NEW YORK NURSE: June 2011
Q.: I am an RN working in an outpatient Medical-Oncology clinic. Often while working in the chemotherapy administration room, the physician tries to give verbal orders to adjust the chemotherapy dose, change administration times, add or delete pre-medications, etc. Are nurses allowed to take verbal orders for any aspect of the administration of chemotherapy?
A.: In 2008, the American Society of Clinical Oncology (ASCO) and the Oncology Nursing Society (ONS) initiated a collaborative project to develop standards for safe chemotherapy administration to adult cancer patients in the outpatient setting.
Suggestions regarding how to improve safety, reduce the risk of errors, and provide a framework for best practices were given. The plan was to increase the quality of chemotherapy administration through standardized approaches, the development of policies and procedures for system improvement, and the review of errors by an interdisciplinary, professional staff.
This collaborative group recommended that all chemotherapy orders must be in writing. A standardized, regimen-level, preprinted or electronic format should be used for all chemotherapy prescription writing for both oral and parenteral orders. It was suggested that faxed or e-mailed orders be considered written orders and that new orders or changes to existing orders must also be made in writing. Verbal orders are not allowed except when conditions require that the chemotherapy be either placed on hold or stopped.
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