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Inpatient chemotherapy administration

I am interested in knowing who administers inpatient chemotherapy at your hospitals, particularly smaller hospitals<150 beds. Our inpatient nurses claim they can not maintain competency for administration of chemotherapy regardless of what education they receive. There are discussions regarding the IV nurses or Oupatient Infusion Center nurses accepting responsibility for this and we are trying to get input on what others are doing. Thanks for any input.

I think your nurses are
I think your nurses are correct about not being able to maintain their competency. How many oncology patients require inpatient chemotherapy? With what frequency are these patients seen? How many nurses are you expecting to maintain this competency for these patients? I firmly believe that this is a practice that should be reserved for those with adequate knowledge, skill and expertise in the area. That does not encompass the entire nursing staff who may be starting peripheral IV catheters. Lynn

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257


Office Phone 770-358-7861

We are a small community

We are a small community hospital (320 beds) and my IV Team used to administer all the IVP chemotherapy while the floor RN's who had taken a chemotherapy class, had a didactic and return demo gave the continuous infusions.  It also became hard for the whole team to maintain competency.  Now we have traine a few floor RN's as above  (with representatives on each shift) and they give the IV push drugs.  We limited the number of floor staff trained, for the same reasons you question - any more and they would not have been able to maintain their competency.  This has worked quite well.  However, we are working with a consulting company on competency and they state chemo is just a med, and all nurses shold be competent in medication administration.  The competency comes from the difference in sending and accepting the medication from the pharmacy, from calculating the BSA and disposing of hazardous waste. 


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