In response to the ever-changing practice of cancer care, in May 2024, the American Society of Clinical Oncology (ASCO) and ONS released updates to their administration safety standards to provide clarification and guidance for oncology healthcare professionals. Here’s what you need to know about the changes as an oncology nurse.

Patient navigation has the potential to improve patient satisfaction, reduce health disparities, and ultimately optimize cancer outcomes. However, navigation services are often funded externally through grants or considered unreimbursed administrative costs because of lack of reimbursement. In January 2024, the Centers for Medicare and Medicaid Services (CMS) established its first coding and payment for principal illness navigation (PIN) services. CMS said that funding the services would improve health equity in patients with serious, high-risk conditions such as cancer.

Patients with cancer, especially those from underrepresented groups or who are experiencing racism, inequalities, social determinants of health factors, and other barriers to care, need oncology nurse navigation now more than ever before. Developed as a “strategy to improve outcomes in marginalized populations by eliminating barriers to timely diagnosis and treatment of cancer and other chronic diseases,” navigation has made a difference for patients since its introduction in 1990.

Today, six oncology-focused professional and patient organizations, including the Oncology Nursing Society (ONS), published standards for use in oncology navigation care. With input from many major navigation-focused disciplines, the standards guide best practices for care providers across cancer settings.

Oncology nurses are critical to meeting three components of the newly revised Commission on Cancer (CoC) standards released in fall 2019: certification, survivorship, and barriers to care.

The Commission on Cancer (CoC), an organizational consortium of which ONS is a governing member, provides standards for cancer programs to follow to achieve a high level of continuous quality improvement. Last updated in 2016, the standards are currently undergoing analysis and revision, and CoC is seeking public comments until June 3, 2019.

To ensure that the Oncology Nursing: Scope and Standards of Practice are consistent with overall nursing standards and to increase the visibility of the oncology nursing standards in the greater nursing and healthcare communities, ONS released an updated version of its reference book in March 2019. The American Nurses Association (ANA) recognizes oncology nursing as a nursing specialty, and the new edition carries ANA’s approval of the oncology nursing scope of practice and acknowledgement of the oncology nursing standards of practice.

To meet or maintain Magnet designation, the American Nurses Credentialing Center (ANCC) Magnet Recognition Program expects organizations to incorporate specialty standards and guidelines into the care delivery system. 

Standardized surveillance recommendations may be too short for patients with ovarian cancer and too long for other gynecologic cancers, according to findings from a study presented at the 2018 Society of Gynecologic Oncology Annual Meeting on Women’s Cancer.

Informed consent is a comprehensive process as opposed to a check mark on a list of tasks to complete prior to starting cancer therapy. The American Society of Clinical Oncology/ONS Chemotherapy Administration Safety Standards explain that informed consent provides a patient with “sufficient information about the disease diagnosis and treatment options so that the individual can make a reasonable decision about treatment on the basis of an understanding of the potential risks and anticipated benefits of the treatment.”

Which of the following is NOT an ASCO/ONS Chemotherapy Administration Safety Standard?

A. Chemotherapy orders include sequencing of agents, when applicable.  

B. A licensed independent practitioner is on-site and readily available to staff where chemotherapy is administered.

C. Two chemotherapy-competent RNs must be in the infusion area at all times when chemotherapy is infusing.  

D. If chemotherapy is administered in a non-healthcare setting, a second identifier such as a driver’s license, is used to verify the patient’s identity.  

More than a decade ago, the National Academy of Medicine first proposed that “all patients should be given a comprehensive summary and a clear explanation of the details of their cancer therapy as well as recommendations for necessary follow-up.” This seemingly simple task has proved difficult to deliver in many cancer care settings.

Preventing a cancer diagnosis is the most surefire way to survive it. However, the public and news media communicate more about emerging treatments and newly approved oncology drugs and less about ways people can take steps to prevent cancer before it starts. Oncology nurses have a role and obligation to spread public health education and an attention to disease prevention, so many Americans change risky habits that would otherwise lead to future cancer diagnoses.

In clinics and oncology floors across the country, IV pumps are infusing, chemotherapy is administered through IV push, and nurses are moving swiftly from one patient to the next. Administering chemotherapy is a complex, in-depth procedure that requires training, education, and a level of experience beyond that of the standard healthcare professional. However, even the best oncology nurses need the support of their team members and the administration to provide the safest possible care environments for their patients.

Implanted ports are an important lifeline for patients receiving antineoplastic treatments; however, despite vast nursing research on the maintenance and utilization of venous implanted ports, still so much remains to be learned. Many of the practices surrounding implanted ports remain controversial.

Advancements in medical records technology provide safeguards and contribute to overall patient safety. However, consider the following treatment scenarios and how they may present opportunities for error and jeopardize patient safety.

As healthcare institutions are looking to adopt new technologies to better assist patients, telehealth is becoming a prominent resource for many practitioners. By providing the ability to call or video conference with healthcare providers, institutions can offer patients the care they need from the comfort of their own homes.

Beginning in January 2018, oncology nurses will see changes to the way their patients’ cancers are staged with the American Joint Committee on Cancer (AJCC) system. According to a presentation at the National Comprehensive Cancer Network annual conference in March 2017, when the AJCC 8th Edition Cancer Staging System takes effect on January 1, 2018, more cases may be classified as stage I, especially for patients with breast cancer.

The ONS Oncology Nurse Generalist competencies define the fundamental knowledge, skills, and abilities that nurses new to oncology practice should develop or acquire within the first one to two years of oncology practice. The target audience includes both beginning nurses new to practice as well as seasoned nurses who enter the oncology specialty after working in another area.

When the National Academy of Medicine, formerly the Institute of Medicine, released its 2010 report, The Future of Nursing: Leading Change, Advancing Health, it cited a need for improvement in nursing education and practice through the implementation of nursing competencies.

Access devices have been used for decades to administer the complex treatments and supportive care that oncology nurses deliver daily to patients with cancer. As these devices and other products evolve, nurses need evidence-based methodologies for critiquing their safety and effectiveness.

The ONS clinical inbox frequently receives questions about whether nurses need to be “chemotherapy certified” to give specific chemotherapy and/or biotherapy agents.