What are the responsibilities of the Nurse when administering cancer therapy?

From Cancer Guidelines Wiki

Introduction

The nurse is responsible for the safe and appropriate administration of cancer therapy medications (chemotherapy, biological therapy, targeted therapy and associated supportive medications) in accordance with legislative requirements, national standards and local policy. The nurse is responsible for ensuring the protocol and prescription is reviewed, the patient has received appropriate education and information on therapy and that protocol stated patient assessments are performed prior to administration of therapy.

This section defines responsibilities of the nurse when administering cancer therapy to a patient. It does not include self-administration by the patient.


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Evidence Summary

The nurse forms the last link in the chain of responsible healthcare providers in the provision of cancer therapy and thus offers a final opportunity for detection of error and support of patients before administration of therapy commences.[1]

Guidelines define the role and scope of the nurse when administering cancer chemotherapy, targeted therapy and supportive medications for patients with cancer.[1][2] The roles, responsibilities and expectations of nurses in the multidisciplinary team should be defined locally and should clarify how each discipline will communicate and work collaboratively with respect to providing cancer therapy.[1]


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Recommendations

Consensus-based recommendationQuestion mark transparent.png

The nurse is responsible for ensuring:

  • Family, carers or others are adequately informed about the treatment and administration process. Education and information should be based on the patient’s reading level and literacy and level of understanding of information provided (Neuss et al, 2017).
  • Patient education and consent processes have been completed and documented according to local institute requirements.
  • The planned treatment is verified with the patient and understood by them (Neuss et al, 2017).
  • All medication is stored appropriately prior to administration.
  • Independent verification of the medication order (including chemotherapy, targeted therapy and supportive medication) according to the protocol, the patient’s treatment plan, patient laboratory parameters and other individual parameters.
  • The therapy and associated treatments are administered to the patient in a safe and timely manner.
  • Any immediate and longer term effects are appropriately managed.
  • All professional and legal responsibilities with respect to administration of medications are met.

(Neuss et al, 2017)[3]


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References

  1. 1.0 1.1 1.2 Goldspiel B, Hoffman JM, Griffith NL, Goodin S, DeChristoforo R, Montello CM, et al. ASHP guidelines on preventing medication errors with chemotherapy and biotherapy. Am J Health Syst Pharm 2015 Apr 15;72(8):e6-e35 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/25825193.
  2. Carrington C, Stone L, Koczwara B, Searle C, Siderov J, Stevenson B, et al. The Clinical Oncological Society of Australia (COSA) guidelines for the safe prescribing, dispensing and administration of cancer chemotherapy. Asia Pac J Clin Oncol 2010 Sep;6(3):220-37 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/20887505.
  3. Neuss MN, Gilmore TR, Belderson KM, Billett AL, Conti-Kalchik T, Harvet BE, et al. 2016 Updated American Society of Clinical Oncology/Oncology Nursing Society Chemotherapy Administration Safety Standards, Including Standards for Pediatric Oncology. Oncol Nurs Forum 2017 Jan 6;44(1):31-43 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/28067033.

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