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“Nurse Adherence to Safe-Handling Practices” by Colvin et al.


As it is noted in the article “Nurse Adherence to Safe-Handling Practices: Observation Versus Self-Assessment” by Colvin, Karius, and Albert (2016), one of the primary nursing concerns is occupational exposure. Accordingly, the problem of proper adherence to safety guidelines is of immense great because nurses should be aware of the consequences caused by occupational exposure for their health. Due to the lack of academic research in the field of nurse adherence to chemotherapy medications safe-handling practices, Colvin et al. (2016) dwell on the investigation of this area of concern. Therefore, the purpose of this paper is to critically analyze the study by Colvin et al. (2016) in order to retrieve important implications for evidence-based nursing practice.

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Research Question Discussion

First of all, it should be noted that the authors do not explicitly develop a research question. However, it could be formulated in the following way: In ambulatory oncology nurses, can adherence to chemotherapy safe-handling practices decrease the exposure to the negative effects of chemotherapy (Colvin et al., 2016)? Additionally, Colvin et al. (2016) decided to include both actual and subjective factors that influence the adherence to safety guidelines and nurses’ perception of its importance. It could be observed that the authors’ objective is well-developed and comprehensive enough, given the fact that it is a pilot study. Also, the article is based on the vast literature and evidence research.

Description of the Research Design

Due to the fact that it was decided to compare objective and subjective nurses’ behaviors and attitudes toward safety practices in the oncology clinical settings, the research design constitutes mixed methods that contribute to the development of the prospective comparative study. Given the study’s research question, the chosen approach to study design is appropriate. Accordingly, the primary strength of the given research design is that it allows retrieving both qualitative and quantitative information, which was essential for completing the study’s objective. The disadvantage of the chosen method is that it partially relies on self-reporting, which might cause biased answers. However, it is made with the objective of retrieving the qualitative data on subjective nurses’ behaviors.

Description of the Sample

The setting of the research was the Cleveland Clinic, a 1,400 beds medical center with 76 ambulatory oncology infusion treatment chairs for chemotherapy (Colvin et al., 2016). 33 ambulatory oncology nurses agreed to participate in the study, and also 22 cases of safety practice adherence were observed. It is possible to state that the sample size is relatively small. For example, a study “Factors Influencing Nurses’ Use of Hazardous Drug Safe-Handling Precautions” by Callahan et al. (2016) utilized a sample of 115 nurses while researching the same area of concern. However, given the specificity of the field of study and, primarily, the pilot nature of the research by Colvin et al. (2016), it could be concluded that the number of participants was adequate.

Data Collection Method

According to the authors, two primary data collection methods were used: micro-ethnography and questionnaires (Colvin et al., 2016). In the first phase, micro-ethnicity observations were conducted by three observers, each having a different level of experience in micro-ethnography as well as oncology. They assessed such aspects of nurses’ behavior as handling, administering, and disposing of chemotherapy agents (Colvin et al., 2016).

The second phase included the distribution of self-assessment questionnaires to outpatient nurses. Each of the research stages involved ethical considerations, as the data was collected confidentially, and nurses had been provided anonymity when answering questionnaires. In general, data collection methods were appropriate for the purposes of the study, and they were in compliance with ethical standards.

Limitations of the Study

The most evident limitation of the research under discussion is the size of the sample with which the authors worked. It is clear that the pilot nature of the study was an appropriate excuse for such a small number of participants. However, the article by Callahan et al. (2016) exemplifies that larger sample size could be efficiently gathered and studied. Therefore, in the subsequent studies, the authors should consider extending the sample so that the findings of future studies would be more generalizable. Given the immense magnitude of the problem of occupational exposure, it is essential that the study’s results would be applicable to a vast majority of clinical settings.

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Discussion of the Study’s Findings

The primary finding of the study is the overall adherence to safety practices was lower than was expected, with nurses successfully implementing only several techniques from safety guidelines. The findings partially answer the research question and the overall purpose of the study, and they are credible enough, despite the fact that the sample size was small. Moreover, it could be mentioned that the findings partially do not support the research question because the authors did not consider studying the related long-term clinical outcomes of occupational exposure.


In general, the study by Colvin et al. (2016) is an example of a relatively successful study, given the fact that it was one of the first studies in the identified area of concern. The authors had a well-developed research plan; the study design and research methods were chosen appropriately. However, the small sample size and the inability to incorporate important related factors do not benefit the credibility and generalizability of the study’s findings. Nevertheless, the research by Colvin et al. (2016) is still applicable to the nursing practice to some extent as it offers insights into the comprehensive use of safety practices and techniques.


Callahan, A., Ames, N. J., Manning, M. L., Touchton-Leonard, K., Yang, L., & Wallen, G. R. (2016). Factors influencing nurses’ use of hazardous drug safe-handling precautions. Oncology Nursing Forum, 43(3), 342-349. Web.

Colvin, C. M., Karius, D., & Albert, N. M. (2016). Nurse adherence to safe-handling practices: Observation versus self-assessment. Clinical Journal of Oncology Nursing, 20(6), 617-622. Web.

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