Immunotherapy Administration: Oncology Nursing Society Recommendations

Abstract

As the use of immunotherapeutic agents increases in single-agent and multimodality treatment regimens, oncology nurses face the challenge of administering and caring for patients receiving new and unique agents. Oncology Nursing Society clinical staff and clinical nurses collaborated to produce a set of recommendations to educate nurses involved with the monitoring of patients receiving immunotherapy on administration procedures and safe handling of these agents to ensure patient and staff safety and to reduce risk of error. The recommendations are meant to provide clinical nurses with a framework on which to build policies and procedures for administering new treatment modalities. .

Patient Safety in the Administration of Antineoplastic Chemotherapy and of Immunotherapics for Oncological Treatment: Scoping Review

“…Regarding the journals, two had published seven (14.9%) articles in the Clin J Oncol Nurs [6][7]18,[27][28][34][35] (impact factor 0.881, Journal Citation Reports 2017-2018), six (12.8%) studies in the Oncol Nurs Forum 9,17,20,22,26,52 (impact factor 1.785, Journal Citation Reports 2017-2018), five (10.6%) in the J Oncol Pract 4,17,38,40,45 (impact factor 2.509, Journal Citation Reports 2017-2018) and in the Eur J Oncol Nurs 23,44,46,48,51 (impact factor 1.812, Journal Citation Reports 2017-2018), three (6.4%) publications in the J Pediatr Oncol Nurs 5,30,32 (impact factor 1.294, Journal Citation Reports 2017-2018), two (4.3%) in the Qual Saf Health Care 25,29 (according to the latest data, not indexed in the Journal Citation Reports). The other studies were published in different health journals.…”

“…The other studies were published in different health journals. 3,[13][14][15][16]19,21,[24][25]31,33,43,[36][37]39,42,47,[49][50] The safety of cancer drug administration in adults, children and young people in hospitals, [3][4][6][7][13][14][15][16][17][18][19][20][21][22]27,33,[35][36][40][41]44,[47][48][49][50]52 outpatient clinics, [3][4][5][16][17][18][19...…”

“…Only two studies [6][7] were found on evidence-based administration and safe handling procedures specific for immunotherapies (4.3%), and both with a 5A evidence level, 6-7 from consensus and expert opinion, but with a strong recommendation: nurses must have knowledge about the protocols and immunotherapy to be administered; dose reductions are often not an option in immunotherapy treatment plans; immunotherapy doses are administered completely; greater attention to multiple treatment plans (immunotherapy, CTX, teletherapy and/or other antineoplastic agents); the medical history made by nurses needs to include psychiatric assessments with questions about mood and sleep pattern changes secondary to immunotherapeutic drug-induced hypothyroidism or hyperthyroidism and, in physical assessments, include mainly weight, fatigue, and pain monitoring; perform postadministration monitoring including adherence, toxicity and complications. [6][7]…”

“…These techniques can be employed alone or in combination to provide better results. 1,6 Regarding immunotherapy, clinical trials provide information on the efficacy of these agents in different types of malignant neoplasms. Thus, there is a need for protocols and bundles that have guidelines with an emphasis on patient safety in the administration of immunotherapies to enable them to provide safe and evidence-based care.…”

“…[7][8] It is noteworthy that immunotherapies differ in their pathophysiology and have high specificity for tumor cells, in addition to limited toxicity to normal cells, unlike conventional cancer therapies. [6][7] Therefore, it is essential to identify the scientific evidence of patient safety in the administration of both chemotherapeutic and immunotherapeutic agents.…”