October 5, 2009 — National standards for safe administration of chemotherapy drugs in the outpatient setting have been issued for the first time in the United States.

Details are outlined in a paper published online September 28 in the Journal of Clinical Oncology.

"Because of the complexity of chemotherapy administration and the risk of severe adverse effects, standardizing care in settings where chemotherapy is delivered is essential," the authors write.

The new standards, compiled by the American Society of Clinical Oncology (ASCO) and the Oncology Nursing Society (ONS), aim to reduce the risk for errors and provide a framework for best practices in cancer care.

Both societies have also developed additional materials to assist in the implementation of the new standards (available online at www.asco.org/safety and www.ons.org/clinical). These guides should help oncology practices review and develop the policies and procedures needed to adhere to the new standards, they add.

"Administration of chemotherapy is a complex process, and safety challenges will only grow as the number and complexity of chemotherapeutic regimens increase and as oral chemotherapy drugs become more commonplace," lead author Joseph Jacobson, MD, said in a statement. Dr. Jacobson is the immediate past president of ASCO's Quality of Care Committee, and chair of the Department of Medicine at the North Shore Cancer Center in Salem, Massachusetts.

The new standards were developed by a multidisciplinary workgroup made up of oncologists, nurses, pharmacists, social workers, practice administrators, and patient advocates. A draft of the document was made available for comment for 6 weeks, during which time more than 300 comments from members of the public were submitted.

Electronic Records May Improve Safety

ASCO and ONS recommend increased use of electronic medical record systems, which they believe might improve safety and quality of outpatient chemotherapy administration. E-prescribing, for example, could prove to be a tool for reducing errors in chemotherapy ordering, because automated systems can reduce errors in regimen selection in a busy clinical setting, the authors explain.

"By automating processes related to prescribing and administering chemotherapy, safety checks can be built in along the way," said Marty Polovich, MN, RN, AOCN, cochair of this project and second author on the paper.

"However, we don't believe that patient safety has to wait for electronic systems," she added. "Implementing these standards is a step toward ensuring that patients receive their anticancer therapies as intended, no matter the type or size of setting in which they are treated."

J Clin Oncol.Published online September 28, 2009. Abstract