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.
Should a Provider Be on Site During Chemotherapy Administration?
In clinics and oncology floors across the country, IV pumps are infusing, chemotherapy is administered through IV push, and nurses are moving swiftly from one patient to the next. Administering chemotherapy is a complex, in-depth procedure that requires training, education, and a level of experience beyond that of the standard healthcare professional. However, even the best oncology nurses need the support of their team members and the administration to provide the safest possible care environments for their patients.
What Precautions and Recommendations Are Necessary for Patients Receiving Oral Chemotherapy in the Home?
So far, 2017 has seen an incredible amount of U.S. Food and Drug Administration approvals for new agents and indications. Biotherapy and targeted agents represent many of the newly approved treatment options—a great deal of which are offered in oral form, increasing the opportunity for patients to receive treatment at home.
September Is Sepsis Awareness Month
As September winds down, ONS, a partner in the Centers for Disease Control and Prevention’s (CDC’s) and American Nurses Association’s Nursing Infection Control Education Network, is raising awareness of Sepsis Awareness Month by highlighting resources and strategies for oncology nurses who are deeply rooted in preventing and treating sepsis in patients with cancer.
How Did You Continue to Provide Cancer Care for Patients After a Natural Disaster?
When a severe tornado hit Joplin, MO, on the evening of May 22, 2011, the situation was serious. St. John’s Regional Medical Center in Joplin was hit so hard that it is still unusable. It needed to be evacuated, nearby Freeman hospital became quickly overwhelmed with patients, and the surrounding community prepared for action.
Cancer Care When Disaster Strikes
In the early hours of September 13, 2008, Hurricane Ike—a category 2 hurricane—hit Galveston Island, TX, bringing with it sustained winds of up to 110 miles per hour and storm surges reaching as high as 17 feet. By the next day, more than 200 shelters had opened across Texas to house the estimated 40,000 people who had been forced to evacuate from their homes.
Natural Disasters Take a Toll on Both Patients and Nurses, at the Cancer Center and at Home
I live in Middle Tennessee, an area that’s part of tornado alley, a pathway across central United States that has a higher incidence of tornadoes. We routinely prepare for the storms, listening for the tornado sirens whether at home or work. Although there have been a number of tornado touchdowns in our region in recent years, fortunately none have directly hit our healthcare facilities.
What Is ONS’s Perspective on the Ambulatory Staffing Dilemma?
Appropriate nurse staffing is only one of the critical factors that contribute to optimal patient outcomes and is as important as the systems, technology, and quality standards in any care setting. The relationship between poor staffing, daily variation in quality, and increased workload to increased care errors, missed care, and patient and nurse dissatisfaction is well described.
Time Is Short When Addressing Hypersensitivity Reactions to Chemotherapy
Between administering antineoplastic agents, monitoring patient vitals, and preparing patients for treatment, oncology nurses are required to balance their attention between many intricate tasks. Chief among the division of duties is that oncology nurses closely monitor their patients for hypersensitivity reactions (HSRs) to prescribed agents.
How Safe and Effective Is Scalp Cooling for Chemotherapy-Induced Alopecia?
Chemotherapy-induced alopecia has been reported by 77% of patients as the most-feared side effect of cancer treatment. In fact, as many as 10% of women say they would consider refusing chemotherapy or choosing a less effective treatment to avoid losing their hair.
Safely Provide Outpatient Care to Patients Receiving Hematopoietic Stem Cell Transplantations
High-dose chemotherapy with hematopoietic stem cell support is a well-established treatment for many hematologic malignancies. This treatment can be a difficult journey for patients and families. Historically, patients have been treated in a traditional hospital setting in anticipation of severe side effects, including mucositis, febrile neutropenia, thrombocytopenia, and pulmonary, renal, and hepatic complications. Patients can remain profoundly immunosuppressed for months while recovering from transplant. However, better supportive care in recent years has allowed many centers to move all or a portion of their transplant care into an outpatient setting.
Using Standards Balances Technology Advancements With Critical Thinking
Advancements in medical records technology provide safeguards and contribute to overall patient safety. However, consider the following treatment scenarios and how they may present opportunities for error and jeopardize patient safety.
Who Is Monitoring Your Infusions for Administration Safety?
Inquiries received in the ONS clinical inbox often ask about various responsibilities of nurses who hold an ONS chemotherapy provider card and have been deemed competent to administer cancer treatments within their practice setting.
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.
Raise Awareness in July for Ultraviolet Safety and Skin Cancer Risk
With summer in full swing, it’s the perfect time to head outdoors and enjoy the sunny weather. But are you protecting yourself from potential risks? The U.S. Department of Health and Human Services has named July as Ultraviolet (UV) Safety Month. The goal is to spread the word about how important it is to protect everyone’s skin from the harmful effects of UV rays. This presents a teaching opportunity for oncology nurses and their patients—not just during July but all year long.
CDC Warns Healthcare Workers of Emerging, Multidrug-Resistant Fungus
Candida auris is a multi-drug resistant yeast that is known to cause invasive infection and death. It first emerged in June 2016 and continues to present itself as a serious global threat. According to the Centers for Disease Control and Prevention (CDC), throughout 2017, healthcare facilities in multiple countries report serious illnesses caused by C.auris in hospitalized patients.
When Ineffective Pain Control Means Chemical Coping
Central to our role as oncology nurses is provision of symptom relief balanced with a manageable side-effect profile. Although opioids are extremely effective at cancer pain management, they also bind to the brain’s limbic system and can produce reward responses. This can result in dependence and drug-seeking behaviors.
Multidisciplinary Approach Is Useful for Radiation Safety Training
Tara Tatum, MBA, RN, and Stella Dike, MSN, RN, OCN®, both from the University of Texas MD Anderson Cancer Center, presented the findings during a poster session at the ONS 42nd Annual Congress in Denver, CO. The poster was titled “Radiation Safety Education: An Innovative, Multidisciplinary Approach to Enhancing the Knowledge and Skills of Oncology Nurses in an Inpatient Radiation Setting.”
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.
What Oncology Nurses Need to Know About Immunotherapy Agents
As immunotherapeutic options for cancer treatments continue to grow, oncology nurses need a deeper understanding of the therapies, how they work, and how to manage their side effects, so they can continue to provide the best patient care.
Mindfulness Meditation Can Improve Safety in Your Practice
Mindfulness meditation is a popular topic in the media now. Research has already demonstrated the clinical benefits of mindfulness-based stress reduction for patients with chronic pain or anxiety disorders. Although there’s been limited research about the benefits of mindfulness stress reduction for oncology nurses and their patients, some evidence suggests that engaging in mindfulness exercises could lead to a safer environment.
Competencies Create Expert, Accountable Nurses Delivering Quality Care
When the National Academy of Medicine, formerly the Institute of Medicine, released its 2010 report, The Future of Nursing: Leading Change, Advancing Health, it cited a need for improvement in nursing education and practice through the implementation of nursing competencies.
Decrease Hospital-Acquired Conditions Through Focused Patient Safety
Oncology nurses play a critical role in monitoring patient safety. Despite recent improvements in addressing safety gaps, estimates suggest that 1 in every 10 hospitalized patients will acquire a new condition during his or her stay. For patients with cancer—many of whom have weakened immune systems—hospital-acquired conditions could lead to severe quality-of-life issues or increased mortality rates.
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.
New Access Device Standards Will Help Improve Safety in Your Practice
Access devices have been used for decades to administer the complex treatments and supportive care that oncology nurses deliver daily to patients with cancer. As these devices and other products evolve, nurses need evidence-based methodologies for critiquing their safety and effectiveness.
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.
The Importance of Respiratory Protection for Oncology Nurses
Oncology nurses are at an increased risk of exposure to airborne hazards when they’re administering cytotoxic treatments and caring for immunosuppressed patients that are susceptible to resistant infections. Airborne transmission occurs through small particles or droplet nuclei that remain in the air for extended periods of time. Healthcare organizations are expected to provide sufficient respiratory protection for workers potentially exposed to infectious organisms and hazardous agents.
How Grief Can Impact Safety and Patient Outcomes
New Computing Technology Ensures Safety for Telemedicine and Telemonitoring in Oncology Care
Become a Champion of Safety Through Error Recognition and Reporting
Join the 2016 Chapter Challenge for Safety
Addressing the Challenge of CAUTI Prevention When Safety is at Stake
How Can You Achieve Safety Across Disciplines?
Safety Starts With You: Creating Your Own Culture of Safety
Reflecting on Medical Errors and Advocating for Change
Incorporating Advanced Practitioners Into Team-Based Oncology Care
Transparency Makes a Difference When Creating a Culture of Safety
Older Adults May Be Taking Dangerous Medication Combinations
Verification Nurses Identify Chemotherapy Order Errors and Improve Patient Safety
Respecting Hazardous Drugs Protects Nurses, Patients and Eliminates Fear
Celebrate Patient Safety Week
March 13-19, 2016 marks Safety Awareness Week. It encourages both patients and healthcare professionals to take a role in promoting patient safety. This is an appropriate message, because it takes everyone working together to make care as safe as possible for patients, families, and the healthcare professionals who provide this care.
New Hazardous Drug Safe Handling Guidelines May Require Changes for Your Practice
Recognizing Smart Catches All Day, Every Day
Evaluating Security in the Outpatient Setting
It has been a little over a year since cardiologist Dr. Michael J. Davidson, 44, was shot and killed at Brigham and Women's Hospital in Boston. He was murdered during the day by the son of a patient he treated who had died a few months prior to the shooting. I remember that day well. I was working in my clinic and all of us wondered, “How could this happen? And could it happen in our clinic?” I like to think that all of our patients and families are thankful and appreciative for all we do for them, but unfortunately that isn't always the case.
Using the I'M SAFE Method to Create a Culture of Safety
Fostering a Culture of Safety: Is Less Really More From the Patient Perspective?
There is currently a huge focus on patient safety. It's not just in the news and literature. It pervades the clinical environment. I'm currently spending my days between two major teaching hospitals and an outpatient cancer institute, all in Boston, MA. Some of the safety concerns I have encountered just in the past week include
What You Wear Matters When It Comes to Safety
“Hey, you didn’t dress up for me today. Where’s your pretty blue dress?”
At first I wasn’t sure what the patient in the chemotherapy chair was talking about. After a moment, I realized the patient was referring to the blue safety gowns we wear. I heard the infusion nurse respond as she removed the chemotherapy from the hazard bag, “Oh yeah, I’m kind of in a hurry today.”
While the patient could possibly benefit from the chemotherapy, for the nurse that same drug posed a serious hazard.