Researchers at University of Michigan Receive $2.3 Million Grant to Promote Safety, Reduce Exposure Risk, at Chemotherapy Infusion Sites


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Christopher Friese, PhD, RN, AOCN®, FAAN

Over 20 million doses of [chemotherapy] are given annually in infusion centers. The data gathered from this study can be used to inform practice and make policy changes that will improve the safety of a large number of health-care workers.

—Christopher Friese, PhD, RN, AOCN®, FAAN

Researchers at the University of Michigan School of Nursing and Comprehensive Cancer Center have received a $2.3 million grant to study oncology nurses’ exposure to hazardous drugs, including identifying ways to reduce exposure.

“There are significant acute and long-term side effects from hazardous drug exposures in oncology settings, but not enough evidence-based, risk-reduction efforts to protect health-care workers,” said Christopher ­Friese, PhD, RN, AOCN®, FAAN, University of Michigan School of Nursing Assistant Professor and Member of University of Michigan’s Comprehensive Cancer Center and Institute for Healthcare Policy and Innovation. Dr. Friese aims to lower the risk through a new study called DEFENS: Drug Exposure Feedback and Education for Nurses’ Safety. The 4-year study, with funding from the National Institute for Occupational Safety and Health (NIOSH), will examine oncology nurses’ use of personal protective equipment and biological exposure to hazardous drugs at approximately a dozen health-care institutions nationwide.

“Nurses are the single largest group of oncology care providers,” Dr. Friese said. “Patients and families work with nurses the most when chemotherapy is part of treatment. It’s important to recognize the need for well-prepared oncology nurses to deliver care safely and avoid poor outcomes.”

Worker exposure to hazardous drugs like chemotherapy is a “persistent problem” and may result in adverse health effects (NIOSH Alert 2004-165). In a preliminary study, Dr. Friese found that among 242 surveyed oncology nurses, 16.9% reported skin or eye exposure to hazardous drugs in the past year. Organizational factors such as nursing workloads, practice environments, and performance of safety behavior are associated with an increased risk of spills.

Key Components

The 4-year study has two key components. First, nurses will provide information concerning chemotherapy spills in the clinic and provide blood samples to determine whether the agents are detectable. Second, nurses will receive an educational module on safe drug handling, with and without specific feedback about how to improve their practice. The goal is to increase the number of nurses who use protective equipment likes gowns and gloves on a consistent basis. Eleven of the nation’s leading cancer centers and more than 300 nurses will participate.

Coinvestigators for this multidisciplinary study will include Duxin Sun, PhD, Professor at the University of Michigan College of Pharmacy and Director of University of Michigan Pharmacokinetics Core, and ­Marjorie ­McCullagh, PhD, RN, APHN-BC, COHN-S, Associate Professor of Nursing, Director of the Occupational Health Training Program, and Contributing Faculty to University of Michigan’s NIOSH-Funded Education and Research Center.

“Over 20 million doses of [chemotherapy] are given annually in infusion centers. We believe the data gathered from this study can be used to inform practice and make policy changes that will improve the safety of a large number of health-care workers,” Dr. Friese said. ■



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