Oncology Policies and Procedures (Second Edition)

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Note: This product is available as a web-based version only. No print version is available.
Each year, hospitals in the United States spend thousands of dollars in labor hours writing and revising policies and procedures for program accreditation.
The second edition of Oncology Policies and Procedures will save your institution time and resources by providing a collection of current standards of practice for use in the clinical setting. These documents were developed to simplify the process of annually producing and updating policies. Each document includes fields for custom identification and policy number insertion appropriate for your individual institution. You simply need to insert your institution’s name and customize choices and preferences for your institution or practice, and the policy or procedure is ready for use. Institutional logos may be incorporated as desired.
The resource is divided into eight sections: Administration, Electronic Health Records, Human Resources, Nursing, Safety and Pharmacy, Supportive Services, Blood and Marrow Transplantation, and Billing Procedures for Outpatient Chemotherapy. The Blood and Marrow Transplantation section is new to this edition. A full table of contents is listed below. 
Each policy contains a bibliography that offers a broad view of the latest body of work for further reading and education. Job descriptions have been included in the Human Resources section to help cancer program administrators to establish roles and duties for members of the oncology team. References to certifications and national organizations for credentialing will help administrators and hiring personnel to appoint the most appropriate level of staff for the position. An additional folder includes sample forms, checklists, and consent documents that can be used in their current state or modified for use in your clinical area.

Table of Contents


  • Introduction
  • Oncology Services Quality Improvement
  • Patient Safety and Infection Control
  • Oncology Services Operations Plan for Oncologic Emergencies
  • Patient Consent and Education for Chemotherapy

Electronic Health Records

  • Introduction
  • Documentation Standards
  • Care Plan
  • Electronic Communication Between Clinicians and Patients Outside of the Electronic Health Record or Patient Portal Communication System
  • Electronic Health Record Downtime and Reconciliation
  • Business Mobile Device Management
  • Social Media

Human Resources

  • Introduction
  • National Certification for Cancer Center Professional Staff
  • Job Description: Ambulatory Clinic Oncology Nurse
  • Job Description: Certified Cancer Registrar
  • Job Description: Nursing Informatics Specialist
  • Job Description: Oncology Clinical Nursing Director
  • Job Description: Oncology Clinical Nurse Manager
  • Job Description: Oncology Clinical Pharmacist
  • Job Description: Oncology Licensed Clinical Social Worker
  • Job Description: Executive Director, Oncology Service Line
  • Job Description: Oncology Nurse Clinician
  • Job Description: Oncology Nurse Navigator
  • Job Description: Oncology Nurse Practitioner, Physician Assistant, and Advanced Practice Professionals
  • Job Description: Radiation Therapy RN
  • Job Description: Vice President, Oncology Service Line


  • Introduction
  • Preassessment and Reassessment of Patients Receiving Antineoplastic Chemotherapy
  • Antineoplastic Chemotherapy Administration in Non–Oncology Services
  • Care of Patients Receiving Implanted Radioactive Agents
  • Chemotherapy Competency
  • Chemotherapy Prescribing Requirements
  • Endocrine Therapy
  • Intraperitoneal Administration of Antineoplastic Chemotherapy
  • Intrathecal Administration of Antineoplastic Chemotherapy
  • Intravesical Administration of Antineoplastic Chemotherapy or Bacillus Calmette-Guérin
  • IV Access Device Management
  • Infection Control Policies in Central Line–Associated Bloodstream Infection Prevention Management and Care of Patients on IV Infusion Pumps
  • Management of Infusion Reactions to Antineoplastic Chemotherapy and Biotherapy Agents
  • Management of No-Show Patients
  • Patient Education Regarding Oral Cancer Chemotherapy Regimens
  • Required Laboratory Testing for Patients Receiving Cytotoxic Therapy
  • Scheduling a New-Patient Appointment
  • Sedation Administration Prior to Bone Marrow Biopsy
  • Telephone Triage
  • Interpreter Services
  • Vesicant Administration and Extravasation Management

Safety and Pharmacy

  • Introduction
  • Administration of Antineoplastic Chemotherapy and Biotherapy Agents by the RN Alternative Duty for Hazardous Drug Handlers
  • Calculation and Verification of Doses for Cancer Antineoplastic Chemotherapy and Biotherapy Agents
  • Cancer Chemotherapy and Biotherapy Order Templates
  • Compounding and Dispensing of Hazardous Drugs
  • Continuity of Cancer Care During a Disaster
  • Disposal of Hazardous Drugs
  • Maintenance of Compounding Hoods
  • Maintenance of IV Pumps
  • Management of Accidental Release of Radioactive Materials
  • Management of Acute Hazardous Drug Exposure
  • Management of Hazardous Drug Spills
  • Medical Surveillance for Hazardous Drug Handlers
  • Medication Order Templates for Clinical Research
  • Oncology-Specific Abbreviations: Acceptable and Unacceptable
  • Patient Identification Prior to Provision of Care
  • Training for Staff Handling Hazardous Drugs
  • Appendix A. ISMP List of Confused Drug Names
  • Appendix B. ISMP List of Error-Prone Abbreviations

Supportive Services

  • Introduction
  • Care Coordination
  • Distress Screening and Management
  • Identification and Utilization of Patient Assistance Programs for Cancer Treatment Lymphedema Education and Management
  • Nutrition Services
  • Pain Assessment and Management
  • Palliative Care Assessment
  • Psychosocial Care
  • Sexuality and Sexual Function
  • Survivorship

Blood and Marrow Transplantation

  • Introduction
  • Allogeneic Cellular Therapy Product Administration
  • Granulocyte–Colony-Stimulating Factor Administration Guidelines for Hematopoietic Stem Cell Transplant Recipients
  • Allogeneic Hematopoietic Stem Cell Care Procedure for Donor
  • Autologous Hematopoietic Stem Cell Transplant
  • Bone Marrow Harvest
  • Patient Preparation for Discharge Following Hematopoietic Stem Cell Transplant Donor and Recipient Confidentiality
  • Related Donor and Recipient Evaluation and Selection
  • Donor and Recipient Consent
  • Infection Prevention and Control in Recipients of Hematopoietic Stem Cell Transplant Peripheral Blood Stem Cell Apheresis
  • Post-Transplant Care for Hematopoietic Stem Cell Transplant Recipients Preparative and Conditioning Regimens for Blood and Marrow Transplantation Processing and Storage of Autologous Peripheral Blood Stem Cells
  • Search Process for Matched Unrelated Donors and Cord Blood Units
  • Patient Education for Blood and Marrow Transplant
  • Chimeric Antigen Receptor Immune Effector Cell Therapy

Billing Procedures for Outpatient Chemotherapy

  • Introduction
  • Chemotherapy Administration and Nonchemotherapy Administration Charge Capture Billing Practice Education and Training for Outpatient Nurses
  • Monitoring and the Nurse’s Role in Audits


  • Chemotherapy Competency Checklist
  • Hazardous Drug Administration Safe Handling Checklist
  • Infusion Reaction Orders
  • Patient Wallet Card (Printable)
  • Sample Chemotherapy and Biotherapy Order Template
  • Sample Medication Order Template for Clinical Trials
  • Telephone Triage Documentation Form



Dolores M. Esparza, RN, MS Oncology Services Consultant Temecula, California


  • Monica Bartlett, MPA, BSN, RN-C, CPON®, NE-BC, CPHIMS, Director of Pediatric Specialties Clinic and Pediatric Surgical Services Kaiser Permanente, Roseville, California
  • Rebecca Bennett, RN, MSN, PPCNP-BC, FNP-BC, Nurse Practitioner, Acute Pain Service Rady Children’s Hospital, San Diego, California
  • Susan D. Bruce, MSN, RN, OCN®, AOCNS®, Clinical Nurse Specialist, Duke Raleigh Cancer Center Raleigh, North Carolina
  • Darcy L. Burbage, RN, MSN, AOCN®, CBCN®, Oncology Nurse Navigator, Helen F. Graham Cancer Center Newark, Delaware
  • Eve Jeanine Doty, RN, CFM, CPO Director of Operations, Active Life, Albuquerque, New Mexico
  • Christina Ferraro, MSN, NP-C, RN, BMTCN®, Blood and Marrow Transplant Nurse, Coordinator, Cleveland Clinic, Taussig Cancer Institute, Cleveland, Ohio
  • Angela Garrido, MSN, ANP-C, AOCNP®, Nurse Practitioner, Cedars-Sinai Tower Hematology Oncology Group, Beverly Hills, California
  • Denise Givens, RN, MSN, FNP-BC Nurse Practitioner, Acute and Chronic Pain Service Rady Children’s Hospital, San Diego, California
  • Alexandra Hulten, MSW Regional Coordinator, Greater Nashville Regional Council Tennessee State Health Insurance, Assistance Program Nashville, Tennessee
  • Anne Katz, PhD, RN, FAAN Clinical Nurse Specialist, Certified Sexuality Counselor, CancerCare Manitoba, Winnipeg, Manitoba, Canada Instructor
  • Anthony M. LaMacchia, BS, CPA Executive Administrative Director Comprehensive Blood and Cancer Center, Bakersfield, California
  • Valerie Relias, PharmD, BCOP Clinical Pharmacy Specialist Division of Hematology/Oncology Tufts Medical Center, Boston, Massachusetts
  • Charis Spielman, MPH, RD, CSO, CNSC, Oncology Dietitian, El Camino Hospital Cancer Center, Mountain View, California
  • Timothy Tyler, PharmD, FCSHP, FHOPA, Director of Pharmacy, Laboratory, and Oncology Supportive Care Services Comprehensive Cancer Center, Desert Regional Medical Center, Palm Springs, California
Member Price: $129.00Nonmember Price: $199.00
Published By: 
Oncology Nursing Society
Publication Date: