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Question re: routine staff labs on those who administer chemo

  • 1.  Question re: routine staff labs on those who administer chemo

    Posted 05-05-2019 07:52
    My question is: Does your institution draw a yearly CBC/d on the staff who routinely administer chemotherapy/immunotherapy infusions?

    Thanks,

    Kristin Phillips RN, BSN, OCN
    Infusion RN
    Cone Health Cancer Center- Mebane

    Sent from my iPhone


  • 2.  RE: Question re: routine staff labs on those who administer chemo

    Posted 05-06-2019 04:04
    ​no we don't dear.

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    Lara Al Hamad
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  • 3.  RE: Question re: routine staff labs on those who administer chemo

    Posted 05-06-2019 06:52
    Hi Kristin,

    We do a routine lab draw once a year and on new employees at time of hire -



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    Karla Lang BSN RN
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  • 4.  RE: Question re: routine staff labs on those who administer chemo

    Posted 05-06-2019 06:57
    We do an annual CBC with a diff and a U/A.  This was from the ONS Safe Handling of Hazardous drugs book.  This is for RNs who hang the chemo and Pharmacy associates who may mix since these are the biggest areas of risk for exposure.​

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    Cheryl Nagy RN, BHA, OCN
    Director, Oncology Services
    Lima OH
    419-998-4461
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  • 5.  RE: Question re: routine staff labs on those who administer chemo

    Posted 05-06-2019 08:50
    ​Hi Kristin; Massachusetts General Hospital does not...does yours?

    Thanks!
    Anne Marie

    Anne Marie Haynes RN, OCN, JD
    Hematology Practice Nurse
    MGH/North Shore Cancer Center
    Danvers, MA  01923




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    Anne Marie Haynes RN, OCN, JD
    Hematology Practice Nurse
    MGH/North Shore Cancer Center
    Danvers, MA 01923
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  • 6.  RE: Question re: routine staff labs on those who administer chemo

    Posted 05-06-2019 10:07
    We do not - some of the nurses have GPs that will order routine labs, some do not. There was no language in the ONS standards to specify blood work, rather just an assessment. For those centers that do draw blood work, can you share your process? Do you have a letter for staff to take to  their physician or does the employer draw this at work?
    We used to have a letter many years ago that suggested to physicians that nurses should have annual labs as they work with cytotoxic/hazardous medication but this is gone. Many staff are asking for one but OH&S has not supported this with specific labs to draw.


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    Rebecca St.Jean
    Leukemia/BMT program of BC
    RN BSN CON(c) BMTCN CNE
    rebecca.stjean@vch.ca
    604-875-4111 loc 61885
    Vancouver, BC, Canada
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  • 7.  RE: Question re: routine staff labs on those who administer chemo

    Posted 28 days ago
    Although I support employee monitoring and routine CBCs for anybody I just don't see a CBC revealing too much in terms of exposure and therefore I chose not to battle this one in terms of access especially since it is a "should" not a "must" on the USP <800>.

    I would love to hear from anyone any examples of how a CBC with diff has aided in relation to exposure identification?
    thank you

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    Ali Jackson RN BSN OCN
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  • 8.  RE: Question re: routine staff labs on those who administer chemo

    Posted 26 days ago
    I am with Ali Jackson on this one.
    Performing a random CBC is akin to taking a snapshot of Interstate 5 at 2am and declaring Seattle has no traffic. The only "possible" (and I use this loosely) benefit is if we did frequent serial blood draws (e.g., weekly) which is absolutely unsupportable.

    Where I do agree in biologic monitoring is after a spill. One could check the CBC immediately post exposure and then 10-14 days later to see if there is a "nadir effect."

    But short of performing daily urine testing with HPLC equipment (not available in most hospital labs), there's no way to see if someone has been exposed.

    Seth
    For more information on exposure, click here.

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    Seth Eisenberg RN ASN OCN BMTCN
    PROFESSIONAL PRACTICE COORDINATOR, INFUSION SERVIC
    Seattle Cancer Care Alliance
    Federal Way WA
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