探討護理人員安全處理化療藥物之議題

Explore the Issue of Safe Handling of Cancer Drugs by Nurses

護理人員執行化療藥物之給藥是否會導致自身的危害？以及如何使用安全防護措施以減少危害，一直是護理專業上的一個重要議題。本文利用文獻查證，介紹國內常使用的化療藥物、探討影響護理人員暴露化療藥物的因素，以及暴露可能造成的健康危害做一說明，並提出遵守臨床指引為預防暴露化療藥物的有效策略。文獻中指出國內常使用的化療藥物，包括5-FU、Cisplatin及Cyclophosphamide，而護理人員無論是調配藥物、執行給藥或處理潑灑、嘔吐物以及排泄物，均可能經由吸入、食入、皮膚接觸以及針扎途徑而暴露化療藥物，甚至引起急性與慢性的健康危害，除此之外，穿戴合適的個人安全防護裝備，包括口罩、雙層手套、防水拋棄式長袖隔離衣，可減少暴露化療藥物。透過本文期望能增加護理人員對此議題的認知，並能落實標準作業流程安全處理化療藥物。

Harmful effect of administrating cancer drugs and safety precautions to reduce health risks by nurses are important clinical issues. We reviewed literature regarding the commonly used cancer drugs in Taiwan, the factors that affect nurses’ exposure to cancer drugs, and the potential adverse health risks from exposure to these drugs. We suggested that compliance to guidelines when handling cancer drugs is an effective strategy to prevent exposure. The literature shows that the commonly used cancer drugs in Taiwan include 5-FU, Cisplatin, and Cyclophosphamide. Exposure could occur when nurses are mixing drugs, administrating drugs, and handling spilling, vomit, and excreta. Exposure pathways include inhalation, ingestion, dermal contact, and accidental injection, resulting in an increased risk of acute and long-term health hazards. Appropriate personal protective equipment, including masks, double gloves and disposable, low-permeability, long-sleeved gowns can minimize the risk for exposure. We hope this article can increase the awareness of this issue among nurses and facilitate application of standard operational procedures to safely handle cancer drugs.