Date of Graduation

Fall 12-3-2020

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions




Population Health Leadership

First Advisor

Elena Capella EdD, MSN/MPA, RN, CNL, CPHQ, LNCC

Second Advisor

Carlee Balzaretti DNP, RN


Problem: The U.S. Pharmacopeia (USP, 2016) Convention Chapter 800: Hazardous Drugs: Handling in Healthcare Settings took effect on December 1, 2019. According to Polovich and Olsen (2017), " The implementation of the USP <800> Standards. will represent an important step forward to protect nurses and other potentially exposed healthcare workers (HCWs): (p.1).

Context: The Doctor of Nursing Practice (DNP) project implemented a hazardous drug (HD) safe-handling personal protective equipment (PPE) toolkit in accordance to USP <800>standards and hospital policies at an ambulatory cancer infusion center to improve nurses' adherence with PPE use.

Interventions: The project consisted of (a) a safe-handling PPE toolkit, (b) a PPE observation tool, (c) an expert panel discussion, (d) a nurses' skills session, (e) an online safe-handling survey, (f) an HD safe-handling checklist, and (g) a performance dashboard.

Measures: Outcome measures included a (a) 90% or higher compliance rate with PPE use during hazardous drug administration and (b) sustained adherence to USP <800> standards and hospital policies by February 1, 2020.

Results: A 90% compliance rate for PPE use during hazardous drug administration was achieved by February 1, 2020. Sustainability is at risk due to the COVID-19 pandemic and global PPE shortages, however, nurses were able to adapt to new processes to conserve vital resources and will be reassessed in six months.

Conclusions: A systems-thinking approach to the implementation of USP<800> was successful in improving compliance and adherence to PPE use among ambulatory care infusion nurses.



Electronic Thesis Document Huff 2020 Final.pdf (93 kB)
Electronic Thesis/Project Submission Agreement Form