The following article features coverage from ONS Bridge 2020. Click here to read more of Oncology Nurse Advisor‘s conference coverage.

 

Characteristics and outcomes associated with a new oncology nurse position that was established at an urban hospital with an inpatient oncology unit were described in a poster presentation on the Oncology Nursing Society (ONS) Bridge, a virtual conference.

Following the identification of barriers to effective chemotherapy delivery by chemotherapy nurses at this facility, including problems encountered with administering chemotherapy both on and off the oncology inpatient unit, as well as areas of noncompliance with safety guidelines, such as those outlined in the American Society of Clinical Oncology/Oncology Nursing Society (ASCO/ONS) chemotherapy administration safety standards,2 a full-time chemotherapy nurse was hired to focus solely on facilitating the safe, timely, and effective delivery of chemotherapy at this institution.

This full-time position, termed the “Chemo RN Consultant,” was described as being filled by a “chemotherapy competent nurse” who worked 7 days per week.

Of note, this nurse did not have their own patient assignments; rather their responsibilities were centered on “facilitating chemotherapy double checks and administering chemotherapy throughout the hospital, providing consultation to patients and non-chemotherapy-competent nurses, coordinating bone marrow biopsy and intrathecal chemotherapy procedures, and collaborating with multidisciplinary team members to facilitate care for the patient across the healthcare continuum,” explained the presenters.


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A comparison of chemotherapy-related outcomes for the year before (2017) and after (2018) filling the Chemo RN Consultant position revealed reductions of 62 minutes in the time needed to deliver intrathecal chemotherapy and 42 minutes in the time between the release of the chemotherapy order to initial administration.

Furthermore, there was a 2.5-fold increase in the number of hospital chemotherapy-related incident reports representing chemotherapy-related deficiencies in 2018 compared with those filed in 2017 due to the Chemo RN Consultant identifying chemotherapy errors and safety events. An additional increase in the number of these reports was noted during 2019.

Of note, the number of nurse-related chemotherapy errors decreased by approximately two-thirds from 2018 to 2019. 

In their concluding remarks, the presenters suggested that “implementing this position in other hospitals would improve the efficiency of chemotherapy administration and facilitate safety standards and policy compliance.”

References

1. Norton K, Illa C, Reuber L. Chemo RN consultant: improving the safety and efficiency of chemotherapy administration throughout the hospital. Presented at: ONS Bridge; September 8-17, 2020. Accessed September 10, 2020. https://ons.confex.com/ons/2020/qi/eposter.cgi?eposterid=765

2. Neuss MN, Gilmore TR, Belderson KM, 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;44(1):31-43.