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Administering Chemotherapy for Non-Oncologic Indications Karen A. Roesser RN, MSN, AOCNS Thomas Johns Cancer Hospital, Richmond, VA ONS Position on the Education of the Nurse who Administers Chemotherapy & Biotherapy Specialized education and preparation to ensure safe level of care Education to include: Principles of cancer chemotherapy and biotherapy Types, classifications, and routes Pharmacology of agents in cancer care Chemo/biotherapy indications in cancer care Pertinent molecular biomarkers Chemotherapy/radiotherapy protectants Principles of safe preparation, storage, labeling, transportation, and disposal ONS Position Statement on Education (cont.) Personal protective equipment Administration procedures including administration schedule, dose, route; patient consent, and documentation Process to ensure patient safety Assessment, monitoring, and management of patients in all care settings Patient/family education on side effects and symptom management Post-treatment care including urgent f/u procedures, late or long-term side effects Followed by clinical practicum ONS, 2012 ONS Treatment Basics Course (2010) Antineoplastic Therapy in the NonOncology Setting Increase understanding of use of chemotherapy in non-oncologic (largely autoimmune) settings Mechanism of action Indications Dose Side effects Nursing considerations Treatment Basics Course (cont.) Administration Safe-handling Symptom management Four hour course (no clinical practicum) Chemotherapy/biotherapy trainers may become Treatment Basics trainers (online course) ONS Chemo/Biotherapy Trainer’s Survey Question Answer Settings Med/Surg,Interventional Radiology, Emergency Department Agents Methotrexate, Rituximab, & Cyclophosphamide Non-oncologic diseases Rheumatoid arthritis, ectopic pregnancy, ITP Routes Oral, IV, SC/IM, intravesicular (bladder) Treatment Basics Trainer Yes-336 No-790 Treatment Basics Training 2010 2011 2012 Number of Trainers 85 108 264 Number of courses 63 116 94 Number of students receiving CNE 535 798 802 Future Plans for Revisions to Treatment Basics Course Chemo/biotherapy to non-onc patients Increased focus on specific treatment for specific diseases May pick and choose various modules based on audience Will mirror ONS Chemotherapy/Biotherapy online course How to Safely Administer Chemotherapy for Non-Oncology Indications ONS chemotherapy-competent nurse to administer Education provided to non-oncology nurse Treatment Basics Course Development of course at institution which includes components of ONS position statement Develop policy which incorporates above Plan for administration component and maintaining competency