Should a nurse be chemotherapy competent in order to administer antineoplastic therapies?

It is ONS's position that any nurse involved in the administration and care of a patient receiving antineoplastic therapies be deemed competent by their institutions to do so to ensure a safe level of care for patients receiving treatment and the clinicians administering the agents. The education program should encompass both didactic education and a clinical practicum. This is stated in the ONS (2020) position statement on the Education of the Registered Nurse who Administers and Cares for the Individual Receiving Antineoplastic Therapies. In this position statement, ONS does not differentiate between settings (oncology or non-oncology), indications, routes, or doses when advocating for practice standards related to antineoplastic administration. Each employer must determine how that would occur in their setting, based on the appropriate state rules and standards of practice.

In the ASCO/ONS Chemotherapy Administration Safety Standards, standard 3.18 notes: "Chemotherapy is administered by a qualified physician, physician’s assistant, registered nurse, or advanced practice nurse defined in standard 1.1. (Neuss et al., 2017, p. 36)" These standards, for the purposes of administration, do not delineate between IV and oral chemotherapy.

References:

Neuss et al., (2017). 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.

Oncology Nursing Society (2020). Education of the registered nurse who administers and cares for the individual receiving antineoplastic therapy. https://www.ons.org/make-difference/ons-center-advocacy-and-health-policy/position-statements/education-nurse-administers-antineoplastic-therapies