The ASCO/ONS Chemotherapy Administration Safety Standards address creating a safe staffing environment, and state a licensed independent practitioner needs to be on-site and immediately available to staff who administer chemotherapy in the health care setting” 

The Center for Medicare and Medicaid Services (CMS) (Sauley, 2018) states that chemotherapy and radiation administration requires “direct supervision” CMS defines this as “the physician or advanced provider providing supervision must be immediately available and interruptible to provide assistance and direction throughout the performance of the procedure; however he or she does not need to be present in the room when the procedures is performed. 

ONS/ASCO standards (Neuss et al, 2017) also state that two chemotherapy competent professionals be present at the time administration is initiated in order to complete independent double checks of antineoplastic orders and administration settings.

References:

Neuss, M.N., Gilmore, T.R., Belderson, K.M., Billett, A.L., Conti-Kalchik, T., Harvey, B.E., . . . Polovich, M. (2016). 2016 updated American Society of Clinical Oncology/Oncology Nursing Society chemotherapy administration safety standards, including standards for pediatric oncology. Oncology Nursing Forum, 44(1), 31-43 https://onf.ons.org/onf/44/1/2016-updated-american-society-clinical-oncologyoncology-nursing-society-chemotherapy.

Saulet, D. (2018). The Advisory Board - “What you need to know about Medicare’s physician supervision requirements. Retrieved online from: https://www.advisory.com/research/oncology-roundtable/oncology-rounds/2013/01/what-you-need-to-know-about-medicares-physician-supervision-requirements