The standardized procedure depicted deals with the administration of chemotherapy to cancer patients in a manner that is in accordance with the CA State Medical Board and the Board of Nurses. In developing such standards, registered nurses are allowed the capacity to hone their administering skills and keep up to date on training and education. In addition, such a standard provides patients with the assurance that their care is being handled in a manner that is both respectful of their own case. In administering such drugs, nurses act in accordance with the standards at hand as well as in conjunction with the patient's physicians in order to ensure the best possible care and results.
Standardized Nursing Procedure
Infusing Chemotherapy Procedure
INFUSING CHEMOTHERAPY PROCEDURE FOR REGISTERED NURSES
IN THE STATE OF CALIFORNIA
INFUSING CHEMOTHERAPY PROCEDURE
Methods and Development:
In developing a functional standardized procedure for the infusing of chemotherapy in accordance with the Medical Board of Ca., Title 16, CCR Section 1379 and Ca. Code of Regulations, the following method has been established in order to ensure the administration of chemotherapy to cancer patients by registered nurses who meet the strict standards depicted in the following procedure in terms of education, respect, quality control, and accuracy. In ensuring patients that their chemotherapy will be administered in accordance with a standard of procedure that meets not only the aforementioned board regulations, but that of the Board of Nursing, patients have the capacity to undergo treatment in a mindset of reassurance and comfort in a difficult time.
Procedure:
(1) Specify which standardized procedure functions registered nurses may perform and under what circumstances.
Wash hands
Put on sterile gloves before hanging chemotherapy
Ensure sterile gloves have been tested and are safe using when handling chemotherapy agents
Pharmacy will spike the chemotherapy and prime the tubing
Discard the gloves in the container designated for chemotherapy waste
Determine and verify the route of administration (IVP, IV infusion) of the chemotherapeutic agent
All continuous infusions classified as vesicants must be administered via a central line (UCHC, 2010, p.4)
Non-vesicants may be administered peripherally (UCHC, 2010, p.4)
Hang the chemotherapeutic agent and infuse via central or peripheral line at a rate indicated by physician and documented in physician's orders
Each chemotherapy agent requires separate IV tubing, and two should never be administered through the same tubing unless specifically ordered by the physician (UCHC, 2010, p.4).
Use new tubing with each dose of chemotherapy
Monitor patient
Monitor in terms of side-effects, effectiveness of pre-chemotherapy medications, hydration, and overall patient stability and safety (LSUHSC, 2009, p.1).
Upon completion, discard waste in waste-safe receptacles
(2) State any specific requirements which are to be followed by registered nurses in performing particular standardized procedure function
Specifications should be followed as per instructions in patient's chart dictated by the administering physician or physicians
(3) Specify any experience, training, and/or education requirements for performance of standardized procedure
In performing the procedure at hand, certain experience levels, training, and education are to be required for the performance of standardized procedure functions.
Current Registered Nurse License (LSUHSC, 2008, p1.)
Completion of Oncology Nursing Society's Chemotherapy and Biotherapy Certification Course (UCHC, 2010, p.2).
(4) Establish a method for initial and continuing evaluation of the competence of those registered nurses authorized to perform standardized procedure functions.
Complete continued chemotherapy administering training and ongoing education
(5) Provide for a method of maintaining a written record of those persons authorized to perform standardized procedure functions.
Completion of the chemotherapy administration check list and return demonstration will be maintained by the HHS Education Department or in their personnel file. A copy of the document action will be given to the RN for their file (HHS, 2001, p.8).
(6) Specify the scope of supervision required for performance of standardized procedure functions, for example, immediate supervision by a physician.
No supervision required upon completion of training and educational coursework
(7) Set forth any specialized circumstances under which the registered nurse is to immediately communicate with a patient's physician concerning the patient's condition.
Shortness of breath
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