In clinics and oncology floors across the country, IV pumps are infusing, chemotherapy is administered through IV push, and nurses are moving swiftly from one patient to the next. Administering chemotherapy is a complex, in-depth procedure that requires training, education, and a level of experience beyond that of the standard healthcare professional. However, even the best oncology nurses need the support of their team members and the administration to provide the safest possible care environments for their patients.

Hypersensitivity reactions to chemotherapy administration can be extremely dangerous for patients. These events, though usually infrequent, require the presence of an onsite provider who can issue medical orders in the event of a patient reaction. Without a licensed provider, immediate care for hypersensitivity reactions could be delayed or miscommunicated and leave the patient without the necessary care.

The 2016 ASCO/ONS Chemotherapy Administration Safety Standard 1.4 calls for “a licensed independent practitioner on-site and immediately available to staff who administer chemotherapy in the healthcare setting.” An institution must provide the appropriate support staff on-site to ensure oncology nurses can administer chemotherapy with the utmost attention to safety.

Advocate for Patient Safety

Not all chemotherapy administration units provide a licensed practitioner onsite at all times. This can stem from staffing issues, institutional policies, or other extenuating circumstances. Regardless of the situation, it’s imperative that licensed providers are available to issue medical orders and on-the-spot support to oncology nurses as they care for patients receiving chemotherapy, especially as new treatments like immunotherapies and targeted therapies are being given.

If your institution isn’t adhering to chemotherapy administration safety standards, it can feel daunting to address it with leadership. However, oncology nurses are well versed at advocating for their patients. Address any potential lapses in safety with nursing leadership first. Be prepared to show examples or case studies that illustrate the problems of lacking a licensed provider on site for patient care.

Refer to the 2016 ASCO/ONS Chemotherapy Administration Safety Standards to review your institutional policies and address gaps in safety. Oncology nurses are the leaders of quality, safe patient care, and advocating for institutional change is well within the scope of practice. Nurses should feel empowered knowing their voices, expertise, and perspective can improve safety for patients with cancer.

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