Are You Following the Latest Chemo Safety Recommendations?
In response to the ever-changing practice of cancer care, in May 2024, the American Society of Clinical Oncology (ASCO) and ONS released updates (https://doi.org/10.1188/24.ONF.1-24.AP) to their administration safety standards to provide clarification and guidance for oncology healthcare professionals. Here’s what you need to know about the changes as an oncology nurse.
What Has Changed
Since the standards’ last update in 2016, the first difference you’ll see is right in the title: The 2024 standards use the term (https://doi.org/10.1188/24.ONF.1-24.AP) antineoplastic therapy or regimen to describe chemotherapy, targeted therapy, and immunotherapy. Hormone therapy is not included in that definition.
What Was Added
As the patient population diversifies and the cancer healthcare community gains greater awareness of and evidence to support their individual needs, the 2024 standards contain new guidance (https://doi.org/10.1188/24.ONF.1-24.AP) on:
- Initial and ongoing assessment of social determinants of health
- Safe administration of antineoplastics in the home setting
- Institutional policy requirements for:
- Fertility and pregnancy assessment prior to treatment
- Management of hypersensitivity and anaphylactoid reactions and cytokine release syndrome
- Use of electronic health record ordering format for all feasible antineoplastic medication orders
What Was Modified
For some of the previous recommendations, the 2024 standards contain updated or new details (https://doi.org/10.1188/24.ONF.1-24.AP) to reflect current evidence or provide clarity:
- Patient education includes the treatment’s impact on fertility, advice on pregnancy prevention, and effective contraception.
- Patients’ height and weight (https://voice.ons.org/news-and-views/respect-patients-religious-hair-wraps-or-coverings-when-taking-accurate-height-and) are measured in metric units, and a licensed professional verifies the documentation before a patient starts a new regimen.
- All medications, including over-the-counter, herbal, and complementary supplements, are reconciled and a licensed practitioner reviews any changes.
- The verification process, including a fourth verification in the presence of the patient, and addresses use of institutionally approved video-enabled technology for verification (https://doi.org/10.1188/24.cjon.1-5.ap).
Why You Can Trust the Standards
Following an established evidence-based process, an interprofessional expert panel that included physicians, nurses, pharmacists, and quality management representatives, conducted a literature review (https://doi.org/10.1188/24.ONF.1-24.AP) and revised the existing standards where needed. The draft updates went through public comment, further revised as appropriate, and ultimately approved by ONS and ASCO leadership.
Read the new standards, Antineoplastic Therapy Administration Safety Standards for Adult and Pediatric Oncology: ASCO-ONS Standards (https://doi.org/10.1188/24.ONF.1-24.AP), in the Oncology Nursing Forum and Journal of Clinical Oncology: Oncology Practice.