Abstract:
Background: Systemic anti-cancer therapy (SACT) may adversely affect healthcare workers with
chronic low-dose exposure. Nurses who work in cancer treatment units are at a higher risk of
exposure. Personal Protective Equipment (PPE) provides key protection.
Objective: To assess the perceived barriers to the use of PPE in handling SACT among nurses
Methods: A descriptive cross-sectional study was conducted among randomly selected 250 nurses
working at the National Cancer Institute in Sri Lanka. The barriers to the use of PPE in handling
SACT were assessed by the validated Hazardous Drug Handling Questionnaire (HDHQ).
Questionnaire on perceived barriers to the use of PPE met satisfactory reliability and validity
requirements (Cα =0.83, KMO = 0.752, χ2 = 2057.65, and p<0.001). Data were analyzed with
descriptive and inferential statistics using SPSS version 25.0.
Results: The mean (+ SD) age of the participants and working experience at the oncology unit
were 35.93 (+4.29) and 6.98 (+3.1) years, respectively. The majority were females (81.0%) and
educated up to Diploma level (73.6%). According to HDHQ, the majority reported perceived
barriers, including not receiving training on the use of PPE (61.2%), being uncomfortable to wear
(89.6%), and performing procedures (88.8%) with PPE, always not available (90.4%),
unavailability of obtaining chemotherapy-designated PPE (94.8%), unavailability of policy to
receive PPE (82.4%), high cost of PPE (84.8%), and feeling too hot with use of PPE (95.2%).
However, the majority reported that PPE is necessary (97.2%), PPE is effective (93.6%), and there
is sufficient time to use PPE (89.2%). The perceived barriers to the use of PPE were associated
with gender (p=0.038), experience in the oncology setting (p=0.029), and patient count in the ward
(0.001).
Conclusions: Commonly perceived barriers to the use of PPE in handling SACT were insufficient
training, unavailability of chemotherapy-designed PPE, feeling too hot with the use of PPE,
physical discomfort and difficulty in conducting nursing procedures, unavailability of policy to
receive PPE and the high cost of PPE. Perceived barriers to the use of PPE were associated with
gender, working experience, and patient count. The measures need to be taken to minimize the
perceived barriers to the use of PPE in handling SACT.