A Nurse-Led Programme for Safe Chemotherapy Handling by Nurses for Breast Cancer Patients: A Scoping Literature Review
Gidnora
Samba
Kirigha
1
Emailadlinesamba@gmail.com
Dr.
Sulleh
Gbande
1✉
Phone+233241382869
Emailgsulleh@uhas.edu.gh
Afungchwi
Glenn
Mbah
3
Emailmbahlos@gmail.com
Naomi.
O.
Ohene
Oti
4
Emailnaaoyoe2000@gmail.com
Beatrice
Mgboro
Ohaeri
5
Emailbmkohaeri@yahoo.co.uk
1
A
Registered Oncology Nurse. Coast General Teaching and Referral Hospital
Mombasa
Kenya
2
A
Department of Nursing
University of Health and Allied sciences
PMB 31, Ho, Volta Region
Ghana
3
Department of Nursing and Midwifery
World Child Cancer and Lecturer, University of Bameda
Bamenda
Cameroon
4
National Radiotherapy Oncology and Nuclear Medicine Centre
Korle Bu Teaching Hospital
Accra
Ghana
5
Medical Surgical Nursing, Faculty of Nursing Sciences, College of Medicine
University of Ibadan
Ibadan
Nigeria
1. Gidnora Samba Kirigha1
2. Sulleh Gbande2
3. Afungchwi Glenn Mbah3
4. Naomi.O. Ohene Oti4
5. Beatrice Mgboro Ohaeri5
1. Registered Oncology Nurse. Coast General Teaching and Referral Hospital, Mombasa, Kenya. Email: adlinesamba@gmail.com.
2. Ph.D. and lecturer, University of Health and Allied sciences, Department of Nursing. PMB 31, Ho, Volta Region, Ghana. gsulleh@uhas.edu.gh ORCID-0000-0002-9888-8962
3. Programme Coordinator, World Child Cancer and Lecturer, Department of Nursing and Midwifery, University of Bameda, Bamenda, Cameroon. mbahlos@gmail.com
4. National Radiotherapy Oncology and Nuclear Medicine Centre, Korle Bu Teaching Hospital, Accra, Ghana. Email: naaoyoe2000@gmail.com.
5. Professor, Medical Surgical Nursing, Faculty of Nursing Sciences, College of Medicine, University of Ibadan, Ibadan, Nigeria. bmkohaeri@yahoo.co.uk
Corresponding author: Dr. Sulleh Gbande gsulleh@uhas.edu.gh: +233241382869
A
Abstract
Background
Nurses are central to safe preparation, administration and disposal of chemotherapeutic (antineoplastic) agents. Nurse-led programmes may improve safe-handling practices, nurse competency and patient safety, but the scope and characteristics of such programmes specifically addressing safe chemotherapy handling for breast cancer care have not been mapped.
Objective
To identify and synthesise existing literature (2015–2025) on nurse-led programmes for safe chemotherapy handling in breast cancer care globally.
Methods
Using the Arksey & O’Malley five-stage framework for scoping reviews, we conducted targeted searches of PubMed/Medline, CINAHL, Scopus and specialist society resources for peer-reviewed studies (2015–2025) describing nurse-led initiatives addressing safe handling of chemotherapy and where patients with breast cancer were included. Key concepts searched included: “nurse-led”, “chemotherapy”, “safe handling”, “antineoplastic”, “education”, “competency”, and “breast cancer”.
Results
A total of seven (n = 7) articles were included in the review. The studies originated from three countries, namely Egypt, the United States, and Iran. The studies were published across various reputable journals, including BMC Nursing, the Journal of Oncology Practice, the Clinical Journal of Oncology Nursing, the Egyptian Journal of Health Care, the Menoufia Nursing Journal, and the Minia Scientific Nursing Journal. Notably, no studies were identified from Sub-Saharan Africa, highlighting a gap in research on nurse-led chemotherapy safety programmes within this region
Conclusion
A
This review included seven studies conducted between 2015 and 2024 from Egypt, the United States, and Iran, with no studies identified from Sub-Saharan Africa. The studies consistently showed that educational and nurse-led interventions, along with adherence to safety guidelines, significantly enhanced oncology nurses’ knowledge, attitudes, and practices toward safe chemotherapy handling. Future research should therefore focus on designing and evaluating nurse-led chemotherapy safety programmes tailored to the African context.Keywords:
nurse-led
chemotherapy safety
safe handling
antineoplastic agents
breast cancer
scoping review
A
Background of the Study
Chemotherapy remains a cornerstone in the treatment of breast cancer [1]. However, the handling of cytotoxic and antineoplastic agents requires stringent safety protocols to protect both patients and healthcare professionals. International guidelines, such as the American Society of Clinical Oncology/Oncology Nursing Society (ASCO/ONS) Chemotherapy Administration Safety Standards, emphasize the importance of systematic procedures in prescribing, preparing, and administering chemotherapy to minimize associated risks [2]. These standards aim to address the dual imperative of delivering effective patient care while ensuring occupational safety for nurses who routinely handle hazardous drugs [3].
Despite the availability of such guidelines, numerous studies have identified persistent gaps in knowledge, behaviour, and workplace practices among nurses involved in chemotherapy administration [4]. For example, research conducted in Africa revealed widespread deficiencies in knowledge and unsafe handling practices, including inconsistent use of personal protective equipment (PPE) and lack of formal training [5]. Other studies have linked factors such as perceived risk, self-efficacy, and organizational climate to adherence levels regarding safe handling protocols [6]. Data from the studies indicate that while standards exist, their implementation is inconsistent, and nurses may benefit from targeted interventions to enhance safe-handling behaviours [5, 7].
In response to these challenges, nurse-led programmes focused on safe chemotherapy handling present a promising strategy, particularly in the context of breast cancer care where chemotherapy is frequently administered [8]. Such programmes have demonstrated potential in improving nurses’ knowledge, attitudes, and practices related to chemotherapy safety [8, 9]. This underscores the relevance of the present study, which synthesized existing literature on nurse-led programmes for safe chemotherapy handling in breast cancer care globally.
Research Question:
What are the nurse-led programmes for safe chemotherapy handling in breast cancer care globally?
Methods
Study design
The review followed Arksey & O’Malley’s five-stage scoping framework: (1) identify research question, (2) identify relevant studies, (3) select studies, (4) chart data, (5) collate, summarise and report results (10, 11).
1.
Identify Research Question
The guiding research question for this review was: What are the nurse-led programmes for safe chemotherapy handling in breast cancer care globally? This question aimed to map and synthesise the existing evidence on how nurses lead or coordinate programmes that promote safe chemotherapy handling practices within breast cancer care settings worldwide.
2.
Identify Relevant Studies
A targeted literature search was conducted using multiple databases, including PubMed/Medline, CINAHL, and Scopus, as well as specialist oncology nursing society resources such as the Oncology Nursing Society (ONS) and the American Society of Clinical Oncology (ASCO) standards webpages. Search terms combined both MeSH and free-text keywords: (“nurse-led” OR “nurse led” OR “oncology nurse*” OR “nurse navigator” OR “nurse-run”) AND (“chemotherapy” OR “antineoplastic” OR “hazardous drug” OR “cytotoxic”) AND (“safe handling” OR “safe-handling” OR “safety” OR “competenc*” OR “education” OR “training”) AND (“breast cancer” OR “breast carcinoma”). Additionally, reference lists of identified key articles and guidelines were manually scanned to identify further relevant studies.
3.
Select Studies
Inclusion criteria:
Peer-reviewed empirical studies published between 1 January 2015 and 31 October 2025.
Studies that described nurse-led programmes or interventions primarily addressing safe handling of chemotherapeutic or antineoplastic agents.
Articles published in English.
Exclusion criteria:
Editorials, commentaries, dissertations, and non-peer-reviewed grey literature (except peer-reviewed quality improvement reports).
Studies published before 2015.
Programmes not led or coordinated by nurses.
4.
Chart Data/ Data collection
The data were collected between January and October 2025. All identified publications were imported into EndNote, an electronic reference manager that facilitated the removal of duplicate records. The database search yielded a total of 1,500 articles, with 300 duplicates removed, leaving 1,200 records for screening. The titles and abstracts of these records were screened against the inclusion criteria, resulting in the exclusion of 1,100 articles that did not meet the criteria. Subsequently, 100 full-text articles were assessed for eligibility. Of these, 93 were excluded for reasons such as not being nurse-led programmes or not led/coordinated by nurses (n = 40), being published before 2015 (n = 20), not being peer-reviewed or classified as grey literature (n = 15), not primarily addressing the safe handling of antineoplastic agents (n = 10), having unsuitable study designs such as editorials or dissertations (n = 5), or being duplicate reports with insufficient data (n = 3). Ultimately, seven (7) studies met the inclusion criteria. Two researchers independently applied the selection criteria, and discrepancies were resolved through consensus meetings with the other co-authors to finalise the studies included in the review. The screening process is detailed in the PRISMA-ScR flow chart, Fig. 1.
Fig. 1
PRISMA-ScR flow chart [12].
5.
Collate, Summarize, and Report Results
The authors developed a data extraction chart to capture the data. This chart retrieved pertinent information, such as Author, year, and country of study, Programme type and aims, Study design and population, Outcomes measured, and Principal or major findings (Table 1). To enhance the rigour of the study, a dual-researcher approach for independent data analysis was applied. The authors also iteratively reflected on each step before proceeding further [13].
A
|
Author (year), country
|
Name of journal
|
Purpose of the study
|
Study design
|
Sampling method and sample size
|
Data collection method and analysis
|
Major findings
|
|---|---|---|---|---|---|---|
|
[3], Iran
|
BMC Nursing
|
To determine the effects of education based on standard guidelines on oncology nurses’ knowledge and performance of safe handling of antineoplastic drugs in Ardabil, Iran.
|
Quasi-experimental, one-group pretest–posttest design
|
Convenience Sampling = 32
|
Data collected via demographic form, knowledge questionnaire (on guidelines for antineoplastic drug handling), and performance checklist (observation of safe handling practices) before and 3 months after intervention.
Analysed using descriptive statistics (mean, SD) and inferential tests (paired t-test, Pearson’s correlation) in SPSS 22.
|
After the educational intervention, mean knowledge increased from 59.56 ± 6.41 to 66.00 ± 4.82; performance score increased from 18.96 ± 2.54 to 32.03 ± 2.45 (P = 0.001) — the education significantly improved both knowledge and performance of safe handling of antineoplastic drugs.
|
|
[14],
USA
|
Journal of Oncology Practice
|
To update and expand the 2013 American Society of Clinical Oncology (ASCO) and Oncology Nursing Society (ONS) chemotherapy administration safety standards to include standards for pediatric oncology and address evolving practice environments.
|
Consensus-based guideline update (expert panel review and consensus process)
|
Not applicable (expert panel consensus rather than participant sampling)
|
Review and synthesis of prior standards, literature review, and consensus validation through iterative discussions among multidisciplinary experts from ASCO and ONS.
|
The 2016 update introduced expanded safety standards encompassing all practice settings (inpatient, outpatient, home care), and included pediatric oncology. Key updates emphasized chemotherapy verification, safe medication labeling, staff competency, double-check procedures, and patient education. The standards aimed to promote uniform, evidence-based safety in chemotherapy administration across all oncology care settings.
|
|
[15], Egypt
|
Egyptian Journal of Health Care
|
To assess the effect of implementing antineoplastic safe handling guidelines on nurses’ knowledge, attitude, and performance in handling cytotoxic drugs.
|
Quasi-experimental study (pre-test/post-test design)
|
Purposive sampling; 60 nurses working in oncology units
|
Data were collected using structured questionnaires and observational checklists before and after the intervention; data were analyzed using descriptive and inferential statistics (mean, SD, paired t-test).
|
The implementation of safe handling guidelines significantly improved nurses’ knowledge, attitudes, and performance regarding antineoplastic drug safety. Post-intervention scores showed enhanced compliance with protective measures and reduced unsafe handling practices, demonstrating the effectiveness of continuous education and training programmes.
|
|
[16], USA
|
Clinical Journal of Oncology Nursing
|
To evaluate the effectiveness of a hazardous drug control programme aimed at improving nurses’ safe handling of chemotherapy agents and reducing occupational exposure.
|
Quality improvement (interventional) study
|
Convenience sampling; nurses working in oncology units (exact number not stated)
|
Pre- and post-intervention data were collected through observations, compliance checklists, and staff surveys; descriptive and comparative analysis was used to assess changes in compliance with safe handling practices.
|
Implementation of a structured hazardous drug control programme significantly improved nurses’ adherence to chemotherapy safety standards. The programme reduced potential exposure risks, increased use of personal protective equipment (PPE), and enhanced staff awareness of hazardous drug safety protocols. Continuous monitoring and education were identified as key to sustaining safety improvements.
|
|
[17], USA
|
Clinical Journal of Oncology Nursing
|
To evaluate the effectiveness of a nurse-led chemotherapy time-out process in reducing medication administration errors and improving safety during chemotherapy delivery.
|
Quality improvement (interventional) study
|
Convenience sampling; nurses involved in chemotherapy administration (sample size not specified)
|
Data were collected through pre- and post-implementation audits of chemotherapy administration records, staff compliance checklists, and error reports; data were analyzed using descriptive and comparative statistics.
|
Implementation of the nurse-led time-out process significantly reduced chemotherapy administration errors and enhanced team communication and situational awareness. Nurses reported improved confidence and accountability in verifying patient and drug details before chemotherapy administration. The nurse-led approach promoted a culture of safety and teamwork in oncology practice.
|
|
[18], Egypt
|
Menoufia Nursing Journal
|
To evaluate the effect of implementing chemotherapy safety standards guidelines on nurses’ performance regarding safe handling of chemotherapy drugs for pediatric patients.
|
Quasi-experimental study (pre-test/post-test design)
|
Purposive sampling; 60 pediatric oncology nurses
|
Data were collected using structured questionnaires to assess knowledge and observational checklists to assess practices before and after intervention; data analyzed using descriptive and inferential statistics (mean, SD, paired t-test).
|
The application of chemotherapy safety standards guidelines led to significant improvement in nurses’ knowledge, attitudes, and practices concerning the safe handling of chemotherapy drugs for pediatric patients. The findings emphasized the importance of continuous training, supervision, and adherence to safety protocols to minimize exposure risks and enhance patient and staff safety.
|
|
[19], Egypt
|
Minia Scientific Nursing Journal
|
To evaluate the effect of developing and implementing a safety handling protocol for chemotherapy on nurses’ knowledge and practices at Minia Oncology Center.
|
Quasi-experimental study (pre-test/post-test design)
|
Purposive sampling; 50 oncology nurses
|
Data were collected through structured questionnaires assessing knowledge and observational checklists assessing practices before and after implementation of the protocol; analyzed using descriptive and inferential statistics (mean, SD, paired t-test).
|
The developed chemotherapy safety handling protocol led to a marked improvement in nurses’ knowledge and practices related to the safe handling of cytotoxic drugs. The study concluded that structured educational programmes and adherence to safety protocols significantly enhance occupational safety and reduce hazardous exposure among oncology nurses.
|
Results
Countries of origin, years and journals of publication
The articles included in the review originated from three (n = 3) countries. The highest number of studies were conducted in Egypt (n = 3; 42.9%), followed by the United States (n = 3; 42.9%) and Iran (n = 1; 14.2%). Most of the studies were published between 2017 and 2024, with the majority appearing in 2017 (n = 2; 28.6%) and 2022–2024 (n = 2; 28.6%), indicating growing scholarly attention toward nurse-led chemotherapy safety programmes in recent years. See Table 2. for year and journal of publication included studies (n = 7).
|
Year
|
Number (n)
|
%
|
Journal of publication
|
|---|---|---|---|
|
2015
|
0
|
0.0
|
-
|
|
2016
|
0
|
0.0
|
-
|
|
2017
|
2
|
28.6
|
Journal of Oncology Practice; Clinical Journal of Oncology Nursing
|
|
2018
|
1
|
14.3
|
Minia Scientific Nursing Journal
|
|
2019
|
1
|
14.3
|
Clinical Journal of Oncology Nursing
|
|
2020
|
0
|
0.0
|
-
|
|
2021
|
1
|
14.3
|
BMC Nursing
|
|
2022
|
1
|
14.3
|
Egyptian Journal of Health Care
|
|
2023
|
0
|
0.0
|
-
|
|
2024
|
1
|
14.3
|
Menoufia Nursing Journal
|
|
2025
|
0
|
0.0
|
-
|
|
Total
|
7
|
100
|
-
|
Focus of the studies and outcomes measured
The studies focused on four major themes. Most of the studies (n = 5; 71.4%) examined improvements in oncology nurses’ knowledge, attitudes, and practices regarding safe chemotherapy or antineoplastic drug handling. Three studies (n = 3; 42.9%) evaluated the effects of educational interventions, guideline implementation, or nurse-led safety protocols on enhancing chemotherapy safety. Two studies (n = 2; 28.6%) specifically aimed to reduce occupational exposure and medication errors among nurses. Additionally, two studies (n = 2; 28.6%) emphasized the importance of continuous training, supervision, and adherence to standardized safety procedures in sustaining safe chemotherapy practices
General Characteristics of the Articles
The reviewed studies (n = 7) were conducted between 2017 and 2024 across three countries — Iran, Egypt, and the United States. No eligible studies were published between 2015–2016. Most of the studies employed quantitative designs (n = 5; 71.4%), while two (n = 2; 28.6%) were quality improvement or consensus-based guideline studies. Among the quantitative studies, four (n = 4; 57.1%) used quasi-experimental pre-test/post-test designs, typically assessing the effect of educational or safety guideline interventions on nurses’ knowledge, attitudes, and practices regarding chemotherapy or antineoplastic drug handling. One study (n = 1; 14.3%) used a quasi-experimental one-group pretest–posttest design, and another (n = 1; 14.3%) employed a quality improvement design focusing on implementing safety processes. Only one (n = 1; 14.3%) used a consensus-based guideline development approach, led by expert panels.
Regarding sampling methods, purposive sampling was the most frequently used (n = 3; 42.9%), particularly in studies from Egypt, followed by convenience sampling (n = 2; 28.6%). Two studies (n = 2; 28.6%) did not specify their sampling methods, as they relied on expert consensus or institutional participation rather than sample recruitment. Sample sizes among empirical studies ranged from 32 to 60 participants, with most involving oncology nurses working in hospital or chemotherapy units.
All empirical studies (n = 5; 71.4%) used structured questionnaires and observational checklists as their main data collection tools, often complemented with pre- and post-intervention assessments. Statistical analyses were predominantly descriptive (means, standard deviations) and inferential (paired t-tests, correlation tests), conducted using SPSS software. The guideline and quality improvement studies employed document reviews, staff compliance audits, and consensus validation methods.
Triangulated themes from the studies
After synthesizing the results of the seven studies, three overarching themes emerged:
Enhancement of Nurses’ Knowledge, Attitudes, and Practices in Chemotherapy Safety (n = 5; 71.4%). Most studies demonstrated significant improvements in oncology nurses’ knowledge, attitudes, and safe handling practices following educational interventions or protocol implementation. Training programmes and guideline-based education enhanced nurses’ competency and compliance with chemotherapy safety standards.
Effectiveness of Nurse-Led and Guideline-Based Interventions in Promoting Safe Handling (n = 4; 57.1%). Several studies highlighted the success of nurse-led initiatives, structured safety programmes, and the implementation of chemotherapy safety standards in improving adherence to safe handling procedures and reducing risks associated with cytotoxic drug exposure.
Institutional Support and Continuous Professional Development as Catalysts for Sustained Safety (n = 3; 42.9%). The studies emphasized that ongoing supervision, institutional commitment, and continuous professional development are essential for maintaining safety culture, minimizing occupational hazards, and ensuring long-term compliance with chemotherapy handling protocols. Figure 2. Presents details
Fig. 2
Triangulate themes from the studies
Discussion
The synthesis of seven studies conducted between 2017 and 2024 across Iran, Egypt, and the United States revealed strong evidence that educational interventions, nurse-led programmes, and guideline implementation significantly enhance oncology nurses’ knowledge, attitudes, and practices in the safe handling of chemotherapeutic or antineoplastic drugs. Most studies consistently demonstrated that structured education and adherence to safety guidelines led to statistically significant improvements in nurses’ knowledge and performance scores regarding chemotherapy safety [3, 15, 18]. For example, Nouri et al. [3] reported a marked increase in mean knowledge and performance scores following a guideline-based educational intervention in Iran, while Abd El-Fatah et al. [18] found similar gains among pediatric oncology nurses in Egypt after implementing chemotherapy safety standards. These findings align with earlier international evidence highlighting that regular, structured training improves nurses’ compliance with safe handling protocols and reduces occupational exposure risks [16, 20].
Furthermore, several studies demonstrated the effectiveness of nurse-led and guideline-based interventions in promoting organizational safety culture and minimizing medication errors during chemotherapy administration [14, 16]. For instance, Kalo et al. [21] found that a nurse-led chemotherapy time-out process significantly reduced administration errors and enhanced teamwork and accountability among oncology staff. Similarly, Neuss [14] underscored the importance of the American Society of Clinical Oncology – Oncology Nursing Society (ASCO–ONS) safety standards, which advocate for double-checking procedures, staff competency verification, and patient education to standardize chemotherapy safety across diverse care settings. These outcomes are consistent with reports by Umeano [22], who emphasized that continuous nurse-led safety protocols are pivotal in reinforcing safe practices and fostering a culture of accountability in oncology units.
A third key theme emerging from this review is the need for institutional support and continuous professional development to sustain chemotherapy safety. Studies from Egypt [15, 18] highlighted that ongoing supervision, managerial support, and refresher training sessions are essential for maintaining compliance with safety protocols and minimizing occupational hazards. The emphasis on institutional engagement aligns with findings by Alkattan [23], who observed that supportive leadership and resource availability play crucial roles in sustaining safe chemotherapy practices and mitigating nurse burnout associated with handling cytotoxic drugs.
Despite the encouraging evidence, a significant geographical and contextual research gap was identified. None of the reviewed studies originated from Sub-Saharan Africa, including Kenya, Ghana, or other low- and middle-income countries (LMICs), where chemotherapy services are expanding rapidly but often lack comprehensive safety frameworks [3, 14–16, 18, 19, 21].This absence suggests limited empirical attention to the development and evaluation of nurse-led chemotherapy safety interventions within African oncology care systems [24]. Given the increasing cancer burden in LMICs and the heightened risk of occupational exposure among oncology nurses, there is an urgent need for context-specific research to assess the effectiveness, feasibility, and sustainability of such interventions in African settings. Future studies should explore how local health system constraints, resource availability, and policy environments influence the implementation of safe chemotherapy handling protocols in these regions.
Limitations
This scoping review was limited to peer-reviewed studies published in English between 2015 and 2025, which may have excluded relevant research published in other languages or non-indexed regional journals. The search was also restricted to databases accessible through institutional subscriptions, which might have led to the omission of unpublished or grey literature. Furthermore, the relatively small number of included studies (n = 7) and their concentration in only three countries—Egypt, Iran, and the United States—limit the generalisability of the findings. The predominance of quasi-experimental and quality improvement designs also constrains the ability to draw causal inferences regarding the long-term effectiveness of nurse-led chemotherapy safety interventions.
Conclusion
This review identified seven studies conducted between 2017 and 2024, originating from Egypt, the United States, and Iran, with none from Sub-Saharan Africa. No eligible studies were published between 2015–2016. The findings consistently demonstrated that educational interventions, nurse-led programmes, and adherence to safety guidelines significantly improved oncology nurses’ knowledge, attitudes, and practices related to chemotherapy handling. However, the absence of studies from Sub-Saharan Africa contexts highlights a substantial research gap in low- and middle-income countries where chemotherapy services are rapidly expanding. Future research should focus on developing and evaluating context-specific, nurse-led chemotherapy safety programmes that consider resource limitations, institutional support, and sustainability within African oncology care systems.
Declarations
Ethics approval and consent to participate
Not applicable; however, the study adhered to the ethical principles guiding scoping literature reviews and followed the PRISMA-ScR flow chart.
Consent for publication
Not Applicable
A
Data Availability
The datasets generated (Articles) and/or analyzed in this study are available and can be obtained from the corresponding author upon reasonable request.
Competing interests
The authors declare that they have no competing interests
A
Funding
None
A
Author Contribution
G.S.K, S.G., A.G.M., N.O.O.O., and B.M.O: Conceptualization, Methodology, Review, Editing and original draft.Final approval: All authors G.S.K, S.G., A.G.M., N.O.O.O., and B.M.O. approved the manuscript
Final approval: All authors G.S.K, S.G., A.G.M., N.O.O.O., and B.M.O. approved the manuscript
A
Acknowledgement
We wish to acknowledge the organizers of the “Preparing African Nurses to Be Policy Leaders in Cancer Treatment and Control” programme (Pfizer, the International Society of Nurses in Cancer Care (ISNCC), and the African Organisation for Research and Training in Cancer (AORTIC) under the African Nurses as Policy Leaders in Cancer Treatment and Control programme)
Reference
1. Behranvand N, Nasri F, Zolfaghari Emameh R, Khani P, Hosseini A, Garssen J, et al. Chemotherapy: a double-edged sword in cancer treatment. Cancer immunology, immunotherapy. 2022;71(3):507 − 26.
2. Yanagihara K, Yoshida M, Yamakawa T, Kato S, Tamura M, Nagata K. Efficacy and Safety of Dose-Dense Chemotherapy in Breast Cancer: Real Clinical Data and Literature Review. Current Oncology. 2025;32(8):441.
3. Nouri A, Seyed Javadi M, Iranijam E, Aghamohammadi M. Improving nurses’ performance in the safe handling of antineoplastic agents: a quasi-experimental study. BMC nursing. 2021;20(1):247.
4. Hojati Z, Goudarzi F, Hasanvand S, Galehdar N, Birjandi M. The impact of training chemotherapy safety standards with a smartphone application on the knowledge, attitude, and performance of nurses. BMC Nursing. 2023;22(1):43.
5. Oyuku M, Nshakira N. Factors influencing compliance with chemotherapy handling and administration standard operation procedures among nurses and pharmacists at Uganda cancer institute: descriptive study. BMC Health Services Research. 2025;25(1):1010.
6. Abu-Alhaija D, Bakas T, Shaughnessy E, Miller E. The factors that influence chemotherapy exposure among nurses: an integrative review. Workplace health & safety. 2023;71(5):212 − 27.
7. Gamal G, Gamal L, Eldessouki K, Abozied A. Chemotherapy health hazards among oncology nurses and its possible relation to malpractice and workplace environment. Evidence-Based Nursing Research. 2019;1(3):182 − 91.
8. Lai XB, Ching SSY, Wong FKY, Leung CWY, Lee LH, Wong JSY, et al. A nurse-led care program for breast cancer patients in a chemotherapy day center: a randomized controlled trial. Cancer nursing. 2019;42(1):20–34.
9. Guerrero JG, Attallah DM, Gomma NH, Ali SA. Improvements in practising nurses’ knowledge, skills, self-efficacy, confidence, and satisfaction after a simulated clinical experience of caring for a patient undergoing chemotherapy: a quasi-experimental study. BMC nursing. 2024;23(1):66.
10. Sucharew H, Macaluso M. Methods for research evidence synthesis: The scoping review approach. Journal of hospital medicine. 2019;14(7):pp.416-8.
11. Arksey H, O'Malley L. Scoping studies: towards a methodological framework. International journal of social research methodology. 2005;8(1):19–32.
12. Peters MDJ, Marnie C, Colquhoun H, Garritty CM, Hempel S, Horsley T, et al. Scoping reviews: reinforcing and advancing the methodology and application. Systematic Reviews. 2021;10(1):263.
13. Verdejo C, Tapia-Benavente L, Schuller-Martínez B, Vergara-Merino L, Vargas-Peirano M, Silva-Dreyer AM. What you need to know about scoping reviews. 2021.
14. Neuss MN. 2016 updated American Society of Clinical Oncology/Oncology Nursing Society chemotherapy administration safety standards, including standards for pediatric oncology. Number 1/January 2017. 2017;44(1):31–43.
15. Moustafa Elpasiony N, Said Abdelhady Garf F, Ali Hafez A, Ramadan Ahmed S. Influence of Antineoplastic Safe Handling Guidelines on Enhancing Nurses’ Performance. Egyptian Journal of Health Care. 2022;13(4):1293 − 307.
16. Crickman R, Finnell DS. Chemotherapy Safe Handling. Clinical journal of oncology nursing. 2017;21(1).
17. Kimberly Kalo MSN, Diana Karius MS, James FBMS, Shannon LMMS, Nancy M. Chemotherapy Safety. Clinical journal of oncology nursing. 2019;23(2):197–202.
18. Abd El-Fatah YAEL, Ahmed SSG, Mahmoud RA-EM. Safety Standards Guidelines: Effect on Nursesꞌ Performance Regarding Safe Handling of Chemotherapy Drugs for Pediatric Patients. Menoufia Nursing Journal. 2024;9(1):133 − 52.
19. G Abd–Elrazik M, S Girgis A, M Gamal L, A Gamal–Eldein G. Effect of Developing Safety Handling Protocol for Chemotherapy on Nurses' Knowledge and practices at Minia Oncology Center. Minia Scientific Nursing Journal. 2018;3(1):16–23.
20. Walton AL, Olsen MM. Safe Handling of Hazardous Drugs. LWW; 2025.
21. Kalo K, Karius D, Bena JF, Morrison SL, Albert NM. Chemotherapy Safety: Reducing errors with a nurse-led time-out process. Clinical journal of oncology nursing. 2019;23(2).
22. Umeano A. Nursing leadership strategies for fostering interprofessional collaboration with pharmacists to improve medication safety and patient-centered healthcare outcomes. 2024.
23. Alkattan RA. Nurses' Perceptions Regarding Risk of Occupational Exposure to Cytotoxic Drugs in a Tertiary Hospital in Saudi Arabia: A Grounded Theory Study. 2022.
24. Gbande, S., Maree, J. E., & Obiora, O. L. (2025). Supporting women receiving palliative chemotherapy for breast cancer. International Journal of Palliative Nursing, 31(9), 456–463.