Safe Handling Practices in Oncology With Jacqueline Redeemer

Welcome to Onc Nurse On Call, the new podcast from Oncology Nursing News, hosted by editors-in-chief Patricia Jakel, MN, RN, AOCN, and Stephanie Desrosiers, DNP, MSN, RN, AOCNS, BMTCN, delivering maximum impact in minimum time.

This week, Jakel and Desrosiers are joined by Jacqueline Redeemer, RN, MN, AOCNS, a clinical nurse specialist (CNS) in solid tumor oncology at The University of California, Los Angeles, who shared her experience integrating safe handling practices into her clinic as a CNS.

While observing a hepatic arterial infusion procedure in interventional radiology (IR), Redeemer noted that staff were not consistently applying oncology nursing standards. Because the IR department did not frequently administer chemotherapy, there was a misconception that the high-dose melphalan used in the procedure posed minimal risk due to the way it was perfused. Redeemer utilized her CNS training to emphasize that even a small percentage of a highly concentrated dose remaining in systemic circulation required rigorous protection. She noted that the dose being administered was nearly 10 times higher than typical intravenous levels, making the 10% residue a significant safety concern.

To address these gaps, Redeemer initiated a collaborative performance improvement project involving pharmacy, environmental services, and IR leadership. A primary challenge was the introduction of closed system transfer devices (CSTDs), which were unfamiliar to the IR team.

“All staff that would manage or engage with either administering or handling body excreta or anything after...they needed to be in service and receive education,” Redeemer explained, noting that the training extended to technologists, perfusionists, anesthesiologists, and physicians.

“An oncology nurse needs to be at the table at all times when there are decisions about how to administer, handle, or [introduce] new drugs,” she stated. By involving specialized nursing leadership, healthcare systems can ensure that safety standards remain consistent and evidence-based, regardless of the clinical setting or the route of administration.