BMC Nurs. 2026 Jan 27. doi: 10.1186/s12912-026-04307-6. Online ahead of print.
ABSTRACT
BACKGROUND: Occupational exposure of healthcare workers to antineoplastic drugs can be prevented through the consistent use of protective measures. Despite clear scientific evidence of exposure risks, adherence to safety standards and use of personal protective equipment remain insufficient. The most frequently cited barriers include lack of training, weak safety culture, and inconsistent institutional policies. Training interventions have been shown to improve knowledge, attitudes, and performance related to safe handling.
METHODS: This study evaluated the effectiveness of an educational intervention on factors influencing the use of personal protective equipment among nurses who administer antineoplastic drugs, guided by the “Factors Predicting Use of Hazardous Drug Safe Handling Precautions” model. A single-group, before-and-after comparative design was applied. The study included 67 nurses from internal medicine, adult oncology, and pediatric oncology departments of a university hospital in western Turkey. Data were collected using the Hazardous Drug Handling Questionnaire before and three months after the intervention. The program was structured according to national and international guidelines and based on Pender’s Health Promotion Model. Statistical analyses were conducted using paired sample t-tests and McNemar’s test.
RESULTS: The intervention led to significant improvements in knowledge of hazardous drug risks, self-efficacy, perceived risk, interpersonal modeling, and frequency of personal protective equipment use (p < 0.05). No significant changes were observed in perceived barriers, interpersonal norms, or perceived conflict of interest. Nurses’ perceptions of workplace safety climate declined slightly after training (p = 0.047). Reports of the presence of written procedures and spill kits in units increased significantly. Moreover, the proportion of nurses associating health problems with occupational exposure nearly doubled after the intervention.
CONCLUSION: The educational intervention effectively enhanced individual-level determinants of safe handling behaviors. However, the limited impact on organizational-level factors indicates that training alone cannot ensure sustained behavior change. These findings highlight the need for institutional strategies that include leadership engagement and supportive policies. Strengthening nurses’ competencies and self-efficacy in personal protective equipment contributes to building a safety-oriented workplace culture and supports the delivery of safe, high-quality nursing care.
PMID:41593583 | DOI:10.1186/s12912-026-04307-6
