The ONS clinical inbox frequently receives questions about whether nurses need to be “chemotherapy certified” to give specific chemotherapy and/or biotherapy agents.

In this case, “certification” is a common misnomer. ONS does not have or endorse any program that results in being certified to administer chemotherapy. No didactic program or examination provides a nationally recognized certification for chemotherapy/biotherapy administration. ONS’s chemotherapy/biotherapy courses provide a chemotherapy certificate and a provider card for students who successfully complete all course requirements (see sidebar), but this is not the same as professional certification or licensure.

Because ONS is not a regulatory agency or accrediting body, we cannot mandate that any specific education, training, or certificate be required to administer these high-risk agents. Rather, we encourage that policies and procedures are developed at each individual practice clearly stating what education and clinical competence must be demonstrated prior to being able to engage in chemotherapy- or biotherapy-related procedures. Each institution or practice must determine how it will assess nursing competence in performing various chemotherapy-related skills (ONS, 2015; Polovich, Olsen, & LeFebvre, 2014). 

ONS’s (2015) standard is that RNs should complete didactic content regarding certain chemotherapy- and biotherapy-related principles, and then complete a clinical practicum under the auspices of the institution or supporting agency. Due to the high-risk nature of these agents, it is our position that this would apply to all chemotherapy and biotherapy agents regardless of dose, route, or indication for treatment.

Within the ONS Chemotherapy and Biotherapy Guidelines and Recommendations for Practice (Polovich et al., 2014), is a chapter titled, “Competence in Chemotherapy Administration,” addressing both the didactic and clinical aspects of establishing competency. Annual competency renewal through clinical activities or simulation is recommended for all staff involved in chemotherapy or biotherapy administration. The book’s appendix provides an example of a clinical practicum evaluation that focuses on demonstrating proficiency in treatment administration skills as well as pre-treatment and post-treatment assessments.

Each institution or practice must determine how it will assess nursing competence in performing various chemotherapy-related skills.

Oncology Nursing Society (ONS). (2015). Education of the RN who administers and cares for the individual receiving chemotherapy and biotherapy [Position statement]. Retrieved from

Polovich, M., Olsen, M., & LeFebvre, K.B. (2014). ONS chemotherapy and biotherapy guidelines and recommendations for practice (4th ed.). Pittsburgh, PA: Oncology Nursing Society.