ASCO/ONS Chemotherapy Safety Standards
ONS and the American Society of Clinical Oncology (ASCO) have collaborated to develop the first national standards for the safe administration of chemotherapy drugs, released in 2009, and focused on the adult population in the ambulatory setting. View the original published standards.
In 2011, a workgroup was convened to review feedback and revise the safety standards as needed. The scope has been extended to both the outpatient and inpatient settings. View the 2011 revised standards.
Background
In December 2008, the American Society of Clinical Oncology (ASCO) and the Oncology Nursing Society (ONS) held a workshop to develop consensus regarding standards for safe administration of chemotherapy to adult patients in the outpatient setting. Although relevant guidelines and policy statements exist (e.g., Controlling Occupational Exposure to Hazardous Drugs, Chapter 2: Safe Handling of Chemotherapy Drugs [OSHA]; Chemotherapy and Biotherapy Guidelines and Recommendations for Practice [ONS], Criteria for Facilities and Personnel for the Administration of Parenteral Systemic Antineoplastic Therapy [ASCO]), specific requirements to promote patient safety have not been well defined by key stakeholders. The complexity of administration of antineoplastic agents, and the potential safety issues involved, are unique to oncology care and require careful consideration.
Standards Development
ASCO and ONS convened a 40-member multidisciplinary workgroup representing diverse practice settings, including oncologists, nurses, pharmacists, social workers and practice administrators. View a complete list of workshop participants. Workshop participants drafted more than 60 initial standards based on the relevant literature, guidelines and practice. These draft standards were refined to prepare a version for public comment that are:
- focused on patient safety
- relevant to diverse outpatient practice settings providing chemotherapy to adult patients with cancer
- actionable, and
- measurable.
It is anticipated that the final standards will be useful for informing practice policies and procedures, internal quality assessment, and external quality monitoring.
Public Comment
The draft standards were posted for public comment from January 27, 2009 to March 13, 2009. All submitted comments were logged and used to select and refine the final standards set. Three hundred and twenty-two individuals responded to the public comment survey over the six-week period. Three hundred-twelve on the survey site and 10 by e-mail to ASCO or ONS directly. The public comment survey provided the text of the 34 standards, asked if the standard should be included in the final set, and provided a space for comments. Review the summary of the public comments.
Publication
The developmental process and final standards were published in the November, 2009 issue of the Oncology Nursing Forum and online in the Journal of Clinical Oncology. Online publishing of the final article was made available on September 28, 2009.
View the September 28, 2009 press release.
2011 Revision of the ASCO/ONS Chemotherapy Safety Standards
In January 2011, a workgroup consisting of ASCO and ONS members was convened to review feedback received since publication of the ASCO/ONS Standards for Safe Chemotherapy Administration and to clarify the Standards as needed. The most significant change to the Standards is the decision to extend their scope to the inpatient setting. This change reflects the conviction that the same standards for chemotherapy administration safety should apply in all settings.
The ASCO/ONS workgroup concluded that these patient safety standards should apply whether chemotherapy is administered in the outpatient or inpatient setting. They reviewed each standard in the context of an inpatient environment and determined such expansion of scope was feasible and appropriate. The revisions were again posted for public comment, and were passed by both the ONS and ASCO Board of Directors.
Publication of the revised standards became available online December 13, 2011, and the printed article in the January, 2012 editions of the Oncology Nursing Forum and the Journal of Oncology Practice. View the 2011 revised standards.
Implementation
To assist organization in the implementation of these standards, to review and develop needed policies and procedures, a guide has been made available on the ASCO website, at www.asco.org/safety.