Factors Influencing Nurses’ Use of Hazardous Drug Safe-Handling Precautions

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To identify factors associated with oncology nurses’ use of hazardous drug (HD) safe-handling precautions in inpatient clinical research units.


Descriptive, cross-sectional.


The National Institutes of Health Clinical Center in Bethesda, Maryland.


115 RNs working on high-volume HD administration units.


Survey data were collected online using the Hazardous Drug Handling Questionnaire. Data were analyzed using descriptive statistics and multiple regression analysis.

Main Research Variables:

Exposure knowledge, self-efficacy, barriers to personal protective equipment use, perceived risk, conflict of interest, interpersonal influences, workplace safety climate, and total mean HD precaution use.


Participants demonstrated high exposure knowledge, self-efficacy, perceived risk, interpersonal influences, and workplace safety climate. Participants demonstrated moderate barriers and conflict of interest. Total mean HD precaution use proved highest during HD administration and lowest for handling excreta at 48 hours. Average patients per day significantly influenced total HD precaution: nurses exhibited more HD precaution use when assigned fewer patients.


Despite high exposure knowledge, barriers to personal protective equipment use and conflict of interest may contribute to reduced adoption of personal protective practices among oncology nurses.

Implications for Nursing:

Hospital and unit-specific factors captured by the predictor variables could contribute to institutional HD policy.

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