Cytotoxics: Keeping Staff and Patients Safe

M. Kaszycki, C. Luyten, CA Mac Belford, P. Stalker, C. Jones, J.

Gibbings, J. Yoon
DESCRIPTION
AIM
SUMMARY OF RESULTS
ACTIONS TAKEN
Over 2,000 doses of cytotoxics are
administered to patients outside of
designated oncology areas at London
Health Science Centre. After several
audits were completed, it was determined
that there was not enough trained staff to
handle these drugs. Staff identified gaps
with safe handling, environmental
practice, education, and proper supplies to
safely administer cytotoxic agents.
To develop and implement strategies to
increase awareness and build resources to
meet staff needs related to cytotoxic
safety.
As a result of the multiple change
interventions for handling and
administering cytotoxic agents, staff and
education leaders reported feeling
supported and competent to protect
themselves and their patients. The multi-
interventional improvements support
increased awareness and accountability for
cytotoxic safety. Resources and supplies
are now readily available to staff and their
work environments. Next steps include
developing a corporate online education
learning module, and additional on-call
support for safety issues arising on
evening, nights and weekend shifts. The
Kirkpatrick Model will be tested as part of
next steps to determine training
effectiveness of the education modalities
utilized in this initiative.
With strategic guidance from Senior
Leadership and the Chemotherapy
Governance Committee a variety of
strategies were developed. Collaboration
with other departments resulted in quality
improvements that included but were not
limited to a just-in-time chemo resource
nurse model, updated policy and
procedures, user friendly resources, and
hands-on education.
Step by Step
Spill
Management
Chemo
Resource
Nurse
Supplies
Available on
all Units
Guidelines
for Non-
Oncology
Nurse
Alerts in Drug
Manual
Updated
Nursing
Procedure
Classroom
Education
Links in Drug
Manual
Room
Precaution
Signage
Ilearn module
Cytotoxic
Quality
Improvements
Figure 3. Clinical Educators providing just-in-time services for staff
Figure 1. Multi=intervention model for cytotoxic safety
Figure 2. Spill kit instruction
in the event of an adverse event