Educating Oncology Nurses With Simulation: A Chemotherapy Spill

The purpose of the quality improvement (QI) project was to determine if the use of a simulated chemotherapy spill increased the competencies and confidence of oncology nurses employed on an inpatient chemotherapy unit. An educational QI design was utilized including a confidential voluntary pre and post intervention survey. The National League for Nursing / Jeffries Simulation Framework (NLN/JSF) was chosen to be used in conjunction with Kolb's Experiential Learning Theory in the creation of the QI project. The simulations were held on a 25 bed oncology unit located in Providence Rhode Island. Twenty-nine oncology nurses participated. The simulation objectives were to locate and follow the current hospital policy, to locate and follow the specific material safety data sheet (MSDS) for the particular drug utilized and to clean up the simulated spill based on the current policy. Twelve simulations were conducted. Only 20.6% of RNs had been previously exposed to a chemotherapy spill. More than half of RNs felt the simulation resembled real life and all felt that the simulation very much or somewhat prepared them to handle a chemotherapy spill. The results of the comparable questions were all statistically significant (P = <0.001) and suggest that the simulation did increase the nurses’ awareness of and comfort in locating the current hospital policy and MSDS. RN’s reported increased knowledge of the contents within a chemotherapy spill kit and an increase in feeling prepared to deal with a spill in the future. Nurses verbalized simulation as a preferred method of learning over, lecture, computerized tests and modules. During the simulation process unintentional finding revealed omissions and discrepancies in the current hospital policy. These finding lead to changes in the current practice and hospital policy. Future research to include larger cohorts in multiple oncology settings is needed to support educating nurses with simulation. Simulation may also be useful in creating, reviewing and revising policies.