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2nd Chemo/Immuno certified RN for checks

  • 1.  2nd Chemo/Immuno certified RN for checks

    Posted 10 days ago
    ​Recently, at the infusion center I work at, I've noticed during the double checking of chemo and the "mabs" (Rituxan, Darzalex, Opdivo, etc) that only one of the two RNs doing the check is chemo/immuno certified. I was told by my manager that as long as ONE of the RNs is chemo/immuno certified, a second RN can double check the dosing and sign it off. This is not my understanding. I thought chemo and immunotherapies had to be checked by TWO chemo/immuno certified RNs. Has something changed recently that I'm not aware of?

    Traci Christensen OCN
    Infusion Nurse Specialist
    Intermountain Healthcare
    American Fork UT

  • 2.  RE: 2nd Chemo/Immuno certified RN for checks

    Posted 10 days ago
    Good question!  In order to answer your question, I have 3 questions for you:
         One question is:  what are the steps of your double check process?  The ONS Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (2019) - on page 205-206 - outlines the correct steps.  And there is an example in this book (Appendix D - pp. 623-624).
         Another question is:  Are BOTH nurses, who are doing the verification, following these steps?  One purpose of having nurses certified is to provide them with the education so that they will do the steps in the process correctly.
         A final question is:  what does your hospital  policy say?  Does your policy say that only ONE chemotherapy certified nurse is present during the verification process?  If yes - then legally your nurses are following policy if you only have one chemotherapy certified nurse during the verification process.  If not - then maybe you want to share the resources that I have outlined above with your manager, and advocate for change at your facility.

     Good luck!

    Jeanene (Gigi) Robison, MSN, APRN-CNS, AOCN
    Clinical Education Specialist, Oncology
    St. Elizabeth Healthcare
    Edgewood, KY

  • 3.  RE: 2nd Chemo/Immuno certified RN for checks

    Posted 10 days ago
    Thank you Jeanene! This is very helpful!

  • 4.  RE: 2nd Chemo/Immuno certified RN for checks

    Posted 8 days ago
    ​A point of clarification - Neither ONS or ONCC offer a chemotherapy certification.   ONCC offers the Oncology Certified Nurse (OCN), a Chemotherapy/Immunotherapy Certificate Course (this is not a certification) and a provider card after completion of the Chemotherapy Fundamentals Course.
    We require a double check by two chemotherapy competent RNs.  A chemotherapy competent RN has completed the initial chemotherapy course and has successfully demonstrated a defined number of chemotherapy administrations supervised by a chemotherapy competent RN.  Annual observation of chemotherapy administration by a chemotherapy competent RN is also required.

    Ruth VanGerpen RN MS AOCNS
    Lincoln NE

  • 5.  RE: 2nd Chemo/Immuno certified RN for checks

    Posted 5 days ago
    In our facility, therapy is verified by two chemo-certified RNs. They verify orders and dosage and if both are available, verify the remainder of the double-check process (right patient, right time, etc).
    For treatments scheduled for off-shifts (e.g nights/weekends) where there is only one chemo-certified RN, per our policy, the treatment can be verified between:
    1. the outgoing chemo-certified RN and the in-coming chemo-certified RN. OR
    2. If there is only one chemo-certified RN, the treatment is verified between the chemo-certified RN and the oncology pharmacist.
    When the time then arrives for the chemo-RN to administer the therapy, the doublecheck process is done by him/her and a non-chemo RN. At this point, this is purely the right patient, right route, right time that is being verified, as the dosage would have already been verified by either #1 or #2 above.
    Makes sense?

    Our policy provides accommodation for situations where there is only one chemo-certified RN available when a treatment needs to be administered.


    Florence Okafor MPH, MSN, RN, NPD-BC, CPHON
    Professional Development Specialist:
    Adult Oncology; Ambulatory Infusion Center;
    Adolescent & Young Adult Oncology; &
    Baylor All Saints Medical Center
    Fort Worth TX