ASCO/ONS Chemotherapy Standards

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 2013 standards.

View the 2011 revised standards.

View the original 2009 standards.

2015 Draft Standards Open for Public Comment Until January 13, 2016

The ASCO/ONS Chemotherapy Administration Safety Standards continue to evolve. In 2015, the revision represents collaboration with the American Society of Pediatric Hematology/Oncology (ASPHO) and the Association of Pediatric Hematology/Oncology Nurses (APHON) to incorporate safety issues faced in pediatric oncology. Additionally, the 2015 standards have been revised and reformatted into four domains, addressing different aspects of chemotherapy delivery, and the glossary has been expanded, providing definitions to add clarification to the statements.

The 2015 draft standards will be available for public comment until January 13, 2016. Download the draft standards and glossary to review prior to entering the survey. Each proposed standard will be reviewed for applicability to practice and the ability to be implemented consistently. Comments are greatly encouraged, and will be taken through the comment survey until January 13, 2016. A crosswalk has been created to compare the two versions of the 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.


To assist in the application of these standards and to aid your institution in reviewing and developing its policies and procedures, the ASCO website contains a guide to implementation.

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 (Second 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.