ONS Connect - August 2008 - (Page 13)

Anna Vioral, MSN, RN, OCN®, worked with a multidisciplinary team to develop a safe-handling policy for her institution. tration on chemotherapy worksheets, maintain safe-handling guidelines, and recommend that patients are in private rooms. The other appendix is for agents that require safe-handling precautions but do not need the other requirements. Ensuring Compliance Through Education ONS member Marianne Casale, RN, MSN, CS, APN, C, AOCN®, an oncology clinical nurse specialist at Chester County Hospital in West Chester, PA, oversees her institution’s chemotherapy guidelines, ensuring that they are up to date and that they are being met by all staff handling hazardous agents. Casale uses a chemotherapy competency checklist to verify that the nurses are following the institution’s guidelines. She rotates to all shifts so she can update her staff with oncology information; she also ensures that healthcare providers in nononcology areas, such as registered dieticians, physical therapists, and case managers, are aware of and follow institutional policies for safe handling. In addition to monitoring the guidelines, Casale provides education on oncology and safe-handling topics. “I pick a new topic every three weeks and do about 25 in-services over that three-week period to give all shifts and other disciplines that are interested in learning about oncology the opportunity to attend,” Casale says. “We are achieving about a 97% attendance rate.” Casale also teaches the ONS Chemotherapy and Biotherapy Course twice a year for staff, and her facility is planning to offer the Oncology Core Curriculum, which is scheduled to be presented over the next two and a half years. Not only do nurses have access to in-service education in the workplace, August 2008 ONS CONNECT or emergency department, if warranted, and they file a medical report for their records,” Vioral says. The medical surveillance policy is based on national recommendations and ONS and CDC guidelines. The multidisciplinary task force is currently recommending policy changes to offer free complete blood counts and urinalysis at least yearly for employees who routinely mix and administer hazardous agents. Vioral emphasizes that staff education on safe handling precautions occurs at the time of hire for every employee to AGH and annually thereafter. The oncology staff and those administering chemotherapy and hazardous agents receive additional chemotherapy competency education every other year. In addition, employees exposed to hazardous agents are monitored through random observations and audits for compliance. “Maintaining guidelines and a safe environment across our large institution is the biggest challenge,” says Vioral. Other issues she faces are determining and approving which agents are hazardous and keeping staff up to date on safe-handling precaution requirements. Compliance regarding the administration and disposal of oral agents has become challenging because those agents are now being administered not only in oncology but also in other departments at the hospital. To best address these concerns, the hospital has two separate safe-handling medication appendices. One is for agents that require a double check by two chemotherapy-certified RNs; the nurses must record the adminis- 13

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ONS Connect - August 2008 Contents Editor's Note Just In Safe Handling of Chemotherapy A Year in the Life—Month Eight Put Evidence Into Practice to Manage Dyspnea Web Connect Capitol Connection Notice Nursing Now Caregiver Care KRAS Status Predicts Response to Cetuximab for Metastatic Colorectal Cancer Calendar of Events Working for You Staying on Top

ONS Connect - August 2008

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