「抗がん剤曝露を防止するための患者・家族への指導指針(案)」の看護師による評価

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  • 「 コウガンザイ バクロ オ ボウシ スル タメ ノ カンジャ ・ カゾク エ ノ シドウ シシン(アン)」 ノ カンゴシ ニ ヨル ヒョウカ
  • The nurses' evaluation of the instruction guidance plan for patients and families to prevent occupational exposure to antineoplastic drugs

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｢抗がん剤曝露を防止するための患者・家族への指導指針(案)｣(以下, 指針案) を作成した. 外来がん化学療法部の看護師422名を対象として, 指針案が現場での使用に妥当な内容であるか質問紙法で調査した. 指針案の内容は(1)抗がん剤の健康影響, (2)排泄物処理, (3)吐物処理, (4)汚染リネンの洗濯, (5)持続注入後の抜針, (6)薬液漏れの対処,(7)経口薬・坐薬・軟膏投与時の注意, (8)目や皮膚に付着した場合の処置であった.279名から回答があり, 外来がん化学療法の専任が39.4％, 病棟等との兼務50.5％であった. 上級看護実践の有資格者は18.0％であった. 指針案は87％以上の看護師が｢参考になる｣としていたが, 排泄物・吐物の処理の項目で兼任よりも専任の看護師の得点が有意に低く, 健康影響以外の７項目で有資格者が無資格者よりも有意に得点が低かった. このことから, 指針案にさらに内容を加筆する必要があると考える.

We developed an instruction guidance (IG) plan for patients and families to prevent occupational exposure to antineoplastic drugs (ADs). The IG included information on the following : (1) the health effects of ADs, (2) ways to dispose of excreta, (3) ways to dispose of vomitus, (4) ways to wash linens contaminated with ADs, (5) how to remove a needle after using an infusion pump to administer ADs, (6) the management of an AD leak, (7) measures when ADs are administered orally, by suppository or as an ointment, (8) measures when eyes or skin are exposed to ADs. Objective : To investigate the understanding of the IG and examine the validity of its clinical utilization. Methods : Questionnaires were administered to 422 nurses who worked in the outpatient chemotherapy section of hospitals in Japan. Results : Responses were received from 279 nurses. The results showed that 39.4％ of the nurses worked full-time in the outpatient chemotherapy section, and that 50.5％ of them were concurrently working in hospital ward. The nurses with the advanced practice nurse (APN) certification comprised 18.0％ of the group. More than 87％ of the nurses thought that the IG was useful, but there were significantly more full-time nurses than concurrent nurses who thought that the descriptions were inadequate regarding the ways to dispose of excrement and vomitus. In addition, there were significantly more APN than non-APN nurses who thought that the descriptions of seven items (other than the health effects of ADs) were inadequate. Conclusion : The full-time and APN nurses recommended adding more information to the IG.

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