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
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Specialized education and preparation
to ensure safe level of care
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Education to include:
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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.)
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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
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Mechanism of action
 Indications
 Dose
 Side effects
 Nursing considerations
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Treatment Basics Course (cont.)
Administration
 Safe-handling
 Symptom management
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Four hour course (no clinical
practicum)
 Chemotherapy/biotherapy trainers
may become Treatment Basics
trainers (online course)
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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
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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
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ONS chemotherapy-competent nurse to administer
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Education provided to non-oncology nurse
 Treatment Basics Course
 Development of course at institution which
includes components of ONS position statement
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Develop policy which incorporates above
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Plan for administration component and
maintaining competency