Infusion Center Rotations Help Inpatient Oncology Nurses Maintain Chemo Competency
As chemotherapy administration shifts from the inpatient to outpatient setting, inpatient nurses may have fewer opportunities to develop and retain high levels of chemotherapy competency in their practice. During a poster session (https://ons.confex.com/ons/2024/cp/eposterview.cgi?eposterid=3139) on April 25, 2024, at the 49th Annual ONS Congress®, ONS members Heather Askren, DNP, NP-C, RN, OCN®, and Brittney Henady, BSN, RN, OCN®, described how (https://ons.confex.com/ons/2024/meetingapp.cgi/Paper/13691) their institution standardized care and helped maintain nurse competency throughout the hospital by assigning inpatient RNs to quarterly shifts at the outpatient cancer center.
For their project, Askren and Henady created a process for chemotherapy-trained inpatient RNs to work a quarterly eight-hour shift in an outpatient cancer center. The rotation allowed nurses to gain more experience and receive hands-on education on various topics, with each quarter highlighting a key topic:
- Extravasation
- Hypersensitivity
- Spill management
- Charting and patient education
To streamline planning, the quarterly shifts occurred on Mondays. On their assigned Mondays, each nurse first met with the oncology director or a nurse navigator for 30–45 minutes to review their patient assignment and protocol regimen and complete math checks. They also looked at that quarter’s education topic of focus with hands-on practice when possible. In addition, the outpatient clinic staff were available to answer inpatient RNs’ questions, show them where charting occurs, and locate policies and procedures.
After the intervention, nurses reported having greater confidence in managing the topics reviewed during their outpatient rotation, and Askren and Henady identified areas where staff demonstrated a need for further education. Nurses indicated a desire to learn more about laboratory tests, clinical trials, and management of disease progression treatment.
Although some inpatient nurses were initially hesitant about the rotations, after completing them they said that it “helped them feel more comfortable with inpatient chemotherapy administration.” The program has shown promise in addressing knowledge gaps and supporting nurse competency. In addition to extending the quarterly inpatient RN rotation project for another year, the researchers have started working with night-shift nurses on a yearly rotation.