high-risk operators handling irinotecan on the blood contamination of health care workers in oncology day care units

INTRODUCTION

Health care workers handling antineoplastic drugs (ADs) are at risk of mutagenicity and adverse reproductive effects. Despite protective equipment and AD handling guidelines, AD levels are still detected in caregivers in oncology units. This study attempted to assess blood contamination by irinotecan and its metabolites in all health care workers in oncology day hospital units according to activities specific to each employment category.

METHODS

The study was performed at two different hospitals: a university hospital and a comprehensive cancer centre. Forty-four participants were categorized according to their daily activity as a high-risk operator (29 nurses/ward aides and 5 cleaning staff) and a low-risk operator (7 doctors and 3 secretaries). The collected blood samples were subjected to UHPLC-MS/MS. The plasma and red blood cell (RBC) levels of irinotecan and its metabolites (SN-38; APC) were determined using a validated analytical method detection test.

RESULTS

Two hundred sixty-four assay results were collected (132 plasma results and 132 RBC results). The comparison between low- and high-risk operator-contaminated workers was not significant (18.33% positive results in low-risk operators vs. 25.98% positive results in high-risk operators; P = 0.22). This homogeneity showed overall contamination within the unit. Positive results were obtained in 21.43% of physicians, 11.11% of secretaries, 25.86% of nurses/ward aides and 26.67% of cleaning staff. These results could be explained by the lack or failure of personal and collective protective equipment. A lack of protection and inadequate decontamination procedures can result in surface contamination.

CONCLUSIONS

This study evaluated blood contamination with irinotecan and its metabolites in health care workers from day hospital care units. Among the 24.24% of contaminations observed in care units, the difference between low- and high-risk operator contamination was not significant (P = 0.22). The impact on blood contamination found is the same between low- and high-risk caregivers. This implies that the protective precautions associated with the handling of anticancer drugs must therefore be followed by all staff, including those believed to be at low risk of exposure.

Factors affecting frontline Korean nurses' mental health during the COVID-19 pandemic

AIM

To identify the factors affecting fear, anxiety and depressive symptoms among frontline nurses working with COVID-19 patients or are in charge of COVID-19 screening in Korea.

BACKGROUND

Nurses are at a higher risk of COVID-19 infection because they are in closer, longer-duration contact with patients. These situations can negatively affect the mental health of nurses.

METHODS

This study analysed data from COVID-19 module in the Korean Nurses' Health Study. Data from 906 participants were analysed. To identify the factors influencing mental health, descriptive statistics, Pearson's correlation and hierarchical multiple regression analyses were performed.

RESULTS

Caring for patients who are COVID-19-positive increased levels of fear, anxiety and depressive symptoms of nurses. The hospital safety climate influenced mental well-being among nurses.

CONCLUSION

Caring for patients with COVID-19 had a negative impact on fear, anxiety and depressive symptoms. However, the higher was the perceived hospital safety climate, the lower were the nurses' psychological symptoms. Further research on the mental health of nurses is warranted.

IMPLICATIONS FOR NURSING AND HEALTH POLICY

Institutions should manage human resources to enable periodic rotation of nurses' work and working periods related to COVID-19. In addition, hospital managers should provide sufficient personal protective equipment, related education, and safety climate.

Factors affecting frontline Korean nurses' mental health during the COVID-19 pandemic

Aim

To identify the factors affecting fear, anxiety and depressive symptoms among frontline nurses working with COVID‐19 patients or are in charge of COVID‐19 screening in Korea.

Background

Nurses are at a higher risk of COVID‐19 infection because they are in closer, longer‐duration contact with patients. These situations can negatively affect the mental health of nurses.

Methods

This study analysed data from COVID‐19 module in the Korean Nurses’ Health Study. Data from 906 participants were analysed. To identify the factors influencing mental health, descriptive statistics, Pearson’s correlation and hierarchical multiple regression analyses were performed.

Results

Caring for patients who are COVID‐19‐positive increased levels of fear, anxiety and depressive symptoms of nurses. The hospital safety climate influenced mental well‐being among nurses.

Conclusion

Caring for patients with COVID‐19 had a negative impact on fear, anxiety and depressive symptoms. However, the higher was the perceived hospital safety climate, the lower were the nurses’ psychological symptoms. Further research on the mental health of nurses is warranted.

Implications for nursing and health policy

Institutions should manage human resources to enable periodic rotation of nurses’ work and working periods related to COVID‐19. In addition, hospital managers should provide sufficient personal protective equipment, related education, and safety climate.