Safe Administration of Oral Chemotherapy in Rehabilitation Settings
When administering oral chemotherapy to a cancer patient in a short-term rehabilitation facility, the most appropriate action is to wear personal protective equipment (PPE) while handling the medication and verify patient identification using at least two identifiers before administration. 1
Proper Verification Before Administration
Before administering oral chemotherapy, nurses should:
- Verify patient identification using at least two identifiers (e.g., full name and medical record number or date of birth) 1
- Confirm with the patient their planned treatment, drug route, and symptom management 1
- Verify the accuracy of the drug name, dose, route of administration, and expiration dates 1
- Have a second practitioner independently verify the order before administration 1
Safe Handling Procedures
Oral chemotherapy requires the same safe handling precautions as intravenous chemotherapy:
- Wear appropriate PPE (gloves) when handling oral chemotherapy medications 2, 3
- Avoid crushing or breaking tablets as this can release hazardous drug particles 4, 2
- Administer medications in their original form unless specifically instructed otherwise by a pharmacist 4, 5
- Wash hands thoroughly before and after handling oral chemotherapy 3, 5
Administration Guidelines
When administering oral chemotherapy:
- Give medications on time according to the prescribed schedule 1
- Administer with appropriate fluid (usually water, unless otherwise specified) 1
- Document administration immediately after giving the medication 1
- Have a licensed independent practitioner on site and immediately available during chemotherapy administration 1
Patient Education and Monitoring
After administration:
- Monitor the patient for potential side effects, including nausea, vomiting, and other toxicities 1
- Assess and document changes in clinical status, weight, performance status, and treatment-related toxicities 1
- Evaluate the patient's current medications, including over-the-counter medications that might interact with chemotherapy 1
Common Pitfalls to Avoid
- Never crush or split oral chemotherapy medications unless specifically instructed by a pharmacist, as this can alter drug absorption and expose staff to hazardous substances 2, 6
- Avoid handling oral chemotherapy without gloves, as these medications are considered hazardous drugs with exposure risks similar to intravenous formulations 4, 3
- Do not store oral chemotherapy medications in areas accessible to other patients 3, 5
- Never administer medications without proper verification of the order and patient identification 1
Special Considerations for Rehabilitation Settings
- Ensure proper storage of oral chemotherapy in a secure location away from other medications 4, 5
- Develop facility-specific protocols for safe handling and disposal of oral chemotherapy 2, 3
- Establish clear communication channels with the oncology team for questions about administration or side effect management 1, 6