护士和助产士关于危险药物的知识及安全操作实践：一项横断面研究。
Nurses' and midwives' knowledge and safe-handling practices related to hazardous drugs: A cross-sectional study.
作者信息
van Huizen Pheona, Wembridge Paul, Russo Philip L, Manias Elizabeth, Connell Clifford J
机构信息
Monash Nursing and Midwifery, Monash University, Australia.
Clinical Risk Manager (Medication Safety), Eastern Health, Victoria, Australia.
出版信息
Int J Nurs Stud Adv. 2025 Apr 14;8:100331. doi: 10.1016/j.ijnsa.2025.100331. eCollection 2025 Jun.
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.
背景
危险药物本质上具有毒性，会给医护人员带来职业暴露风险。危险药物经常被开给患者用于治疗各种医疗状况。
目的
探讨护士和助产士在安全处理危险药物方面的知识和做法。此外，了解是否有风险控制措施来支持护士和助产士在医疗环境中处理危险药物时实施最佳做法，以及使用这些控制措施是否存在任何障碍。
方法
这是一项横断面研究，采用便利抽样法，选取了来自澳大利亚一个大都市医疗服务机构的六家医院的护士和助产士。在自行填写的、经过验证的在线问卷中，参与者被要求识别危险药物及其对危险控制措施的使用情况，包括个人防护装备。还测量了自我效能感、感知障碍、感知风险、人际影响和工作场所安全氛围等变量。
结果
共有217名护士和助产士报告他们处理过危险药物。156名参与者（71.9%）完整填写了问卷。参与者主要为女性（196/217，90.3%），拥有护理学学士学位（139/217，64.1%）。危险药物氯霉素、秋水仙碱和度他雄胺经常未被识别为危险药物（分别为80.6%、73.8%和68.2%）。共有78名（35.9%）参与者报告接受过危险药物处理培训，其中34名（43.6%）表示是在过去12个月内接受的培训。参与者（181/203，89.2%）同意或强烈同意他们有信心正确使用个人防护装备，并且获得了现有的最佳个人防护装备（163/203，80.3%）。尽管如此，在报告参与危险药物配制、给药和处置过程的参与者中，约三分之一的人从未佩戴过个人防护装备（分别为32.2%、29.8%和30.9%）。
结论
护士和助产士并非总能识别危险药物，而且尽管他们有信心使用适当的个人防护装备，但一些人报告从未佩戴过。需要采取多方面的多学科干预措施，以提高护士和助产士处理细胞毒性和非细胞毒性药物的知识和实践水平。
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