Education of the Nurse Who Administers and Cares for the Individual Receiving Antineoplastic Therapies

Healthcare professionals who administer antineoplastic therapies (i.e. chemotherapy, targeted therapy, and immunotherapy) require specialized education and preparation. This education is needed to optimize safety and quality of care for patients receiving these therapies and to protect clinicians who are administering these therapies and working in settings where they are administered (Olsen et al., 2023). 

The Oncology Nursing Society (ONS), in collaboration with the American Society of Clinical Oncology, has defined safety standards of administration of antineoplastic therapies (Siegel et al., 2024). ONS defines the content to educate nurses who administer these therapies and care for patients receiving them (Olsen et al., 2023). This position statement describes ONS’s position on the postlicensure education and competency validation requirements for nurses administering antineoplastic therapies and caring for patients receiving them and applies to all routes of administration and indications for treatment. 

Although this position statement is reflective of the education and competencies of the post licensure nurse regardless of licensure or degree, it is ONS’s position that standards of education and competency for all interprofessional clinicians who administer antineoplastic therapies should be evidence based, current, and in alignment with the clinicians’ scope of practice and training.

It is the position of ONS that

• Institutional policies and procedures are developed for the roles, responsibilities, and oversight of administration of antineoplastic therapies using evidence from state nursing practice acts and current literature. 
• Educational programs for nurses administering antineoplastic therapies are comprehensive, evidence based, and appropriate for the nurse, patient population, and setting. Programs consist of didactic learning and a post-test validation of knowledge, followed by the successful completion of a clinical competency validation under the auspices of the nurses’ institution or supporting agency prior to the independent administration of these therapies. 
• Competency in antineoplastic therapy administration and monitoring is evaluated and validated annually. 
• Educational programs for nurses administering antineoplastic therapies for non-oncologic indications should include assessment and evaluation of key administration, patient management, and safe-handling principles. 
• The following content is included in all introductory programs developed for nurses administering antineoplastic therapies: 
  • Types of antineoplastic medications, classification of agents, and routes of administration 
    • Pharmacology of agent(s) being administered, regardless of indications for use 
    • Molecular biomarkers, including genomic assays pertinent to the treatment indication 
    • Chemotherapy and radiation therapy protectants 
    • Principles of safe preparation, storage, labeling, transportation, administration, and disposal of hazardous agents and supplies, including: 
      • Procedures for safe handling of hazardous drugs, including spill management 
      • Appropriate use and disposal of personal protective equipment 
      • Use of engineering controls, if applicable to practice setting 
      • Use of closed-system drug transfer devices 
      • Medication safety and system safeguards, such as infusion pump safety features 
  • Assessment, monitoring, and management of patients receiving antineoplastic therapy, including the supportive therapies that may be required as part of treatment 
  • Appropriate procedures for emergency preparedness, including infusion reactions, anaphylaxis, and extravasation 
  • Appropriate documentation of treatment administration, patient education, and coordination of follow-up care and testing 
  • Patient and family/caregiver education regarding plan of care and resources, specific to side effects and related symptom management, and urgent and ongoing follow-up 
  • Physical and psychosocial impacts of a cancer diagnosis, treatment, coordination of post-treatment care, and survivorship care

Approved by the ONS Board of Directors, 1992; revised July 1997, June 1999, November 2002, July 2005, October 2007, January 2011. Reviewed October 2012, January 2013, January 2014, January 2015. Revised April 2016, October 2017, August 2020, July 2024.

Download this position statement.

References

Olsen, M., LeFebvre, K.B., Walker, S.L., & Dunphy, E.P. (Eds). (2023). Chemotherapy and immunotherapy guidelines and recommendations for practice (2nd ed.). Oncology Nursing Society. 

Siegel, R.D., LeFebvre, K.B., Temin, S., Evers, A., Barbarotta, L., Bowman, R.M., . . . Olsen, M.M. (2024). Antineoplastic therapy administration safety standards for adult and pediatric oncology: ASCO–ONS standards. Oncology Nursing Forum, 51(3), 1–24. https://doi.org/10.1188/24.ONF.1-24.AP

Statement Type 

Education, Certification, and Role Delineation