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July 2010, Volume 40 Number 7 , p 44 - 47


  • Catherine C. Simmons MSN, RN, CNS, OCN


AS MORE CHEMOTHERAPY drugs become available in oral form, many nurses outside oncology units are administering them to patients. Yet nurses on general nursing units may have had little education on how to handle and administer antineoplastic medications safely.If continually exposed to these hazardous drugs without taking proper precautions, nurses may experience toxic effects ranging from contact dermatitis to liver damage, spontaneous abortion, or respiratory tissue damage.1 This article reviews how nurses can protect patients and themselves by learning and following safety standards for oral chemotherapeutic drugs.By one estimate, as many as 25% of all new chemotherapy drugs being developed will be provided in oral form.2 These drugs may be given on general nursing units for two reasons. In one instance, a patient who has a chronic cancer condition comes into the hospital for an unrelated problem and continues to receive oral chemotherapy for cancer. In the second, a patient is receiving an antineoplastic drug for a condition other than cancer, such as rheumatoid arthritis or sickle cell disease.No matter what the patient's clinical status or the drug administration route, antineoplastic drugs must be given in accordance with facility policies and procedures, which are based on professional standards and guidelines outlined by oncologists, pharmacists, and cancer nursing experts. These should be consistent with federal and state standards and guidelines established by organizations such as the National Institute for Occupational Safety and Health and the Oncology Nursing Society (ONS).3,4Facility policy should specify that only nurses who know indications and contraindications for various antineoplastic drugs and who have the education and training to handle them safely and assess and manage adverse reactions should administer these drugs.5 And only oncologists or (as some facility's policies may allow) healthcare providers within their own specialties

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