(85) 3,2,1 – My Chemo Check-Off is Done!

Title: Please see below.

Abstract : Chemotherapy providers at Joe DiMaggio Children’s Hospital expressed feeling unprepared due to the long-standing single administration check-off process. Additionally, the inpatient unit struggled to place providers back on orientation, leading to gaps in competency and confidence.

The goal of this educational program was to improve chemotherapy providers' confidence and competence by implementing a more robust orientation process while the provider remained on orientation.

To address this, feedback from employee engagement surveys and incident reports related to chemotherapy administration were analyzed. A tool was developed to measure confidence pre- and post-check-off, incorporating a Likert scale and open-ended responses. Based on this data, a new “3, 2, 1” check-off process was created. The “3” represents three observations by the orienting provider, who learns all aspects of administration alongside a “chemo buddy.” The “2” refers to two hands-on administrations with direct oversight from the preceptor, including dual-RN sign-off. Finally, the “1” is a full competency check-off with the Educator, ensuring complete proficiency in chemotherapy administration.

Since the implementation of the “3, 2, 1” process, 100% of our 19 new providers have shown increased confidence and competence, as reflected in improved post-check-off ratings. There was also an identified increase in chemotherapy-related incident reports, two for calendar year 2023 and seven for calendar year 2024, attributed to great-catches and newly acquired heightened awareness. To support the new process, the orientation period was extended to 40 shifts to include both the APHON Provider course and the “3, 2, 1” check-off.