ASCO/ONS Chemotherapy Administration Safety Standards

The American Society of Clinical Oncology (ASCO) and ONS are conducting an ongoing collaborative project to use a rigorous, consensus-based process to develop standards for the safe administration of chemotherapy. Current ASCO/ONS standards address the safety of all routes of chemotherapy administration to adult patients in the outpatient and inpatient settings.

The ASCO/ONS Chemotherapy Administration Safety Standards are intended to reduce the risk of error when providing adult patients with chemotherapy, and to provide a framework for best practices in cancer care. Your institution can use them to inform practice policies and procedures, internal quality assessment, and external quality monitoring.

View the 2016 standards.

View the 2013 standards.

View the 2011 revised standards.

View the original 2009 standards.


In December 2008, ASCO and ONS held a workshop to develop a consensus regarding standards for the safe administration of chemotherapy to adult patients in the outpatient setting. Although relevant guidelines and policy statements existed (e.g., OSHA's Controlling Occupational Exposure to Hazardous Drugs, Chapter 2: Safe Handling of Chemotherapy Drugs, the ONS Chemotherapy and Biotherapy Guidelines and Recommendations for Practice, ASCO's Criteria for Facilities and Personnel for the Administration of Parenteral Systemic Antineoplastic Therapy), specific requirements to promote patient safety had 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.


A description of the ASCO/ONS Chemotherapy Administration Safety Standards process for development, consensus, and refinement, as well as a discussion of the standards and results, is available on the ASCO website.

Related Resources

  • Medical surveillance programs are recommended to detect changes in the health status of those working with hazardous drugs. By using a thorough medical and occupational history questionnaire, you will gain a cost-effective way of monitoring employee health over time. In Safe Handling of Hazardous Drugs (Fourth Edition), ONS provides a sample medical surveillance questionnaire that you can adapt to your healthcare setting. Keep in mind that the questionnaire should be reviewed with workers to clarify and expand on responses that may impact their health.
  • Download Personal Protective Equipment for Use with Hazardous Drugs as a resource to help select PPE. This resource has been developed through a collaboration of the American Society of Clinical Oncology, American Society of Health System Pharmacists, Association of Community Cancer Centers, Association of Pediatric Hematology/Oncology Nurses, Hematology/Oncology Pharmacy Association, and the Oncology Nursing Society.

ONS Symptom Interventions and Guidelines

Summaries of evidence and recommendations for the management of cancer-related symptoms and treatment side effects to improve patient outcomes and optimize clinical care delivery.

View All Symptom Interventions and Guidelines