IR Nurses that deal with outpatient LP Chemo

by ronsrn ronsrn Member

We are a hospital that engages in out patient chemo Lumbar punctures. We have been given the task of "activating" chemo orders. Our direction is to meet the patient and performa series of assessments [not the issue] . what is the issue is that there is an order placed by the oncology doctor, there is no evidence it has been double checked by an oncology RN and we are activating the order to give this to the patient. Can anyone advise of a procedure you may be using that can help ours? Some RN's worry this is out of scope or they are being for the lack of a better word "used" as the double check when they are not oncology rns.

Double-Helix, BSN, RN

Specializes in PICU, Sedation/Radiology, PACU. Has 11 years experience. 1 Article; 3,377 Posts

Who is administering the chemo? In our hospital, it's the responsibility of the person administering the intrathecal injection (usually an oncology NP) to double check the medication against the patient's roadmap with another qualified individual.

What does Activating” the order mean in your facility? Does it mean that it sends the order to pharmacy to make the med? Is it considered equivalent to a dual signature? Are other medications activated, or just chemo? In my opinion, the answer depends on the meaning and liability associated with activating an order- and that will be facility specific.



35 Posts

Well all of those questions you just asked so did we. The medication is administered by a radiologist. The order is ordered by an oncology physician . The sketchy part is the activation there is no guidance by our nursing board that deals with activating an order. We have come to the conclusion that we do a nurses note stating by activating this order the RN does not in anyway agreed to the plan of care for this patient. That's kind of the best we can do. We have asked for a second oncology RN to agree that this order can be simply activated by any RN but resistance has deleted this process.



88 Posts

In our facility chemo MUST be verified by 2 oncology RN's. No exceptions. it is then checked with the IR RN and given to the physician for administration.


Specializes in ICU, IR, PACU, CCRN, NE-BC. Has 11 years experience. 47 Posts

IR nurses in my department are also chemo certified not OCN but chemo training is provided. We verify with the the ordering physician and another RN and release the order from the treatment plan for the pharmacy to make then have the radiologist administer the chemo.