Increasing Organizational Chemotherapy Competencies

Problem: Despite its 21 facilities in Northern California, the organization has limited capability to administer chemotherapy infusion, resulting in both provider and patient inconveniences due to lack of qualified chemotherapy-certified nurses. Context: The cost of interfacility transfers for 1 year were over $1.7 million, not including decreased provider and patient satisfaction. Interventions: 12 staff nurses on 6S unit will complete a two-phase individualized training program and earn an Oncology Nursing Society Fundamentals of Chemotherapy Immunotherapy Administration provider card to ensure adequate coverage for patients requiring chemotherapy administration during their hospital stay. Measures: Training existing nurses in chemotherapy was encouraged. Another approach was to add a hiring prerequisite to train new-hire employees to chemotherapy after 6 months. Offering training vouchers outside of tuition reimbursement was initiated. Assistant Nurse Managers to be trained to support operational needs. Results: Through the collaboration with the outpatient infusion center, the 6S microsystem now has 15 nurses fully competent to cosign and administer chemotherapy medications. Conclusions: Along the way, fallouts were experienced. One staff moved to another facility closer to home and another nurse decided not to pursue training due to fear of exposure. Despite these fallouts, the 6S unit is devoted to achieving its global aim of having two to three nurses trained to administer chemotherapy medications per shift, 7 days a week. On August 27, 2021, the unit administered its first 24-hour chemotherapy infusion. Patients, families, and members of the multidisciplinary team are extremely satisfied. Though there is room for improvement, the unit thrives and will continue to serve its patients with joy and great care