Enhancing Safety Competence among Nurses: A Pre - Experimental Study on The Impact of an Educational Program on Cytotoxic Drug Management and its Outcomes in Safe Pharmacy Practice

Background

Cytotoxic drugs are essential in cancer treatment but pose significant occupational hazards due to their mutagenic, teratogenic, and carcinogenic properties. Nurses are at high risk during drug preparation and administration, and inadequate training contributes to unsafe handling practices. Therefore, this study evaluated the effectiveness of a structured educational program in improving nurses’ competence in cytotoxic drug management.

Materials and Methods

A pre-experimental one-group pretest-post-test design was conducted among 60 staff nurses at a tertiary care teaching hospital in Puducherry, India. Competence was assessed using a validated 25-item structured questionnaire covering preparation, administration, Personal Protective Equipment (PPE), spill management, and waste disposal. The intervention consisted of a 45-min structured educational session based on NIOSH and Oncology Nursing Society guidelines. Data were collected before and seven days after the intervention and analysed using descriptive statistics, paired t-test, and chi-square test.

Results

Baseline findings revealed that 60% of nurses had inadequate knowledge and only 3.3% demonstrated adequate competence. Following the intervention, 91.7% achieved adequate knowledge, with no participants remaining in the inadequate category. The mean knowledge score significantly increased from 8.62±2.97 to 16.53±1.44, with a mean difference of 7.91 (t=20.684, p<0.001), indicating a highly significant improvement. The effect size (Cohen’s d=3.33) demonstrated a very large impact of the intervention. A significant association was found between prior training and post-test knowledge scores (p<0.05), while other demographic variables showed no significant association.

Conclusion

The structured educational program significantly enhanced nurses’ competence in cytotoxic drug management. Regular training and reinforcement strategies are essential to promote occupational safety and improve safe pharmacy practice.