Assessment of safe chemotherapy handling behaviors among oncology nurses in a conflict-affected setting: A cross-sectional study from Gaza.

Abstract

Chemotherapy drugs are hazardous and require strict safety protocols to protect health care workers. In the Gaza Strip, cancer is a leading cause of death, yet there is limited research on nurses' adherence to safe chemotherapy handling practices. This study assesses the safe chemotherapy handling behaviors of nurses at the Turkish Palestinian Friendship Hospital in Gaza. A descriptive cross-sectional study was conducted between July and August 2023. All 110 nurses at the hospital were invited to complete a validated, self-administered questionnaire based on the Nova Scotia Health Authority Chemotherapy Checklist. Data were analyzed using SPSS v25 with descriptive statistics, t-tests, and analysis of variance. The response rate was 96.36% (n = 106). The mean self-reported scores for safe behavior domains were: safe handling before administration (81.77%), safe handling during administration (71.33%), safe disposal of equipment (83.05%), and safe disposal of cytotoxic body fluids (72.84%). These scores reflect nurses' perceptions of their own practices rather than objectively observed compliance. Significant associations were found between safe behaviors and age (p = .012), years of nursing experience (p = .001), oncology experience (p = .044), qualifications (p = .004), and previous training (p = .003). Although nurses demonstrated moderate to good compliance with chemotherapy safety protocols, critical gaps remain, particularly in drug administration and disposal practices. Regular targeted training, protocol reinforcement, and hiring of specialized oncology nurses are urgently needed.