ALEXANDRIA, Va. – Today, in a major step toward ensuring high-quality care for people with cancer, two major medical associations are releasing the first-ever national standards for safe administration of chemotherapy drugs. These policies seek to serve as a benchmark for providers of adult cancer care and encourage them to evaluate their current standards.
The American Society of Clinical Oncology (ASCO) and the Oncology Nursing Society (ONS), which represent doctors and nurses who treat people with cancer, developed the standards to reduce the risk of errors and provide a framework for best practices in cancer care.
More than 60 percent of people diagnosed with cancer receive chemotherapy at some point during their treatment, and patient safety is a top priority for oncology professionals. Despite a body of studies on chemotherapy administration, however, few national standards for patient safety have been developed.
“Administration of chemotherapy is a complex process, and safety challenges will only grow as the number and complexity of chemotherapeutic regimens increases and oral chemotherapy drugs become more commonplace,” said Joseph Jacobson, MD, lead author of the Journal of Clinical Oncology (JCO) article highlighting the standards and Immediate Past Chair of ASCO’s Quality of Care Committee. “Adhering to standards for safe chemotherapy administration should be a goal of all cancer care providers.”
The 31 standards issued by ASCO and ONS cover a range of processes related to chemotherapy, including:
• Staff education and training.
• Chemotherapy ordering, preparation and administration.
• Patient education and informed consent.
• Assessing how patients respond to treatment.
• Monitoring toxicity of the treatment to the patient.
In order to avoid chemotherapy administration errors, ASCO and ONS state that practitioners must follow standardized approaches for chemotherapy delivery, develop and follow policies and procedures for system improvement, and undertake a multi-disciplined review of errors when needed.
ASCO and ONS also recommend increased use of electronic medical record systems, which may lead to improvement in the safety and quality of outpatient chemotherapy administration. E-prescribing, for example, may prove to be a tool for reducing errors in chemotherapy ordering, as automated systems can reduce errors in regimen selection in a busy clinical setting.
“By automating processes related to prescribing and administering chemotherapy, safety checks can be built in along the way,” said Marty Polovich, MN, RN, AOCN®, co-chair for this project. “Oncology nurses are committed to improving the safety of chemotherapy administration; however, we don't believe that patient safety has to wait for electronic systems. Implementing these standards is a step toward ensuring that patients receive their anticancer therapies as intended, no matter the type or size of setting in which they are treated.”
ASCO also has developed a guide, available online at www.asco.org/safety, to help oncology practices review and develop policies and procedures needed to adhere to these chemotherapy safety standards.
In developing the standards, ASCO and ONS convened a multidisciplinary workgroup made up of oncologists, nurses, pharmacists, social workers, practice administrators and patient advocates late last year. Using a defined consensus process, the workgroup participants drafted and prioritized a set of standards based on relevant literature, guidelines and practice. The draft standards were made available for public comment for six weeks. More than 300 public comments were submitted and used to finalize the 31 ASCO/ONS standards.
"American Society of Clinical Oncology/Oncology Nursing Society Chemotherapy Administration Safety Standards," by Joseph O. Jacobson, et al.
This article is being published in the September 28 issue of the Journal of Clinical Oncology (JCO), the semi-monthly peer-reviewed journal of the American Society of Clinical Oncology (ASCO), the world’s leading professional society representing physicians who treat people with cancer, and the November issue of the Oncology Nursing Forum, the journal of the Oncology Nursing Society.
For a copy of the standards and available supplemental materials, visit www.asco.org/safety.
The American Society of Clinical Oncology (ASCO) is the world’s leading professional organization representing physicians who care for people with cancer. With more than 27,000 members, ASCO is committed to improving cancer care through scientific meetings, educational programs and peer-reviewed journals. For ASCO information and resources, visit asco.org/presscenter. Patient-oriented cancer information is available at www.cancer.net.
ONS is a professional organization of more than 37,000 registered nurses and other health care professionals committed to excellence in oncology nursing and to leading the transformation of cancer care by initiating and actively supporting educational, legislative, and public awareness efforts to improve the care of people with cancer. ONS provides nurses and healthcare professionals with access to the highest quality educational programs, cancer care resources, research opportunities, and networks for peer support. Learn more at www.ons.org.