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Skill: Administration of Peripheral Cytotoxic Chemotherapy Area of Practice: Module and Status: Cancer Care WBL: Administration and Safe Handling of Cytotoxic Chemotherapy MANDATORY 3 Clare Dikken and Helen Evans – July 2005 Level: Author/date of origin: Author/date of review: Time estimate: Knowledge required related to skill (should know): Classify chemotherapy treatment aims for the regime specific to this skill Describe how cytotoxic drugs act at a cellular level and are classified for the regime specific to this skill Discuss rationale of administration of chemotherapy by different routes: intrathecal, oral, intravenous, topical, intra-arterial and intraperitoneal. Critically discuss the use of combination chemotherapy Discuss the importance of scheduling chemotherapy Discuss differences between monoclonal antibodies and traditional chemotherapy Identify how cytotoxic chemotherapy drugs are metabolised and by which route Discuss COSHH and relevant policies and how to manage adverse incidents in administration e.g. spillage, disposal, critical incident, extravasation, transport and storage of cytotoxic drugs Practice descriptor, i.e. can demonstrate skill used stating knowledge base and act appropriately at this level Awareness of health and safety issues of chemotherapy administration, including protective clothing, safe handling and waste disposal. Adheres to local policies. Assesses suitability of treatment for individuals Assesses suitability of veins for treatment Acts as patients advocate and communicates with other members of MDT as appropriate Obtains verbal informed consent Uses appropriate interpersonal skills during treatment administration Maintains comfort, dignity and consideration of the patient as an individual Discuss occupational health issues: pregnancy, exposure to cytotoxic chemotherapy Critically discuss the use of use of different cannula Identify vesicant chemotherapy agents and how to manage them (including order of drug administration) Demonstrate ability to distinguish between flare reaction and extravasation Discuss the role, accountability and responsibilities of the nurse in the administration of chemotherapy Discuss local and network chemotherapy policies Critically evaluates the impact of cancer services quality measures and the national cancer plan. Effectively assesses, plans, implements and evaluates care of the patient receiving chemotherapy. Ensures effective documentation adhering to NMC guidelines on Record Keeping Applies current research findings to the care of patients receiving chemotherapy Effective hand washing techniques Effective discharge or transfer of patient if appropriate Evidence of recent competence in IV drug administration and cannulation of veins Critically reflects on personal professional practice References: National Board for Nursing, Midwifery and Health Visiting for Scotland.2001.A core curriculum for the administration and safe handling of cytotoxic chemotherapy. Scotland: QA CPD. Sussex Chemotherapy Group 2002. The administration of IV cytotoxic therapies by registered nurses: A framework for training and practice in Sussex. Second edition. Chemotherapy Group, sussex cancer network.