Education of the Registered Nurse Who Administers and Cares for the Individual Receiving Antineoplastic Therapies

Specialized education, preparation, and training of nurses who administer antineoplastic cancer therapies are needed to ensure a safe level of care for patients receiving treatment and the clinicians administering these agents. The Oncology Nursing Society (ONS) defines the process and content to educate nurses who administer treatments and care for patients receiving antineoplastic cancer therapies, which we define as chemotherapy, targeted therapy, and immunotherapy.

It is the position of ONS that

  • RNs are responsible for all aspects of administering and monitoring cancer therapies, including chemotherapy, targeted therapy, and immunotherapy.
  • State practice acts should be consulted when developing institutional policies and procedures.
  • Educational programs for nurses administering chemotherapy, targeted therapy, and immunotherapy are comprehensive, current, and evidence-based, and appropriate for the person, population, and setting. They consist of didactic learning followed by the successful completion of a clinical practicum under the auspices of the nurses’ institution or supporting agency.
  • Competency is assessed and reinforced annually.
  • The following content is included in all introductory and annual competency reassessment programs developed for nurses administering cancer therapies:
    • Types of treatment, classification of agents, and routes of administration
    • Pharmacology of agents, regardless of indications for use
    • Pertinent molecular biomarkers, including genomic assays
    • Chemotherapy and radiotherapy protectant
    • Principles of safe preparation, storage, labeling, transportation, and disposal of agents
    • Safe administration procedures
    • Procedures for safe handling of hazardous drugs including spill management
    • Appropriate use and disposal of personal protective equipment
    • Use of engineering controls, if applicable to your practice setting
    • Use of closed-system drug transfer devices
    • Assessment, monitoring, and management of patients receiving therapy
    • Medication safety and system safeguards, such as infusion pump safety features 
    • Appropriate procedures for emergency preparedness to include infusion reactions and extravasation
    • Appropriate documentation of treatment administration, patient education, and planned follow-up care and testing
    • Patient and family/caregiver education for these agent(s), specific to side effects and related symptom management, and processes for urgent and ongoing follow-up
    • Education and coordination of post-treatment care and testing, adverse events, and long-term side effects, physical and psychosocial impacts of a cancer diagnosis and treatment, and follow-up care during survivorship

Approved by the ONS Board of Directors, 1992; revised July 1997, June 1999, November 2002, July 2005, October 2007,

January 2011. Reviewed October 2012, January 2013, January 2014, January 2015. Revised April 2016, October 2017, August 2020.

Download this position statement.

Statement Type 

Education, Certification, and Role Delineation

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ONS stances on the healthcare issues that affect oncology nurses.

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