American Society of Clinical Oncology/Oncology Nursing Society Chemotherapy Administration Safety Standards

Abstract

Standardization of care can reduce the risk of errors, increase efficiency, and provide a framework for best practice. In 2008, the American Society of Clinical Oncology (ASCO) and the Oncology Nursing Society (ONS) invited a broad range of stakeholders to create a set of standards for the administration of chemotherapy to adult patients in the outpatient setting. At the close of a full-day structured workshop, 64 draft standards were proposed. After a formal process of electronic voting and conference calls, 29 draft standards were eliminated, resulting in a final list of 35 draft measures. The proposed set of standards was posted for 6 weeks of open public comment. Three hundred twenty-two comments were reviewed by the Steering Group and used as the basis for final editing to a final set of standards. The final list includes 31 standards encompassing seven domains, which include the following: review of clinical information and selection of a treatment regimen; treatment planning and informed consent; ordering of treatment; drug preparation; assessment of treatment compliance; administration and monitoring; assessment of response and toxicity monitoring. Adherence to ASCO and ONS standards for safe chemotherapy administration should be a goal of all providers of adult cancer care.

Structures and processes of care in ambulatory oncology settings and nurse-reported exposure to chemotherapy

“…Practices that adhere to this ASCO/ONS endorsed practice6 likely are predisposed to a positive safety culture. Thus, the verification process may not directly influence exposure but rather may serve as a proxy for various processes to protect patients and nurses.…”

“…We developed seven process of care items from the 2009 ASCO/ONS standards for ambulatory chemotherapy administration 6. Nurses rated the frequency that the process occurred on a five-point Likert scale (never to very frequently).…”

“…In 2009, the Oncology Nursing Society (ONS) and American Society of Clinical Oncology (ASCO) acknowledged the potential problems imposed by practice variability and jointly issued voluntary safety standards for ambulatory chemotherapy administration 6. The adoption rate of these standards is unknown, and only 74 practices are certified currently by ASCO's Quality Oncology Practice Initiative for standard adherence 7.…”

Screening for Psychosocial Risk at Pediatric Cancer Diagnosis

“…Recognition of these facts has resulted in recent calls for implementation of systematic psychosocial screening, as the first step in the provision of psychosocial care 1,2 and as an integral part of chemotherapy administration. 3 However, there are 2 key barriers to evidence-based screening. First is the availability of easy to administer, reliable, and valid screening tools.…”

Re-examining the requirements for verification of patient identifiers during medication administration: No wonder it is error-prone

“…In this paper, we evaluate the requirements for VPI during the medication administration process for a patient-identified medication, meaning that the medication contains patient identification information (e.g., medications for chemotherapy; Jacobson et al, 2009;Spruill et al, 2009). Labels for common medications (e.g., aspirin) often do not contain this information.…”