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    COVID-19 Affects Cancer Caregivers, but Here Are Ways to Support Them
    COVID-19
    COVID-19 Affects Cancer Caregivers, but Here Are Ways to Support Them
    February 19, 2021
    Celebrate Oncology Nurse Leaders During Black History Month
    ONS Leadership
    Celebrate Oncology Nurse Leaders During Black History Month
    February 03, 2021
    Am I Too Shy to Lead?
    Nurse staffing
    Am I Too Shy to Lead?
    January 29, 2021
    Zoom Through Video Job Interviews With These Tips for Applicants and Hiring Managers
    nursing professional development
    Zoom Through Video Job Interviews With These Tips for Applicants and Hiring Managers
    January 22, 2021
    The Case of Concurrent Therapy Concerns
    Treatment side effects
    The Case of Concurrent Therapy Concerns
    December 18, 2020
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    Safe handling

    ONS Bridge

    USP <800> Answers Some Difficult Questions About Hazardous Drug Safety

    Exposure to hazardous drugs puts healthcare workers at risk for myriad adverse effects. Until recently, consistent safety information for HD administration and disposal has been lacking. However, with USP Chapter <800> going into effect in December 2019, U.S. Pharmacopeia has changed the landscape of HD safety guidelines.

    September 08, 2020
    Should You Wear a Gown to Disconnect Chemo?
    Safety

    Should You Wear a Gown to Disconnect Chemo?

    The short answer is yes—guidelines from ONS, National Institute of Occupational Safety and Health, Occupational Safety and Health Administration, and U.S. Pharmacopia all call for nurses to always wear appropriate personal protective equipment (PPE) when at risk for exposure, including disconnecting a patient’s chemotherapy. Wearing a gown and other PPE isn’t just good practice—it protects nurses at one of many touchpoints during chemotherapy administration and patient care where healthcare providers are at risk for exposure to hazardous drugs.

    October 21, 2019
    Why Aren’t Nurses Adhering to PPE Requirements?
    Safety

    Why Aren’t Nurses Adhering to PPE Requirements?

    Oncology nurses are dedicated to providing the best, safest cancer care to their patients—protecting them from medical harm and prolonging life. But when it comes to protecting themselves, nurses sometimes take shortcuts in wearing personal protective equipment (PPE) that guards them against exposure to hazardous drugs. 

    September 10, 2019
    Evidence Supports Strategies for Better Safe Handling Practice
    Research

    Evidence Supports Strategies for Better Safe Handling Practice

    The evidence is clear: for more than 40 years, reports have confirmed that hazardous drug exposure poses significant safety risks to providers who handle many agents related to cancer treatments. Healthcare professionals experience several substantial health threats, including reproductive problems, airway and skin irritation, and cancers. Despite the potential health risks, the data are also clear: nurses routinely do not wear personal protective equipment as recommended when handling hazardous drugs.

    September 09, 2019
    USP <800> Brings Change, Collaboration to Pharmacy and Nursing
    Safety

    USP <800> Brings Change, Collaboration to Pharmacy and Nursing

    U.S. Pharmacopeia (USP) chapter <800> provides safety measures for all healthcare workers in any setting where hazardous drugs (HDs) are used in the health system. For situations from the initial delivery of the drug to the institution through administration and disposal, USP <800> provides a vast number of safety measures intended to minimize risk and potential exposure to HDs. To meet the new requirements, medical institutions and pharmacies have had to make significant changes in various systems.

    September 03, 2019
    Handle With Care: How USP <800> Will Affect Nursing Practice
    Safe handling

    Handle With Care: How USP <800> Will Affect Nursing Practice

    Police officers wear body armor and construction workers wear hard hats. Why? Because these professions carry inherent dangers in the line of duty­—and oncology nursing does too. Statistically, healthcare workers face more workplace-related dangers than both law enforcement and construction, yet attention to safety and personal protection isn’t always a central focus. This can be especially true in cancer care, where nurses are required to administer hazardous drugs (HDs) and handle dangerous medications on a daily basis. Although safety recommendations exist, few enforceable standards are protecting nurses handling HDs.

    September 03, 2019
    Press Releases

    HOPA and ONS Collaborate on Safe Handling Guidelines Consistent With National Recommendations

    The Hematology/Oncology Pharmacy Association (HOPA) and Oncology Nursing Society (ONS) have partnered to develop a joint position statement in advance of an upcoming compliance deadline for U.S. Pharmacopeia Chapter 800 (USP <800>).

    September 03, 2019
    The Case of the Safety Session
    Safety

    The Case of the Safety Session

    Doug is a 48-year-old triathlete who was recently diagnosed with chronic myeloid leukemia (CML) after a routine blood test showed an increase in white blood cells and a subsequent bone marrow biopsy showed greater than 20% blast cells. The medical oncologist prescribed the oral drug dasatinib. Doug and his wife meet with Staci, RN, to receive oral therapy education. During the teaching, Doug says his wife will have no trouble dispensing the dasatinib because she already prepares all of their meals and nutritional supplements.  

    August 20, 2019
    The Case of the Explicit Exposure
    Clinical practice

    The Case of the Explicit Exposure

    Mr. Larsen presents to the clinic for his first dose of R-CHOP (rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisone) for a diagnosis of diffuse large B-cell lymphoma. Elizabeth, his oncology nurse, just started the cyclophosphamide when she is paged to the desk for a call from Mr. Larsen’s oncologist. She quickly removes her face shield and gloves as she hurriedly leaves the room to take the call. After completing the call, she returns to Mr. Larsen’s room to remove her gown.  

    July 16, 2019
    What USP Means for Safe Oncology Nursing Practice
    Safety

    What USP Means for Safe Oncology Nursing Practice

    Nurses in oncology who compound hazardous drugs may be familiar with the U.S. Pharmacopeial Convention (USP) because of chapter <795> related to compounding nonsterile medications and chapter <797> addressing compounding sterile medications. But what is USP really, and why does it have an impact on oncology nursing practice?

    May 07, 2019
    ONS Congress

    Safe Handling of Hazardous Drugs Is No Accident

    Oncology nurses must remain vigilant to protect patients and themselves from chemotherapy exposure. During a session on Friday, April 12, 2019, at the ONS 44th Annual Congress in Anaheim, CA, Martha Polovich, PhD, RN, AOCN®, of Georgia State University in Atlanta, and MiKaela Olsen, APRN-CNS, MS, AOCNS®, FAAN, of Sidney Kimmel Comprehensive Cancer Center in Baltimore, MD, instructed nurses on how to ensure safe handling of hazardous drugs (HDs) in their practice settings.

    April 12, 2019
    Do Cytotoxic Agents Impact Ground Soil or Well Water?
    Safety

    Do Cytotoxic Agents Impact Ground Soil or Well Water?

    When patients go home after receiving their regimen of powerful cytotoxic agents, oncology nurses routinely encourage them to double flush after using the bathroom to ensure that trace amounts of hazardous medication are eliminated from the environment to prevent other members of the household from being exposed. But what happens with chemotherapy chemicals found in human waste as they enter a patient’s septic system—and eventually the water supply?

    January 16, 2019
    ONS Responds to 2019 ASCO Safe Handling Standards
    Press Releases

    ONS Safe Handling Guidelines Are Consistent With National Recommendations

    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 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.

    January 14, 2019
    Monitoring Surface Contamination of Hazardous Drugs and Considerations for Remediation
    Safe handling

    Monitoring Surface Contamination of Hazardous Drugs and Considerations for Remediation

    Hazardous drugs are medications known to cause adverse health effects because of exposure in the workplace, according to the National Institute for Occupational Safety and Health. Examples of such agents include chemotherapy drugs, antivirals, hormones, and bioengineered drugs.

    October 18, 2018
    drug spill safe handling
    Safe handling

    Which of the Following Drug Spills Doesn’t Require a Full-Facepiece, Chemical Cartridge-Type Respirator or PAPR?

    Which of the following drug spills doesn’t require a full-facepiece, chemical cartridge-type respirator or PAPR during clean up?

    A. 5-Fluorouracil 

    B. Cyclophosphamide 

    C. Adriamycin  

    D. Nitrogen mustard 

    July 26, 2018
    What ONS Does When the Question Can’t Be Answered Definitively
    ONS Leadership

    What ONS Does When the Question Can’t Be Answered Definitively

    How frustrating it can be not to have enough evidence to answer a question definitively. That happens often in clinical practice, even as we build evidence for it. Expert opinion can help when the body of research does not. This spring, we have continued work in two areas in which answers are not definitive.

    June 07, 2018
    ONS Shares Chemotherapy Education in Sub-Saharan Africa
    Nursing education

    ONS Shares Chemotherapy Education in Sub-Saharan Africa

    For sub-Saharan African (SSA) countries, cancer incidence is on the rise. The increase in cancer rates can be attributed to several factors, including economic and social development and infectious disease rates. In that part of the world, many healthcare professionals don’t have access to up-to-date information regarding safe chemotherapy handling and administration. The American Cancer Society (ACS) and Clinton Health Access Initiative (CHAI) developed the ChemoSafe program to share critical information and resource acquisition focused on safe chemotherapy administration and cancer treatments with healthcare providers in SSA. ONS provided specific nursing content to support the ChemoSafe initiative, including educational materials and courses.

    April 05, 2018
    ONS’s Recommendations for Gowns When Handling Hazardous Drugs
    Safe handling

    What Are ONS’s Recommendations for Gowns When Handling Hazardous Drugs?

    Although USP Chapter <800> implementation has been delayed, ONS experts are receiving questions about clarifications and specifics for wearing gowns when handling hazardous drugs (HDs). Questions include topics such as hanging gowns and reusing, length of time gowns can be worn, the need for gowns with oral chemotherapy agents, and materials requirements of gowns. 

    November 28, 2017
    USP <800> Implementation Delayed
    Safety

    USP <800> Implementation Delayed to December 2019

    The U.S. Pharmacopeia (USP) announced on September 29, 2017, it would delay the implementation of USP General Chapter <800> Hazardous Drugs—Handling in Healthcare Settings to coordinate its implementation with chapter <797> Pharmaceutical Compounding—Sterile Preparations.  According to USP, chapter <797> is still undergoing revisions and will be available for public comment in fall 2018. UPS <800> was set for implementation by July 1, 2018, but both chapters are now expected to become official on December 1, 2019.

    October 05, 2017
    USP <800>
    Safe handling

    What Oncology Nurses Need to Know About USP <800>

    Because of the risks and dangers associated with hazardous drugs, guidelines surrounding their use and handling have been issued since 1981. Since then, several organizations, including ONS (in tandem with the American Society of Clinical Oncology), the American Society of Health-System Pharmacists, the Occupational Safety and Health Administration, and the National Institute of Occupational Safety and Health, have released guidelines for various providers who handle the drugs.

    July 11, 2017
    Safe handling immunotherapy
    Safe handling

    What Safe Handling and Administration Requirements Apply to Immunotherapy?

    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.

    June 27, 2017
    Standards of Care
    Standards

    How Do I Move Standards of Care Into Practice?

    April 26, 2017
    What Are ONS’s Recommendations for Safe Handling of Hazardous Drugs?
    Safety

    What Are ONS’s Recommendations for Safe Handling of Hazardous Drugs?

    Research suggests that healthcare workers who handle hazardous drugs may experience acute effects such as skin rashes or more chronic effects including adverse reproductive events and malignancy. This has led numerous government agencies to make recommendations regarding the safe handling of hazardous drugs. 

    April 25, 2017
    Best Practice Released for Targeted Medication Safety - Router.
    Safety

    Do You Know the Best Practices for Targeted Medication Safety?

    The Institute for Safe Medication Practices (ISMP) has added five new best practices and revised two existing ones for safe medication administration in its recent release of the 2016-2017 Targeted Medication Safety Best Practices for Hospitals.

    February 07, 2017
    Chemotherapy Competence
    Clinical practice

    What Is Chemotherapy Competence Versus Chemotherapy Certification?

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

    January 28, 2017
    nurse while pregnant
    Clinical practice

    What Is ONS’s Stance on Handling Chemotherapy While Pregnant, Breastfeeding, or Trying to Conceive?

    One of the questions that ONS commonly receives in the clinical inbox is whether nurses who are pregnant, breastfeeding, or trying to conceive can safely administer or handle chemotherapy and other hazardous drugs.

    January 03, 2017
    ASCO Annual Meeting

    Incorporating Advanced Practitioners Into Team-Based Oncology Care

    During a session presented at the 2016 ASCO Annual Meeting that discussed team-based oncology care, ONS member Wendy H. Vogel, MSN, FNP, AOCNP®, an oncology nurse practitioner at Wellmont Cancer Institute in Kingsport, TN, discussed how advanced practice providers can be involved in the care team process.
    June 06, 2016
    Patient safety

    Transparency Makes a Difference When Creating a Culture of Safety

    Have you ever made a mistake in nursing? Well, I have and want to share my experience, feelings, and outcome. When this happened, all that I kept thinking was, “Did I harm my patient?” Maybe that sounds familiar to you. I think we can all say that we went into nursing to help others, not harm them.
    June 06, 2016
    Patient safety

    Respecting Hazardous Drugs Protects Nurses, Patients and Eliminates Fear

    A recent article on the Scrubs website, “Chemotherapy Drugs are Killing Nurses” shared important facts and concerns regarding the handling of hazardous drugs. It also highlighted the need for comprehensive education and collaboration to establish a culture of safety around the use of these drugs by building respect, not fear, for hazardous drugs in the workplace.
    April 18, 2016
    Hazardous oncology drugs safe handling guidelines
    Policies and procedures

    New Hazardous Drug Safe Handling Guidelines May Require Changes for Your Practice

    Healthcare workers who prepare and administer hazardous drugs have further incentive to follow the recommended precautions with the February 1, 2016, release of the U.S. Pharmacopeial Convention Chapter 800. Find out more about these recommended precautions.
    March 01, 2016
    Understanding safe handling of oral agents
    Oral adherence

    No Ordinary Pill

    Oral agents are changing oncology treatment, and along with it, who’s responsible for the safety of those treatments. “With oral agents, the onus is now primarily on patients and their caregivers,” says ONS member Kathy Leifeste. This is quite a shift from the nurse-administered IV chemotherapy and biotherapy we’ve grown accustomed to.
    March 01, 2014
    Understanding oncology drug administration safety and efficicacy
    Clinical practice

    The Case of the Hyperthermic Hypodermic

    Erin arrives in your injection clinic for her monthly injection of fulvestrant. She tells you that her regular nurse always warms the drug before the injection by wrapping it in a warm pack because it lessens the discomfort during the injection. She says her nurse also told her it makes the medication easier to administer. What would you do?
    August 20, 2013
    Chemotherapy

    Risk of Miscarriage Is Increased for Nurses Handling Chemotherapy

    April 04, 2012
    Chemotherapy Administration in Non-Oncology Settings
    Chemotherapy

    Chemotherapy Administration in Non-Oncology Settings

    What has long been a role solely of oncol­ogy nurses is now being per­formed by nurses around the hos­pi­tal:
    April 01, 2012
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