Salient Features and Outline of the Joint Japanese Guidelines for Safe Handling of Cancer Chemotherapy Drugs

Investigation of occupational safety in oncology nurses

Objective. This study aimed to examine the occupational safety of oncology nurses. Methods. This cross-sectional study was conducted to examine the risks faced by oncology nurses in the units they work in and occupational safety. The data of the study were collected between April and October 2020 using an online questionnaire prepared by the researchers in line with the literature. The sample for the study consisted of 117 oncology nurses who voluntarily participated in the study and filled out the questionnaire completely. Results. More than half of the participants stated that they did not find occupational safety practices sufficient and were not given additional rights or psychological support given the risks of exposure. Conclusions. The study concluded that to improve occupational safety in oncology nurses, the physical conditions of the working environment should be improved, and up-to-date oncology and occupational safety training should be given regularly.

Pre-treatment assessment for patients with breast cancer undergoing chemotherapy: a best practice implementation project

OBJECTIVES

This project aimed to conduct an audit of pre-treatment assessment for patients with breast cancer undergoing chemotherapy and to assess the impact of these changes in improving the compliance with evidence-based best practice criteria in a large tertiary hospital.

INTRODUCTION

Pre-treatment assessment before cancer chemotherapy is paramount in order for patients to receive effective and safe treatment. Numerous guidelines and consensus-based standards for safe chemotherapy administration have been developed, which state that nurses should conduct and document comprehensive health assessments for patients prior to administration of chemotherapy.

METHODS

The project was conducted in the Breast Surgery Department of a nearly 3000-bed tertiary hospital in China. Evidence-based audit criteria were developed based on a JBI evidence summary. The JBI Practical Application of Clinical Evidence System (PACES) and Getting Research into Practice (GRiP) audit tool were used to promote changes in practice. Sample sizes of 13 clinical nurses and 30 breast cancer patients undergoing chemotherapy were included in baseline and follow-up audits.

RESULTS

The baseline audit indicated significant deficits in pre-treatment assessment nursing practice in the unit, with eight of the 12 criteria recording 0% compliance and one criterion recording only 3% compliance. Barriers to compliance were identified by the project team, and a series of strategies were adopted to address the barriers. There was improvement in compliance with all the best practice criteria in the follow-up audit compared with the baseline audit, with each one achieving a minimum of 90% compliance.

CONCLUSIONS

The project showed that regular and focused education and ongoing audits on pre-treatment assessment can help to optimize safe and effective chemotherapy treatment. Further strategies are planned to sustain the implementation of evidence.

Surface contamination of the outer and blister packages of oral anticancer drugs: A multicenter study

INTRODUCTION

All guidelines necessitate wearing personal protective equipment during dispensing of oral anticancer drugs. This study aims to measure the degree of contamination on the press-through-package strips of oral anticancer drugs in Japan.

METHOD

Surface contamination of the external packaging of anticancer drugs was examined by performing wipe tests at four hospitals and two community pharmacies. The following commercially available drugs were examined: Xeloda®, TS-1®, and methotrexate tablets and SA-1® and Rheumatrex® capsules.

RESULTS

The wipe tests' results revealed that the contamination levels of Xeloda® and TS-1® tablets and SA-1® capsules were within their detection limits. In some facilities, the contamination levels on the press-through-package strips of Rheumatrex® capsules were 3.27 × 10^-1, which is close to its detection limit. However, across all facilities, the contamination level of methotrexate tablets was above its detection limit.

CONCLUSION

The results of this study suggested that adherence to oral anticancer drugs may not occur during manufacture or transportation. However, it may be due to the presence of pollutants in the facilities. Prevention of pollution in facilities might eliminate the need to wear personal protective equipment during dispensing of oral anticancer drugs.