Episode 325: What Changed in the 2024 ASCO/ONS Antineoplastic Administration Safety Standards

“These evidence-based standards provide a great framework for best practice in cancer care and the 2016 publication is extensively referenced. However, patient care mistakes and medication errors still happen. So, it’s imperative that we review the current literature and look for new evidence that’s been published,” ONS member MiKaela Olsen, DNP, APRN-CNS, AOCNS^®, FAAN, clinical program director of oncology at Johns Hopkins Hospital and Johns Hopkins Health System told Jaime Weimer, MSN, RN, AGCNS-BS, AOCNS^®, manager of oncology nursing practice at ONS, during a conversation about the new Antineoplastic Therapy Administration Safety Standards for Adult and Pediatric Oncology from ASCO and ONS.

Music Credit: “Fireflies and Stardust” by Kevin MacLeod

Licensed under Creative Commons by Attribution 3.0 

Earn 0.5 contact hours of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by August 16, 2026. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.

Learning outcome: Learners will report an increase in knowledge related to increasing safety of antineoplastic medication administration.

Episode Notes 

• Complete this evaluation for free NCPD.
• Oncology Nursing Podcast^™ episodes:
  • More episodes about antineoplastic administration
  • Episode 209: Updates in Chemo PPE and Safe Handling
  • Episode 142: The How-To of Home Infusions
• ONS Voice articles:
  • Are You Following the Latest Chemo Safety Recommendations?
  • Hazardous Drug Surface Contamination Prevails, Despite More Diligent PPE
  • Respect Patients’ Religious Hair Wraps or Coverings When Taking Accurate Height and Weight Measurements
• ONS books:
  • Chemotherapy and Immunotherapy Guidelines and Recommendations for Practice (second edition)
  • Clinical Guide to Antineoplastic Therapy: A Chemotherapy Handbook (fourth edition)
  • Oncology Nursing: Scope and Standards of Practice
  • Safe Handling of Hazardous Drugs (fourth edition)
• ONS courses:
  • ONS Fundamentals of Chemotherapy and Immunotherapy Administration^™
  • Safe Handling Basics
• Antineoplastic Therapy Administration Safety Standards for Adult and Pediatric Oncology: ASCO-ONS Standards
• Oncology Nursing Forum article: ASCO/ONS Antineoplastic Therapy Administration Safety Standards
• ONS Learning Library: Safe Handling of Hazardous Drugs

To discuss the information in this episode with other oncology nurses, visit the ONS Communities. 

To find resources for creating an Oncology Nursing Podcast^™ Club in your chapter or nursing community, visit the ONS Podcast Library.

To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org.

Highlights From This Episode

“The target population for these standards are, first, our patients—adult and pediatric patients with cancer who are receiving antineoplastic therapy—but as well as those who care for patients with cancer. And we’re not distinguishing between the healthcare worker, the caregiver, all people who care for patients with cancer, including those practitioners or healthcare workers that are not in a traditional oncology setting.” TS 3:25

“The audience is, first of all, oncology clinicians. We spent a lot of time on this panel writing the definition, so it was very clear who people were as we use terminology in the standards. So, an oncology clinician, when we refer to that in the standards, that's a licensed nurse, like a nurse or pharmacist, a licensed clinician, or it could be a non-licensed clinician like a patient care assistant or tech. So, we refer to people as clinicians that are licensed or unlicensed.” TS 4:14

“We need to define all types of therapy for cancer, and chemo is one type of treatment modality. The explosion of new therapies that include cellular therapies such as CAR T and other exciting emerging treatment options are not our traditional chemotherapy. And so the term antineoplastic was agreed upon for all these therapies to treat cancer. That definition in the standards is, and I quote, ‘All antineoplastic agents used to treat cancer regardless of the route.’ And that’s important because the previous guidelines were not as inclusive about that.” TS 6:58

“Another high-level change was the new language about the location of administration to include new healthcare settings. We know that antineoplastic medications are given in a variety of settings, not just your typical inpatient or ambulatory oncology infusion center anymore. We’ve got health plans that are increasingly developing strategies to direct patients to more convenient and less costly sites of service, such as the physician’s office or home infusion, unregulated sites, and more care is being given in these settings. So, it’s really important that we adapt the standards to make sure those patients treated in the home or in a freestanding center are given the same opportunity for safety and quality.” TS 8:39

“The other thing in Domain 1 that I think is crucial for nurses to understand, because it’s a big change, and we made this change based on the literature, looking at patient safety events related to inaccurate weight and height measurements. Domain 1 has a standard 1.7 that says weight and height are measured and documented in the medical record in metric units only. And I see that a lot when I’m going around the country. People still have their scales and pounds and their height in inches, and we’ve got to change that. We shouldn’t be converting things. Both the measurement and the documentation are verified by two individuals, one of whom is a licensed clinician. Prior to preparation and administration of a newly prescribed antineoplastic treatment plan.” TS 13:32

“That third verification is an independent safety check and, in my opinion, should be done in a quiet place where you can go through and do the safety checks that are listed in the standards quietly and thoughtfully, without being in the presence of the patient or caregiver. Those are done in an attempt to do some preliminary safety checks to make sure that when I go in the room to do my safety checks—we often call those bedside safety checks—that if I have an error before that with a dose or something, I’ve caught that before I get to the patient’s side.” TS 20:52

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