Effect of Implementing Chemotherapy Administration SOPs on Nurse’s Knowledge and Attitude at Uganda Cancer Institute

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Uganda Christian University
Background/Purpose: The worldwide increase in cancer cases has led to an escalated use of chemotherapy treatment. Administering chemotherapy is a complex and high-risk process that requires a multidisciplinary approach and a high level of competency. At the study unit, nurses lack specialized training in oncology and typically learn on the job, with no structured training or monitoring of the use of standard operating procedures (SOPs) for chemotherapy administration (CA). Therefore, their competency in administering chemotherapy was currently unknown. This study aimed at assessing the impact of implementing chemotherapy administration SOPs on nurses’ knowledge and attitude towards safe chemotherapy administration. Methods: A single group pretest-posttest quasi experimental design was conducted to assess the effectiveness of implementing chemotherapy administration standard operating procedures (SOPs) on nurses' knowledge and attitude. A semi-structured questionnaire containing demographic data and questions about nurse's knowledge and attitude of chemotherapy administration SOPs was used at pre and posttest implementation. Participants were chosen by convenience. Knowledge questions were scored as one for correct answers and zero for incorrect ones, while attitude questions were rated on a 5-point Likert scale. Results: The results indicated that most participants understood the use of personal protective equipment (PPE) in handling of antineoplastic drugs (ANPDs) (98.6%) and the adverse effects of ANPDs exposure (94.4%). Although 80.6% of participants observed safety precautions, 48.6% did not. Most participants did not engage in conversations with patients before chemotherapy administration to assess their understanding. While reasonable steps were taken to minimize hazardous exposure, 43.1% of participants mentioned work overload. The participants' attitude toward paying attention to precautionary measures did not change significantly after training, with time constraints being cited as a reason for the lack of attitude change. Recommendation: The study recommended that the Uganda Cancer Institute and the Ministry of Health should develop institutionalized chemotherapy administration guidelines and support the implementation of educational training programs for nurses. It also suggested the establishment of an orientation program for newly employed nurses and in-service refresher courses for staff in chemotherapy administration safety. Additionally, the study recommended further research to assess nurses' chemotherapy administration practices.