ECONSENT FOR CHEMOTHERAPY.

In 2008, the Oncology Nursing Society (ONS) and American Society of Clinical Oncology (ASCO) held a workshop that put forth the ASCO/ONS Chemotherapy Administration Safety Standards. Within these standards were recommendations to have both documented informed consent and written information available to the patient on their diagnosis, goals of therapy, planned duration and schedule, information on possible side effects, regimen risks or symptoms that require notification and emergency contact information, and a plan for monitoring and follow-up. In 2016, these standards were updated with adjustments in the language that stated that health care settings must have a policy in place that documents a standardized process for obtaining and documenting chemotherapy consent or assent and that informed consent (with assent optional) for chemotherapy treatment is documented before initiation of a chemotherapy regimen. In 2010, Dr. Hope Uronis began leading a team to bring chemotherapy consent to Duke University Health System. Through her work with multiple departments and disciplines throughout the system, an approved document was crafted for use. In 2020, Dr. Uronis formed an implementation team consisting of two oncology certified nurses and a Duke Health Technology Solutions analyst. This team was able to transition the chemotherapy consent from a paper-only option to an electronic format available within the electronic health record (EHR) and implement the new process into workflows across all three Duke Health hospitals. In addition, the team was able to coordinate use of the eConsent on iPads which were purchased for use in all oncology areas. Having an iPad available helps with accessibility of patients that are at high-falls risk, that need larger font, and have issues using a computer mouse for signing documents. Since implementation of this process, patient feedback has been positive. Patients are able to view the eConsent in their patient accessed EHR both prior to and after signing. This allows for patients to be able to properly review the eConsent language so that they are able to advocate for themselves or their family members appropriately. Implementing change happens in phases, with a period of opposition to be expected. However, because of the efforts of this implementation team, the new eConsent process was widely successful and met with little resistance from stakeholders. [ABSTRACT FROM AUTHOR]