Nurses’ and midwives’ knowledge and safe-handling practices related to hazardous drugs: A cross-sectional study

Background: Hazardous drugs are inherently toxic and can present an occupational exposure risk to healthcare professionals. Hazardous drugs are regularly prescribed for people to treat a variety of medical conditions. Aim: To explore nurses’ and midwives’ knowledge and practices related to the safe...

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Main Authors: Pheona van Huizen, Paul Wembridge, Philip L. Russo, Elizabeth Manias, Clifford J. Connell
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:International Journal of Nursing Studies Advances
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666142X25000396
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author Pheona van Huizen
Paul Wembridge
Philip L. Russo
Elizabeth Manias
Clifford J. Connell
author_facet Pheona van Huizen
Paul Wembridge
Philip L. Russo
Elizabeth Manias
Clifford J. Connell
author_sort Pheona van Huizen
collection DOAJ
description Background: Hazardous drugs are inherently toxic and can present an occupational exposure risk to healthcare professionals. Hazardous drugs are regularly prescribed for people to treat a variety of medical conditions. Aim: To explore nurses’ and midwives’ knowledge and practices related to the safe handling of hazardous drugs. Also, to discover if controls of risk are available to support nurses and midwives to implement best practices when handling hazardous drugs in health care settings and if there are any obstacles to using these controls. Method: This was a cross-sectional study using a convenience sample of nurses and midwives at six Australian hospitals from a metropolitan health care service. In the self-administered, validated online questionnaire, participants were asked to identify hazardous drugs and their use of hazard controls, including personal protective equipment. Variables for self-efficacy, perceived barriers, perceived risk, interpersonal influences, and workplace safety climate were also measured. Results: A total of 217 nurses and midwives reported they handled hazardous drugs. The questionnaire was completed in full by 156 participants (71.9 %). Participants predominantly identified as women (196/217, 90.3 %) and had completed a bachelor's of nursing (139/217, 64.1 %). The hazardous drugs chloramphenicol, colchicine, and dutasteride were frequently not identified as hazardous (80.6 %, 73.8 %, and 68.2 %, respectively). A total of 78 (35.9 %) participants reported having received hazardous drug handling training, of which 34 (43.6 %) stated it was in the past 12 months. Participants (181/203, 89.2 %) agreed or strongly agreed that they were confident that they could use personal protective equipment correctly and were provided with the best available personal protective equipment (163/203, 80.3 %). Despite this, personal protective equipment was never worn by approximately a third of participants who reported being involved in preparing, administering, and disposing of hazardous drugs (32.2 %, 29.8 %, and 30.9 %, respectively). Conclusion: Nurses and midwives did not always recognise hazardous drugs, and, although they were confident in using appropriate personal protective equipment, some reported never wearing it. A multi-faceted multidisciplinary intervention is needed to improve both knowledge and practice for handling both cytotoxic and non-cytotoxic drugs by nurses and midwives.
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spelling doaj-art-7ba7b697d9a547d08b11da3028e9c5272025-08-20T02:05:20ZengElsevierInternational Journal of Nursing Studies Advances2666-142X2025-06-01810033110.1016/j.ijnsa.2025.100331Nurses’ and midwives’ knowledge and safe-handling practices related to hazardous drugs: A cross-sectional studyPheona van Huizen0Paul Wembridge1Philip L. Russo2Elizabeth Manias3Clifford J. Connell4Monash Nursing and Midwifery, Monash University, Australia; Corresponding author at: Monash University, School of Nursing and Midwifery, 35 Rainforest Walk, Clayton, VIC, 3168, AustraliaClinical Risk Manager (Medication Safety), Eastern Health, Victoria, AustraliaMonash Nursing and Midwifery, Monash University, Australia; Cabrini Research, Cabrini Health, AustraliaMonash Nursing and Midwifery, Monash University, AustraliaMonash Nursing and Midwifery, Monash University, AustraliaBackground: Hazardous drugs are inherently toxic and can present an occupational exposure risk to healthcare professionals. Hazardous drugs are regularly prescribed for people to treat a variety of medical conditions. Aim: To explore nurses’ and midwives’ knowledge and practices related to the safe handling of hazardous drugs. Also, to discover if controls of risk are available to support nurses and midwives to implement best practices when handling hazardous drugs in health care settings and if there are any obstacles to using these controls. Method: This was a cross-sectional study using a convenience sample of nurses and midwives at six Australian hospitals from a metropolitan health care service. In the self-administered, validated online questionnaire, participants were asked to identify hazardous drugs and their use of hazard controls, including personal protective equipment. Variables for self-efficacy, perceived barriers, perceived risk, interpersonal influences, and workplace safety climate were also measured. Results: A total of 217 nurses and midwives reported they handled hazardous drugs. The questionnaire was completed in full by 156 participants (71.9 %). Participants predominantly identified as women (196/217, 90.3 %) and had completed a bachelor's of nursing (139/217, 64.1 %). The hazardous drugs chloramphenicol, colchicine, and dutasteride were frequently not identified as hazardous (80.6 %, 73.8 %, and 68.2 %, respectively). A total of 78 (35.9 %) participants reported having received hazardous drug handling training, of which 34 (43.6 %) stated it was in the past 12 months. Participants (181/203, 89.2 %) agreed or strongly agreed that they were confident that they could use personal protective equipment correctly and were provided with the best available personal protective equipment (163/203, 80.3 %). Despite this, personal protective equipment was never worn by approximately a third of participants who reported being involved in preparing, administering, and disposing of hazardous drugs (32.2 %, 29.8 %, and 30.9 %, respectively). Conclusion: Nurses and midwives did not always recognise hazardous drugs, and, although they were confident in using appropriate personal protective equipment, some reported never wearing it. A multi-faceted multidisciplinary intervention is needed to improve both knowledge and practice for handling both cytotoxic and non-cytotoxic drugs by nurses and midwives.http://www.sciencedirect.com/science/article/pii/S2666142X25000396Hazardous drugsHierarchy of controlsKnowledgeMedicationsMidwifeNurse
spellingShingle Pheona van Huizen
Paul Wembridge
Philip L. Russo
Elizabeth Manias
Clifford J. Connell
Nurses’ and midwives’ knowledge and safe-handling practices related to hazardous drugs: A cross-sectional study
International Journal of Nursing Studies Advances
Hazardous drugs
Hierarchy of controls
Knowledge
Medications
Midwife
Nurse
title Nurses’ and midwives’ knowledge and safe-handling practices related to hazardous drugs: A cross-sectional study
title_full Nurses’ and midwives’ knowledge and safe-handling practices related to hazardous drugs: A cross-sectional study
title_fullStr Nurses’ and midwives’ knowledge and safe-handling practices related to hazardous drugs: A cross-sectional study
title_full_unstemmed Nurses’ and midwives’ knowledge and safe-handling practices related to hazardous drugs: A cross-sectional study
title_short Nurses’ and midwives’ knowledge and safe-handling practices related to hazardous drugs: A cross-sectional study
title_sort nurses and midwives knowledge and safe handling practices related to hazardous drugs a cross sectional study
topic Hazardous drugs
Hierarchy of controls
Knowledge
Medications
Midwife
Nurse
url http://www.sciencedirect.com/science/article/pii/S2666142X25000396
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