Chemotherapy Practice Competencies
It is essential the nurse administering chemotherapy have completed a recognised training and assessment course, as per Cancer Care Alliance (CCA) chemotherapy education policy (2006), In 1998 The Royal College of Nursing (RCN) produced clinical practice guidelines in the administration of cytotoxic chemotherapy, together with chemotherapy Nursing Practice Standards (CCA 2006) these set out safe working practices, thereby protecting both patients and staff from the risks associated with the handling and administering of cytotoxic drugs. By following national and local guidelines the nurse also has a professional duty to adhere to their Code Of Conduct devised by the Nursing and Midwifery Council (NMC 2008) to provide a high standard of practice and care at all times, based on the best available evidence or best practice. (NMC 2008). States the nurse for their practice and should work within the limits of their competence. Therefore effective training and having a working knowledge of the (NMC 2004) Guidelines for the administration of medicines the nurse will be familiar with the chemotherapy drugs and their side effects and toxicities, which may range from an acute reaction to one that manifests days or weeks after treatment. The nurse will have the ability to provide effective support and treatment for the patient presenting with the symptoms described in the given question. This would lead me to suspect the possibility of an underlying infection, probably from the Hickman line. Infection is the leading complication associated with central venous catheters (CCA 2006) and an important cause of mortality in cancer patients (Viscoli 1998 p65) This is classed as a clinical emergency and requires immediate intervention preventing life threatening complications. In order to provide a high standard patient centred care, an adequate holistic assessment should be carried out with the patient and carer. In doing so the nurse can communicate affectively with the patient
References: Allwood, M. Stanley, A and Wright, P. (2002) The Cytotoxics Handbook. 4Th ed. Oxford: Rawcliffe Medical Press Limited. Cancer Care Alliance (2006) Chemotherapy Nursing Pratice Standards. Clinical Practice Guidelines. London: Cancer Care Alliance. Cancer Care Alliance (2006) Teaching Pack, A resource for chemotherapy education. Clinical Practice Guidelines London: Cancer Care Alliance. Grundy, M. (2000) Nursing in Haematological Oncology. London: Bailliere Tindall. Howard, M. and Hamilton, P. (1997) Haematology An Illustrated Colour Text. London: Churchill Livingstone Mallett, J Nursing and Midwifery Council (2005) Guidelines for the administration of medicines, London: Nursing and Midwifery Council. Nursing and Midwifery Council (2008) The code, Standards of conduct, performance and ethics for nurses and midwives. London: Nursing and Midwifery Council. Rolston, K.V (1999) New trends in patient management, risk-based therapy for febrile patients with Neutropenic Clinical Infectious Diseases 29 (3) 515-521. Royal College of Nursing (1998) Guidelines for cytotoxic chemotherapy – Clinical Practice Guidelines London: Scutari Projects. Simon, A.Bode, U. and Beutal, K. (2006) Diagnosis and treatment of catheters – related infections in paediatric oncology: Clinical Microbiology and Infection 12 (7) p606-620. Viscoli, C. (1998) The evolution of the empirical management of fewer and neutropenia in cancer patients, Journal of Antimicrobial Chemotherapy, 41, p65.