Current and future nursing issues in the home administration of chemotherapy

Although chemotherapy in the home is now a reality and is seen as positive, there remain many questions that have not been completely answered. Such questions include: Who should be caring for these patients? Which criteria should be used to select the best home care agency? What is the best way to prepare, transport, and administer the chemotherapeutic agents? Which agents are acceptable for home administration? How will the legal and reimbursement issues be resolved? Is home chemotherapy truly safe and beneficial for the patient? Home chemotherapy programs have developed over the past several years and most probably will continue to grow. As oncology nurses we need to identify our very important role in such programs by establishing guidelines and recommendations to ensure that only high quality programs exist. The role of the Oncology Clinical Nurse Specialist in the home care setting will continue to be defined. Home care nurses caring for the oncology client should be certified in this specialty and supported by a Clinical Nurse Specialist in order to significantly affect the quality of living for persons with cancer and their families. 26 Since the nursing profession has the responsibility for the quality of oncology care in the home, so should it assume the authority. Through standards of practice and education based on quality nursing research, we can assure that nursing maintains that responsibility and authority for home oncology and chemotherapy care. No other profession is more qualified.