Date of Graduation

Fall 12-16-2022

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)


School of Nursing and Health Professions


MSN project


Nurses comprise the largest proportion of healthcare providers who make contact with Hazardous Drugs (HDs) during multiple types of clinical activities and have a risk of exposure. Hazardous drugs (HDs) are a class of pharmaceuticals that pose serious health risks to individuals who handle them, including organ toxicity, reproductive and developmental defects, infertility, miscarriage, genetic toxicity, cancer, and even death. This project was implemented in a hospital system within Northern California, on two units that serve medical-surgical, oncology, geriatric, and transplant patients. The Medical Surgical microsystem at this hospital comprises a small group of professionals such as registered nurses (RNs), certified nursing assistants (CNAs), pharmacists, pharmacy technicians, and janitorial staff. The intended aim of this project was to identify all the patients receiving hazardous drugs and observe the nurses assigned to those patients. Nurses were observed with passive and active observation. The success of this project was measured by the number of nurses wearing correct PPE, the number of door and bathroom signs, as well as generation of the MAR isolation banners. It was calculated that around 24.8% of patients were on a hazardous drug, yet only 7.5% of the rooms had appropriate door signs and 1.7% of doors had correct bathroom door signage. This result is an alarming discovery since a lot of non-nursing personnel such as CNAs, janitors, dietary, and visitors rely on door signs. More education should be provided to the nurses on the necessity of placement of the door signs for the whole unit to be seen. Isolation carts that are available on the unit are not properly stocked and require a designated member to fill the carts.