As an increasing number of immunotherapy agents emerge and indications grow at an exponential pace, nurses are frequently administering certain agents for what may be the first time in their practice.
In a supplement to the April 2017 issue of the Clinical Journal of Oncology Nursing, ONS released its first set of recommendations for nurse education and safe handling principles regarding immunotherapy administration. ONS recommendations are based on best-available evidence and the anecdotal experiences of professionals at cancer centers with varied experiences in immunotherapy administration.
Safe Handling With Immunotherapy
Safe handling precautions related to immunotherapy are drug specific. Evidence is limited regarding the hazardous potential of novel immunotherapy agents, so it is up to each practice site to evaluate the immunotherapy agents they administer by reviewing current literature, product information, and safety data sheets. Understanding the mechanism of action helps in determining the potential risk to patients, their family members, and healthcare providers.
Collaboration with infection control or biologic safety departments may assist when developing policies and procedures regarding immunotherapy agents. As an example, live-virus cancer vaccines are one such class of immunotherapy requiring isolation procedures for the duration of treatment or until all lesions are healed.
Oncology Nurse Education and Competencies
ONS recommends that nurses hold a fundamental knowledge of the class of immunotherapy a patient is receiving as well as specific agents and protocols to follow and apply this knowledge to administration and monitoring for adverse events. Similar to processes for defining and maintaining chemotherapy competence, practice institutions involved in immunotherapy administration must determine what didactic education program and competencies will be required of nurses and healthcare practitioners involved in the process, building that into policies and procedures.
The importance of a fundamental knowledge of immunotherapy becomes critical when considering the highly unique and life-threatening complications associated with immunotherapy agents such as interleukins and chimeric antigen receptor therapy or when considering that immunotherapy-related side effects are managed vastly different than chemotherapy-induced side effects. In addition the Immunotherapy in Cancer Treatment course, ONS has added immunotherapy-related content to the ONS/ONCC Chemotherapy Biotherapy Certificate Course.