Introduction:

Despite control measures introduced to provide optimum protection when handling or administering antineoplastic medications and related waste, evidence cannot demonstrate that these eliminate risk of exposure. National and International guidelines recommend, staff handling and, or administering antineoplastic medications and related waste must use full Personal Protective Equipment (PPE) including a particulate P2 (N95) mask.

Objective:

Although strong compliance has been exhibited in the use of impermeable gowns, goggles and gloves, use of respiratory protective equipment (RPE) has not been routinely used within local practice. The objective of this paper serves to investigate the process of implementing a practice change through evidence and education.

Method:

An International literature search on handling antineoplastic medications and related waste was undertaken.

Proposed practice change was delivered through chemotherapy education workshops. Ensuring available supply of N95 masks, and that these were correctly fitted. Dissemination of Antineoplastic Drugs and PPE Fact sheet with attached fit testing advice throughout Cancer Services.

Pre audit surveys were completed by staff to determine level of experience and exposure to relevant information regarding the proposed practice change.

Observational audits were undertaken on experienced Cancer nurses in a high flow oncology day therapy unit prior to implementation of practice change and for 2 months following to monitor compliance.

Results:

Preliminary results indicate that no staff utilized this practice. However with the implementation of the above strategies, results indicated a positive practice change, with 100% of staff stating they now wore N95 masks.

Conclusion:

Results indicated that effective planning and implementation of a practice change based on evidence, is needed to support nursing staff to follow recommendations to wear full PPE during handling, administration, and spill and waste management of antineoplastic drugs. Ongoing audits and education sessions will be required to ensure the sustainability of this practice change.