Chemotherapy administration

Abstract

Chemotherapy administration comprises a major nursing responsibility in oncology settings which impacts on nursing time, staffing requirements, and resource allocation. The underlying question in this study is whether chemotherapy administration can be used as a significant predictor of patient's requirements for nursing care time and what difference, if any, exists between the many different antineoplastic drugs and protocols with respect to time requirements. A survey at the Cross Cancer Institute, Edmonton, Alberta, examined the possibility of developing a categorization of chemotherapy drugs that could be used as predictors of nursing care time. Thirty-one drugs and protocols routinely administered to patients were included in a questionnaire distributed to 41 full-time and part-time nursing staff. The response rate was 68.3%, 28 of the 41 respondents. Five factors involved in the administration of medication were identified and measured; drug preparation time, predrug administration time, time for care during administration, postadministration care time, and patient teaching time. Nurses were asked to compare the time required for each factor in relation to adriamycin, selected as a base measure on the a priori assumption of moderate administrative complexity. Mean scores for each factor were calculated for each drug and an overall score for each drug was obtained. The rank ordered mean scores were weighed according to the relative time involved in comparison with adriamycin. Three groups of drugs emerged, each with distinct nursing time requirements. A rank ordering of the relative importance of each factor in overall drug administration time was obtained as well. The results of this descriptive survey have significance for oncology nurse administrators in terms of measuring nursing workload, establishing staffing patterns, allocation of resources, and planning medication distribution systems. Further study is suggested to examine the predictability of these drug categories, in terms of nursing care, in a variety of settings.