Does a physician or advanced practice provider need to be on site when antineoplastics are being administered?

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 healthcare setting (Neuss et al., 2016). 

The Centers for Medicare and Medicaid Services state that chemotherapy and radiation administration require direct supervision. 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 in the room when the procedure is performed (Saulet, 2018).

ONS/ASCO standards (Neuss et al., 2016) also state that two chemotherapy-competent professionals be present at the time administration is initiated 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 from https://www.advisory.com/research/oncology-roundtable/oncology-rounds/2013/01/what-you-need-to-know-about-medicares-physician-supervision-requirements