Factors Influencing Compliance with Safe Handling of Antineoplastic agents among Clinical Nurses

Abstract

The purpose of this cross-sectional descriptive study was to investigate the levels of compliance with safe handling of antineoplastic agents, time pressure, knowledge of safe handling of antineoplastic agents, and workplace safety climate and to identify factors influencing compliance with safe handling of antineoplastic agents among clinical nurses. Data were collected from 130 clinical nurses at a university-affiliated hospital in Gyeonggi Province between July 10 and 20, 2020. Data on the levels of compliance with safe handling of antineoplastic agents, time pressure, knowledge of safe handling of antineoplastic agents, and workplace safety climate were collected using self-reported questionnaires. Data were analyzed with descriptive statistics, independent t-tests, analyses of variance, Pearson’s correlation, and hierarchical multiple regression analysis using SPSS 22.0. The results of this study were as follows: 1) The average levels of compliance with safe handling of antineoplastic agents, time pressure, knowledge of safe handling of antineoplastic agents, and workplace safety climate were 120.81 out of 175, 28.19 out of 35, 14.22 out of 19, and 55.48 out of 90, respectively. 2) There were statistically significant differences in the levels of compliance with safe handling of antineoplastic agents according to age, marital status, working unit, and nursing experience. 3) Compliance with safe handling of antineoplastic agents correlated positively with knowledge of safe handling of antineoplastic agents and workplace safety climate. Time pressure was found to correlate significantly and negatively with compliance with safe handling of antineoplastic agents. 4) To identify factors affecting compliance with safe handling of antineoplastic agents, hierarchical multiple regression was performed. Significant factors in bivariate analyses were entered into the regression analysis. The model explained approximately 41% of the variance (F=13.93, p<.001) in the compliance with safe handling of antineoplastic agents. Three of the variables were found to be statistically significant factors affecting the compliance with safe handling of antineoplastic agents: nursing experience(β=.38, p<.001), knowledge of safe handling of antineoplastic agents(β=.27, p<.001)), and workplace safety climate (β=.40, p<.001). The findings of this study indicate that the factors influencing compliance with safe handling of antineoplastic agents are knowledge of safe handling of antineoplastic agents, workplace safety climate, and nursing experience. To increase compliance with safe handling of antineoplastic agents, the workplace safety climate and knowledge of safe handling of antineoplastic agents should be improved. The development and application of an effective training program on the safe handling of antineoplastic agents would lead to improvement in this area.

본 연구는 항암제를 취급하는 병동간호사의 시간압박감, 항암제 안전관리지식, 병동안전문화, 항암제 안전관리수행 정도를 살펴보고, 항암제 안전관리수행의 영향요인을 파악하기 위한 횡단적 조사연구이다. 자료수집은 2020년 7월 10일부터 7월 20일까지 경기도 소재 A대학병원에서 항암제를 다루는 병동간호사 143명을 대상으로 하였으며, 회수되지 않은 설문지 5부와 불성실하게 응답한 설문지 8부를 제외하고 총 130명의 설문 응답을 최종 분석에 사용하였다. 수집된 자료는 SPSS 22.0 프로그램을 이용하여 기술통계, independent t-test, one way ANOVA, Pearson’s correlation, hierarchical multiple regression을 이용하여 분석하였다. 본 연구결과를 요약하면 다음과 같다. 1) 대상자의 시간압박감은 35점 만점에 평균 28.19±5.11점, 항암제 안전관리지식은 19점 만점에 평균 14.22±2.22점, 병동안전문화는 90점 만점에 평균 55.48±11.81점, 항암제 안전관리수행은 175점 만점에 평균 120.81±19.26점이였다. 2) 대상자의 일반적 특성에 따른 항암제 안전관리수행은 연령(F=8.06, p=.001), 결혼여부(t=-2.73, p=.007), 근무부서(t=2.14, p=.034), 임상경력(F=7.30, p=.001)에 따라 통계적으로 유의한 차이가 있었다. 3) 대상자의 항암제 안전관리수행은 시간압박감(r=-.37, p<.001)과 통계적으로 유의한 음의 상관관계를 보였으며, 항암제 안전관리지식(r=.33, p<.001)과 병동안전문화(r=.36, p<.001)와는 유의한 양의 상관관계를 보였다. 4) 회귀분석 결과, 항암제 안전관리수행에 유의한 영향요인은 병동안전문화(β=.40, p<.001)였고, 임상경력(β=.38, p<.001), 항암제 안전관리지식(β=.27, p<.001) 순으로 나타났으며, 항암제 안전관리수행에 대한 설명력은 41%로 회귀모형은 유의하였다(F=13.93, p<.001). 이상의 연구결과를 바탕으로 항암제 안전관리수행에 영향을 미치는 유의한 요인은 임상경력, 항암제 안전관리지식과 병동안전문화이며, 항암제 안전관리수행을 높이기 위해서는 간호사가 인식한 병원환경을 안전하게 확립하고 항암제 안전관리지식을 향상시키도록 하여야 할 것이다.