Bulletin of Shimane University Faculty of Medicine

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Bulletin of Shimane University Faculty of Medicine 44
2022-03 発行

直接観察法による抗がん薬注射剤取扱い時の看護師の曝露予防行動の実態 : 「抗がん薬曝露防止対策マニュアル」導入前の調査から

The Realities of Preventing Occupational Exposure to Hazardous Drug Injections by Nurses Using the Direct Observation : Survey on Prior to Implementation “the Manual for the Prevention of Exposure to Hazardous Drug”
Miyamoto, Mayumi Department of Fundamental Nursing, Faculty of Medicine, Shimane University
SENO, Naomi Department of Nursing,Shimane University Hospital
Fukuma, Miki Department of Fundamental Nursing, Faculty of Medicine, Shimane University
SAKANE, Kanako Department of Fundamental Nursing, Faculty of Medicine, Shimane University
Tsunoto, Yuko Department of Fundamental Nursing, Faculty of Medicine, Shimane University
KOBAYASHI, Yuta Graduate School of Medical Research, Shimane University
Uchida, Hiromi Tenri Health Care University
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Description
The purpose is to clarify the realities of occupational exposure prevention behaviors of nurses during the period when the Hazardous Drug Manual was not in use. The subjects were six nurses working in an outpatient chemotherapy department. We divided the directly observed situations into two processes: the priming and the infusion management. The percentage of exposure prevention behaviors implemented was calculated from the observed scenes. After the implementation, the result was analyzed using the Fisher exact test. There were 33 observation scenes in the priming and 21 scenes in the infusion management. The priming process had a high rate of implementation of exposure prevention behaviors, because the work environment was well maintained. However, it was low in the infusion management. During the infusion management, the work is complicated because of including patient care, and there are many opportunities to be exposed to hazardous drugs. Based on these results, in verifying the effectiveness of guideline consolidation, it is very important to assess the exposure prevention behaviors of nurses who provide patient care.
本研究の目的は、抗がん薬曝露予防のガイドラインに基づく業務マニュアル導入前の看護師の抗がん薬注射剤取り扱い時の曝露予防行動の実態を明らかにすることである。対象は外来化学療法室に勤務する看護師6名とした。直接観察した場面をプライミング過程と接続・投与過程の2過程に分け、曝露予防行動実施率の算出およびFisherの直接法で分析した。観察場面はプライミング過程で33場面、接続・投与過程で21場面だった。プライミング過程は作業環境が整備されていたこともあり、曝露予防行動実施率が高かった。一方、接続・投与過程では防護具装着の実施率が低かった。点滴交換時は、患者対応など業務内容が複雑であり、環境側面も含めて抗がん薬に曝露する機会が多い。今後、ガイドライン定着状況を検証するにあたって、患者対応を行う看護師の曝露予防行動の評価は重要となる。
NCID
AA12049432