الفهرس 
Chapter I : IntroductionOnly 14 pages are availabe for public view
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Abstract
Chemotherapy is one of the most commonly prescribed cancer treatment modality. Cytotoxic drugs (CDs) are therapeutic agents mainly used in chemotherapy for their actions on killing cancerous cell. Antineoplastic drugs (ANDs) considered hazardous by the National Institute for Occupational Safety and Health (NIOSH). Long-term occupational exposure to (CDs) is associated with various carcinogenic, and teratogenic effects. Exposure to chemotherapy drugs is associated with many adverse outcomes for occupationally exposed individuals including but not limited to contact dermatitis; fetal loss; infertility; preterm births; and an overall increase in one’s personal risk for cancer. Pregnant nurses are at particular risk for chemotherapy exposure .Organizations such as (NIOSH), Oncology Nursing Society (ONS) and the American Society of Hospital Pharmacists (ASHP), and (OSHA) have recommended safe handling guidelines for ANDs. These guidelines recommend the application of hierarchy of control technologies to mitigate workplace hazards, which include engineering controls, administrative controls, work practice controls, and personal protective equipment (PPE). This study aimed to evaluate the effect of implementing Safety Handling Protocol for Chemotherapy (SHPC) on nurses’ knowledge and practical skills. Quasi-experimental research design was utilized in the current study. The study sample included (50) nurses who are working in outpatient and inpatient chemotherapy department. The required data were collected through the utilization of three tools were designed by researcher and then reviewed by a panel of 5 experts in the field of nursing and included; Tool (I) Arabic administered questionnaire and consisted of three parts: Part I: nurses’ Socio-demographic data such as age, sex, marital status, habits, educational level, years of experience as oncology nurse and previous training about safe handling of chemotherapy. Part II: Medical Data and Part III: Knowledge Questionnaire. Tool (II) structured observational checklist and cover the following areas: nurse’s practical skills before administering, while administering, during disposal of chemotherapy drugs waste and in dealing with a chemotherapeutic agent spillage. Tool (III) includes safe handling protocol for chemotherapy (SHPC) (booklet). As regard to the finding of the current study revealed that, the majority of nurses were females (84%), aged between 2o to 3o years old (64%), married (74%), lived in village (62%), were not pregnant or lactating, not smoker and don’t previously attend training about safe handling chemotherapy (92%) .About half of them had graduated from secondary nursing school (54%) and have more than 1o years of experience in oncology center (48%). nurses had poor knowledge regarding safe handling chemotherapy. The mean score of total nurses knowledge statistically improved from (12.9± 4.8 to 25.4 ± 2.0 & 22.7 ± 2.8 respectively) in pre, immediately post, and after 2 months of implementing (SHPC) with p value (.0001**). Nearly all nurses have unsatisfactory practical skill level before implementing (SHPC) which significantly changed after implementing it. Recommendations: health care professionals who are responsible for handling chemotherapeutic drugs should be adherent to implementation of (SHPC(.