For sub-Saharan African (SSA) countries, cancer incidence is on the rise. The increase in cancer rates can be attributed to several factors, including economic and social development and infectious disease rates. In that part of the world, many healthcare professionals don’t have access to up-to-date information regarding safe chemotherapy handling and administration. The American Cancer Society (ACS) and Clinton Health Access Initiative (CHAI) developed the ChemoSafe program to share critical information and resource acquisition focused on safe chemotherapy administration and cancer treatments with healthcare providers in SSA. ONS provided specific nursing content to support the ChemoSafe initiative, including educational materials and courses.

In March 2018, ONS partnered with ACS and CHAI to deliver the first ChemoSafe educational program at the Ayder Comprehensive Specialized Hospital at Mekelle University in Ethiopia. ONS presented a five-day course on chemotherapy administration and safe handling for nurses and pharmacists from across Ethiopia. The ONS team included members, Annette Galassi, RN, MA, Lori Buswell, MS, APRN, Susie Newton, RN, MS, AOCN®, AOCNS®, and Azeb Kedede, BSN, RN, as well as ONS staff, Kris LeFebvre, MSN, RN, AOCN®, and ONS Chief Clinical Officer Lisa Kennedy Sheldon, PhD, APRN-BC, AOCNP®.

“As more chemotherapy medications are provided to countries throughout Africa, it’s important to have consistent training across countries throughout the region, and that the training matches current evidence-based practices,” LeFebvre says.

Nearly 50 healthcare professionals attended the meeting, including nurses, pharmacists, and technical working group members from Ethiopia.

The objectives of the ChemoSafe program are to:

  • Describe pharmacist and nurse roles in the care of patients receiving chemotherapy.
  • Demonstrate the correct use of personal protective equipment when compounding, handling, and administering chemotherapy.
  • Demonstrate the process for hazardous drug spill management.
  • Calculate chemotherapy dosage and absolute neutrophil counts.
  • Monitor and treat side effects of chemotherapy.
  • Identify pharmacist and nurse roles in creating a culture of safety pertaining to chemotherapy preparation and administration.

“I think the highlight of the training for most nurse participants was the hands-on experience of donning personal protective equipment and doing the chemotherapy administration simulation,” Galassi says. “It’s great that nurses in Ethiopia finally will have access to the necessary supplies and equipment for safe chemotherapy administration—something we take for granted here in the United States.”

Over the course of five days, nurses and pharmacists worked together to educate and share experiences with their Ethiopian colleagues, both together as a group as well as in role-specific subgroups. Lectures discussed cancer diagnosis and treatment, classifications of chemotherapy, treatment plans, the management of infusion reactions and side effects, and the treatment of symptoms. Hands-on activities involved dosage calculations and verification processes, simulated experiences, case studies, and role play opportunities.

The ChemoSafe program was developed as the first step toward supporting higher-level oncology practice in SSA countries. Ultimately, a future train-the-trainer course will focus on preparing oncology nurses, pharmacists, and other healthcare providers to become teachers at their own institutions. Future ChemoSafe program events have been planned for 2018 in other SSA countries, with the next one held in May in Kenya.

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