USP\u3c800\u3e Compliance: A Hazardous Drug Safe-Handling Quality Improvement Project for Ambulatory Care Infusion Nurses

Problem: The U.S. Pharmacopeia (USP, 2016) Convention Chapter 800: Hazardous Drugs: Handling in Healthcare Settings took effect on December 1, 2019. According to Polovich and Olsen (2017), The implementation of the USP \u3c800\u3e Standards. will represent an important step forward to protect nurses and other potentially exposed healthcare workers (HCWs): (p.1). Context: The Doctor of Nursing Practice (DNP) project implemented a hazardous drug (HD) safe-handling personal protective equipment (PPE) toolkit in accordance to USP \u3c800\u3estandards and hospital policies at an ambulatory cancer infusion center to improve nurses\u27 adherence with PPE use. Interventions: The project consisted of (a) a safe-handling PPE toolkit, (b) a PPE observation tool, (c) an expert panel discussion, (d) a nurses\u27 skills session, (e) an online safe-handling survey, (f) an HD safe-handling checklist, and (g) a performance dashboard. Measures: Outcome measures included a (a) 90% or higher compliance rate with PPE use during hazardous drug administration and (b) sustained adherence to USP \u3c800\u3e standards and hospital policies by February 1, 2020. Results: A 90% compliance rate for PPE use during hazardous drug administration was achieved by February 1, 2020. Sustainability is at risk due to the COVID-19 pandemic and global PPE shortages, however, nurses were able to adapt to new processes to conserve vital resources and will be reassessed in six months. Conclusions: A systems-thinking approach to the implementation of USP\u3c800\u3e was successful in improving compliance and adherence to PPE use among ambulatory care infusion nurses