A journey to pediatric chemotherapy competence

Chemotherapy and biotherapy use has increased due to its effectiveness as a treatment for childhood cancer. Nurses need to demonstrate knowledge of these agents' mechanism of action, adverse effects, safe handling, and monitoring parameters. Competence of nurses administering chemotherapy and biotherapy needs to be assessed to ensure safety and quality care. Review of literature reveals that a comprehensive education program and skills validation are the most thorough means of assessing chemotherapy competency. The chemotherapy competency program at the Children's National Medical Center (CNMC) was evaluated and was noted to be inadequate. Although a self-learning module on intravenous push chemotherapy administration and a 1-hour lecture on chemotherapy administration were offered during orientation, there was limited reevaluation of competence at regular intervals. As a result of a literature review, multi-institutional surveys, and intensive review of the CNMC chemotherapy administration module, a comprehensive chemotherapy/biotherapy competency program was developed for nurses administering chemotherapeutic agents. The CNMC chemotherapy competency program was formed with a didactic content course utilizing the Oncology Nursing Society Chemotherapy/Biotherapy Provider Course combined with initial and yearly skills validation. After offering both the didactic portion and three-part competency skills set, nurses have indicated improved satisfaction with the methodology of achieving chemotherapy competency.