JL515. Intra-Professional Collaboration for Safe Chemotherapy Administration
Stephanie L. Jackson, MSN, RN, AOCNS®, BMTCN, Ronald Reagan UCLA Medical Center, Los Angeles, California
© 2018 Harborside™
JADPRO Live at APSHO 2017
Marriott Marquis, Houston, Texas • November 2–5, 2017
The posters for the abstracts below can be found at:
Background: With continuous advancements in science, technology, and medicine, surgical patients are offered increasingly complex treatment options including intraoperative administration of chemotherapy. The expanded use of cytotoxic medications across multiple surgical specialty services in the operating room lead to a need to standardize practices related to chemotherapy administration and safe handling practice. A collaborative group of advance practice nurses created an evidenced-based standard of practice to ensure optimal patient outcomes and a safe practice environment.
Methods: Based on a review of the literature, the Oncology Nursing Society (ONS) standards and National Institute of Occupational Safety and Health (NIOSH) regulations, a comprehensive evidence-based standard of practice for safe intraoperative chemotherapy administration and handling was developed. The clinical improvements specifically focused on in-suite preparation and administration of chemotherapy, correct use of approved chemotherapy-rated personal protective equipment, exposure and spill management, and contaminated waste and instrument handling. In addition, processes were developed for documentation of intraoperative verification of these high-risk medications, as well as formalized communication of chemotherapy precautions during the handover transfer report. Because different levels of knowledge produce variations in practice, educational in-services were provided to the perioperative nurses and surgical technologists. To further support the clinical staff’s understanding of the bundled practice change, this information was reinforced by developing a competency assessment tool; incorporating the content into skills day; revising the electronically accessible policy and procedure; protocol development; and highlighting critical elements in the service-specific doctors’ preference cards.
Conclusions: An evaluation based on the Likert scale was given to the nurses as well as surgical technicians after their skills lab. Ninety percent of the staff felt the competency training was very valuable and 10% felt it was valuable. Quarterly needs assessments are provided to the staff to sustain their knowledge and hands-on competency.
Recommendations: The perioperative nursing practice implications have been knowledge enhancement, increased confidence in professional practice, and promotion of value through reducing redundancy in efforts and workflow. Through re-evaluation of the standard of practice and clinical staff feedback, we were able to evaluate compliance, sustainability, and furthermore, identify opportunities for additional innovative processes related to chemotherapy safety in the operating room. As the field of oncology continues to grow and expand, it is inevitable that non-oncology nurses acquire the skill set to assess, monitor, and evaluate the oncology care provided to patients under their clinical care.
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