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Second Verification RN

  • 1.  Second Verification RN

    Posted 08-28-2019 08:15
    ​Good morning,

    At our Cancer Center, we have hired 3 new employees that are not chemotherapy certified. All are experienced nurses and some in oncology, however they are not certified to hang chemotherapy. Do you have any one in your infusion area that is not certified? Are they able to be second verification on chemotherapy sign off? We have opinions both ways. We have Epic Beacon, which does most of our drug calculations for us.

    If they do not do verification, what all are they doing in your infusion area?

    Thank you!

    Amy Lee, RN, BSN, OCN
    Northeast Oklahoma Oncology Nursing Society

  • 2.  RE: Second Verification RN

    Posted 08-29-2019 07:12
    I work inpatient oncology so it's different than a cancer center but I am not allowed to be the 2nd verifier for chemo since I'm not certified yet. Inpatient most aren't getting chemo infusions anyway so there are plenty of patients I am allowed to care for. I have gotten the back and forth on of I'm allowed to verify oral chemo drugs though. Some say yes some say no.

    Heather Frederick

  • 3.  RE: Second Verification RN

    Posted 08-30-2019 11:10
    ​We do permit this in our institution as long as the nurse has completed orientation and been checked off through an internal competency process we use.  The ONS/ONCC Chemotherapy/Immunotherapy course isn't recommended to be taken until a nurse has been "administering chemotherapy and/or immunotherapy for more than one year", so it makes sense that staff would be able to verify chemotherapy before completing this course.  The key is to make sure the nurse has the proper training and has been deemed to be competent to perform this task.

    Brandi Carr BSN RN OCN
    Cancer Center Director of Operations
    Peninsula Regional Medical Center
    Salisbury, MD

  • 4.  RE: Second Verification RN

    Posted 08-29-2019 07:35
    I supervise an outpatient Oncology clinic. We have our orientees take the course during their first weeks of orientation. It is critical to the work they will be doing and we feel it is important to have them hold that knowledge and ability to care for patients.

    Wendy Thibodeau BSN RN
    Supervisor Oncology Services
    Advocate Aurora Health
    Oak Creek WI

  • 5.  RE: Second Verification RN

    Posted 08-29-2019 09:57
    By the standards set forth with ONS, only a Chemotherapy Competent person with an active provider card may administer or be a second verification person with chemotherapy agents. When we have had nursing without a provider card, that nurse would access ports, draw labs, etc.
    But no chemo injections either. I would further add that one should not totally rely on a computer to provide your calculations for you.
    Safety first.

    Garry Breckenridge MSN, OCN, RN-BC, NPDS
    Education Specialist Oncology
    Learning Institute & Simulation Center
    Dignity Health - St. Joseph's Hospital & Medical Center
    350 W. Thomas Road, Phoenix, AZ 85013

    Garry Breckenridge MSN, OCN, RN-BC, NPDS
    Education Specialist Oncology
    Phone: 602-406-0379
    Mobile: 602-565-0925
    Fax: 602-512-6785
    University of Arizona Cancer Center at Dignity Health St. Joseph's
    625 N. 6th Street, Phoenix, AZ 85004

    Dignity | Collaboration | Justice | Stewardship | Excellence


  • 6.  RE: Second Verification RN

    Posted 09-10-2019 16:32
    Where are you seeing that in ONS standards? I don't see it on my list. It just says before each chemotherapy administration, at least 2 practitioners a​pproved by the health care setting. Also, it says at least 2 individuals, in the presence of the patient, verify the pt id by using at least 2 identifiers. Dana Giddens, RN

    Dana Giddens RN
    Chemotherapy Infusionist RN
    Tuba City AZ

  • 7.  RE: Second Verification RN

    Posted 09-11-2019 15:57

    Hi all - I wanted to help clarify this issue.  The best source for this information is the ASCO/ONS Chemotherapy Administration Safety Standards. You are correct that the individuals performing the verifications are practitioners approved by the health care setting.  However, I wanted to point out that these standards also provide criteria that organizations need to follow to determine who is appropriate to perform this process including initial and ongoing education and competency verification. So while the ONS chemo card is not required, a similar educational process needs to be included.

    I hope that helps!

    Barbara Lubejko RN MS
    Oncology Clinical Specialist
    Oncology Nursing Society

  • 8.  RE: Second Verification RN

    Posted 08-30-2019 11:48
    At our facility, new hires are able to verifiy at chairside patient, drug, route, dose, rate,  Dose calculations and labs are done at office visit, by pharmacy and by patient RN, New employees are not allowed to hang chemo till they complete ONS course Immunotherary/Chemotherapy certifiicate course and complete proficiency tests and probationary period .

    Ann Maxwell RN
    Three Way TN

  • 9.  RE: Second Verification RN

    Posted 09-11-2019 04:50
    We require orientees to complete the Fundamentals Chemotherapy Immunotherapy course before they complete their orientation. At the end of one year the new employee completes the more complex Chemotherapy Immunotherapy course. This provides the necessary certificate to administer these medications and follow ONS guidelines.

    Thomas Baber RN OCN BSN
    Oncology Nurse Manager
    Moore Regional Hospital
    Pinehurst NC