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; and 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.

Outcomes sensitive to nursing service quality in ambulatory cancer chemotherapy: Systematic scoping review

“…Administration of vesicant drugs poses a significant risk associated with many commonly used drugs (Wickham et al, 2006). We found no specific evidence from reviews relating to nursing interventions or approaches to increase safety in ambulatory chemotherapy but there are strong expert recommendations (Jacobson et al, 2009, Wickham et al, 2006, Wengström and Margulies, 2008) (level1 C) and evidence-based recommendations on intravenous drug administration from general settings (level 1 A/B) relating to the safe administration of medication which points to diverse aspects of assessment (including fitness to receive drugs) and technique (including prevention of infection and the treatment and prevention of injury from vesicant drugs) which fall within the scope of nursing practice. Evaluation (before and after) of a multifaceted nurse-led programme designed to increase the quality of care related to chemotherapy-related toxicities (Moore et al, 2008) showed sub optimal care processes at initiation of the project and resulted in improvements in those processes but the study did not report patient outcomes.…”

“…Furthermore, the administration process itself is risky requiring skilled assessment of patient fitness and patency of intravenous access (Walsh et al, 2009). Patient education is a key challenge for patients receiving oral medication where a lack of concordance poses a significant risk (Jacobson et al, 2009). Many of the potential impacts of nursing relate to assessment of toxicities (Walsh et al, 2009) and are reflected in other outcomes considered in this review (e.g.…”

The Challenges of Oral Agents as Antineoplastic Treatments

“…The American Society of Clinical Oncology and Oncology Nursing Society have established chemotherapy administration safety standards for the clinical setting. 83 These procedures need to be implemented in the home setting to assure the patient and family members are safe.…”

2013 Updated American Society of Clinical Oncology/Oncology Nursing Society Chemotherapy Administration Safety Standards Including Standards for the Safe Administration and Management of Oral Chemotherapy

“…1 Briefly, the development process was led by a Steering Group from ASCO and ONS with previous experience in this project (the present authors). Steering group members formalized the scope of the project (Figure 1), and ASCO staff performed a structured literature search to identify relevant literature.…”