ONS Safe Handling Guidelines Are Consistent With National Recommendations

January 14, 2019

PITTSBURGH, PA—January, 14, 2019—Last week, the American Society of Clinical Oncology (ASCO) released its 2019 safe handling standards. Although oncology nurses contributed to the expert panel, ONS does not endorse the ASCO standards because they differ from ONS guidelines (https://www.ons.org/books/safe-handling-hazardous-drugs-third-edition) and recommendations and guidelines from national and governmental organizations in several key ways. As an oncology nurse administering hazardous drugs, here’s what you need to know to keep yourself, your colleagues, and your patients safe.

ONS guidelines and recommendations for safe handling, including compounding, administration, and disposal, are consistent with U.S. Pharmacopeia Chapter 800 (USP <800>), National Institute for Occupational Safety and Health (NIOSH), Occupational Safety and Health Administration (OSHA), and American Society of Health-System Pharmacists (ASHP) recommendations. However, some of the information in the ASCO standards is not consistent with the recommendations from those national organizations.

“Adverse health outcomes in nurses from exposure to antineoplastic agents can take years to manifest and are too distal to guide safe handling recommendations in any practice setting,” ONS Chief Clinical Officer Lisa Kennedy Sheldon, PhD, APRN-BC, AOCNP®, FAAN, said. “Because of the lack of evidence, research, and funding about the safety of the drugs developed during the past 15 years, more support and exploration of the health and safety concerns for healthcare providers are needed for newer agents, such as immunotherapy agents, cell therapies, tumor-infiltrating lymphocytes, live viruses, and vaccines.”

In 2019, ONS will develop new safe handling standards and resources with professional colleagues that are consistent with existing national recommendations.

ONS is dedicated to improving the safe delivery of antineoplastic agents by nurses and other healthcare providers across all health systems and practice sizes. The ONS position statement on safe handling (https://www.ons.org/make-difference/ons-center-advocacy-and-health-policy/position-statements/ensuring-healthcare) addresses the need for hazardous drug-related policies and procedures, education and training, and safe handling precautions in organizations in which hazardous drugs are present, including the use of personal protective equipment, safe work practices, and safety equipment. When used consistently, recommended precautions can reduce occupational hazardous drug exposure and environmental contamination and improve the safety of cancer treatment delivery.

Find resources and tools to help you safely administer hazardous drugs in your practice, including Safe Handling of Hazardous Drugs (https://www.ons.org/books/safe-handling-hazardous-drugs-third-edition) (third edition) (https://www.ons.org/books/safe-handling-hazardous-drugs-third-edition) and Toolkit for Safe Handling of Hazardous Drugs for Nurses in Oncology (https://www.ons.org/toolkits/toolkit-safe-handling-hazardous-drugs-nurses-oncology), at ons.org. For specific questions about safe handling, email clinical@ons.org (mailto:clinical@ons.org) or reach out to us on social media with the hashtag #ONSsafehandling.

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