Handling and Administration of Chemotherapy for nononcolgic reasons

[allonczy]

I work in a large medical center and we are trying to figure out what is best practice for the administration of IM/SQ Methotrexate for ectopic pregnancies etc. and also for the administration of gangcyclovir. Currently the MTX is given by RN's who are not chemo certified. The gangcyclovir which is an antiviral but is to be treated like a cytotoxic agent is also currently being given by nonchemo certified nurses. We are trying to figure out how to decide whether it does indeed need to be a chemo certified nurse who administers these medications or not. As far as pharmacy is concerned a chemotherapy is a chemotherapy and therefore should all have the same requirements. Can anyone lend me their expertise on what their facilities are doing?

[KMRNOCN]

Hummm, that's a good question. I monitor the inpatient chemotherapy, but not in OB. I know those nurses are not chemo certified. I'm going to have to look into this. I'll get back to ya.

[allonczy]

thanks

[onc nurse]

At our hospital, chemo nurses must go to the ED to give MTX for ectopic pregnancies. However, this is not the same for gangcyclovir. It is given by any RN on any floor.

[caroladybelle, BSN, RN]

In most places that I have worked, Onco nurses, that are educated in chemo administration, go to the ER or OB to give methatrexate. The also have to give any chemo given elsewhere - ICU, etc. if needed, though most other pts get shifted to Onco if appropriate.

Gangcyclovir, along with other drugs, utilize chemo precautions, as they can cause mutations in fetal development and have been noted to have other risks from exposure. However, it does not have quite the issues/effects that standard chemo has, thus does not require a chemo nurse to administration. Though, many pts prone to illnesses that require its' use, are frequently cared for on Onco floors.

If all else fails, have a chemo educated nurse do an inservice on how to hang/prime/DC the gangcyclovir safely.

[allonczy]

thank you