title: Documentation of chemotherapy administration by nursing staff in inpatient and outpatient oncology/hematology settings: a best practice implementation project.
abstract: BACKGROUND
  Documentation of chemotherapy administration by nursing staff is undertaken in a written and electronic form at the Canberra Hospital and has been identified as requiring improvement in both inpatient and outpatient settings. Safe prescribing, dispensing, administration and documentation are essential to patient safety, outcomes and quality of care, and to staff safety. Due to the limited available research and evidence on this topic, recommended safety standards for the safe administration of chemotherapy formed the framework for audit criteria and documentation requirements.
  
  
  OBJECTIVE
  The aim of this evidence implementation project was to improve documentation of chemotherapy administration by nursing staff in inpatient and outpatient oncology/hematology units, thereby improving patient care and safety, as well as meeting the legal and educational responsibilities of the nursing staff.
  
  
  METHODS
  This evidence implementation project used the JBI Practical Application of Clinical Evidence System and Getting Research into Practice audit and feedback tool. A baseline audit was conducted to assess current practice and identify areas requiring improvement, followed by reflection on results and design, and implementation of strategies for documentation improvement. Lastly, a follow-up audit was conducted to assess compliance and practice improvement.
  
  
  RESULTS
  The baseline audit results highlighted areas of good current practice, areas requiring improvement and barriers to data collection and practice improvement. Strategies based on raising awareness of best practice guidelines, education and useful tools were developed and implemented. It was evident that the electronic documentation prompts used in the outpatient setting, compared to paper-based documentation in the inpatient setting, contributed to better compliance to documentation guidelines. The follow-up audit demonstrated improved practices across both the inpatient and outpatient settings.
  
  
  CONCLUSIONS
  The aim of improving documentation after chemotherapy administration was achieved, yet there is still room for further improvement. Education will continue through training courses, communication at meetings and utilization of the tools developed. Future auditing is planned to ensure sustainability.
authors.affiliation: 1Chemotherapy Clinical Development Nurse, Cancer, Ambulatory and Community Health Service, Canberra Hospital and Health Services. Australia2The Joanna Briggs Institute, Faculty of Health Sciences, The University of Adelaide, Australia.
authors.forename: Allison
authors.initials: A
authors.lastname: Turner
authors.forename: Matthew
authors.initials: M
authors.lastname: Stephenson
mesh_terms: D000328:Adult; D004282:Documentation / Q000592:standards*; D004358:Drug Therapy / Q000592:standards; D005260:Female; D019983:Guideline Adherence; D006405:Hematology / Q000592:standards*; D006801:Humans; D008297:Male; D009741:Nursing Staff, Hospital / Q000592:standards*; D009859:Oncology Nursing / Q000592:standards*; D017410:Practice Guidelines as Topic