The following article features coverage from the National Association of Clinical Nurse Specialists (NACNS) 2018 Annual Conference in Austin, Texas. Click here to read more of Oncology Nurse Advisor‘s conference coverage. 

Clinical nurse specialists (CNSs) were able to locate instances of, and decrease, the variability of oncologic treatments administered among patients with cancer, according to findings presented at the National Association of Clinical Nurse Specialists (NACNS) 2018 Annual Conference.

Despite updated guidelines and improvements in safety standards, discrepancies in chemotherapy administration were found at different clinical sites even within the same institution. These differences lead to inconsistent treatment and may negatively affect outcomes among patients with cancer.

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For this initiative, a CNS-led interdisciplinary team analyzed the current institutional policies and practices at 1 of 5 hospitals in a health system, and performed a gap-analysis to identify variations in practice at inpatient and ambulatory settings. The interdisciplinary team implemented procedures to review and update current chemotherapy policies.

The data showed that there were variations in 5 different policies concerning oncologic therapy practice, including chemotherapy prescribing, preparation, and administration. The team also identified the use of 2 differing electronic medical records systems as a key factor in increasing the variability of practice between clinical sites.

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Results showed that clinical nurse specialists played a crucial role not only in identifying variations, but also implementing standards to reduce variation. The investigators concluded that “standardization of electronic medical record and policy can lead to reduction in variations in practice and ensure that chemotherapy administration occurs in a setting of safety and quality.”


Marvill C. Putting purpose into policy: a clinical nurse specialist-led initiative to reduce variation in chemotherapy practice. Oral presentation at: NACNS 2018 Annual Conference; February 28-March 3, 2018; Austin, TX.