# Anticancer treatment administration checks at the chair: assessment, independent double checks and line tracing

Source: https://onco.cc/protocols/sact-administration-checks-at-the-chair/  
OnCo record `sact-administration-checks-at-the-chair` (Protocol). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

On each treatment day a nurse checks how you are, your temperature, pulse, blood pressure, allergies and side effects. Before the drip starts, two trained staff check the bag against your prescription and against you, using two identifiers such as your name and date of birth, and follow the tubing from bag to line. You will be told the drug's name, how long it takes and what to report at once.

## Summary

The ASCO-ONS Antineoplastic Therapy Administration Safety Standards (2024) replaced the 2016 ASCO/ONS standards' three verifications with four: before preparation (order elements and dose calculation), at preparation (a second clinician checks vials, concentration, volume, diluent and tubing), after preparation and before administration (two licensed clinicians independently verify drug, dose, volume, rate, route, expiry and appearance), and a new fourth verification in the presence of the patient, in which two licensed clinicians, at least one on site and the other in person or by approved video, check two patient identifiers, the drug, dose, rate and duration, route, administration set and pump settings. The panel added the fourth check because drugs are now often prepared away from where they are given, and added visual inspection of the administration set ('tracing the lines').

On each treatment day staff assess and record performance status, vital signs, date of birth, allergies and previous reactions, toxicities and pain, and update the medication list; the nurse confirms the drug, infusion time, route and symptoms to report with the patient before starting. A practitioner certified in basic life support must be present and a licensed practitioner on site, with hypersensitivity, extravasation and, where relevant, cytokine release order sets and drugs to hand.

The standards are not graded. The panel notes that remote video verification looks feasible but that no well-designed research has evaluated its effect on safety.

## Fields

- Kind: Protocol
- Last checked: 2026-11-11
- Also known as: chemotherapy bedside checks; chemotherapy double check; independent double check; two-nurse check chemotherapy; fourth verification; tracing the lines; pre-administration checks; chemotherapy time out

## Connected records

- protocols: [Ambulatory chemotherapy pumps at home: set-up, checks, spills and disconnection](https://onco.cc/protocols/ambulatory-chemotherapy-pumps-at-home/), [Anticancer treatment prescribing and pharmacy verification before each cycle](https://onco.cc/protocols/sact-prescribing-and-pharmacy-verification/), [Infusion and hypersensitivity reactions during anticancer treatment: recognition, emergency treatment and rechallenge](https://onco.cc/protocols/infusion-reaction-management/), [Intrathecal chemotherapy safety and vinca alkaloids given only by minibag](https://onco.cc/protocols/intrathecal-chemotherapy-and-vinca-alkaloid-safety/), [Management of chemotherapy extravasation by drug class](https://onco.cc/protocols/chemotherapy-extravasation-management/), [Peripheral cannula for anticancer treatment: vein choice, siting and checks, including vesicants](https://onco.cc/protocols/peripheral-cannula-for-anticancer-therapy/), [Safe handling of hazardous anticancer drugs where they are given: protective equipment, closed systems, spills, waste and body fluids](https://onco.cc/protocols/hazardous-drug-handling-in-clinical-areas/)
- technologies: [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/), [Infusion pumps, ports, and ambulatory chemotherapy devices](https://onco.cc/technologies/infusion-devices-vascular-access/), [Smart infusion pumps with drug libraries (Novum IQ, Plum, Infusomat Space, Agilia, Ivenix)](https://onco.cc/technologies/smart-infusion-pumps/)
- terms: [Cytokine release syndrome (CRS)](https://onco.cc/terms/crs/), [Infusion reactions, hypersensitivity and extravasation](https://onco.cc/terms/extravasation-infusion-reaction/)
- ideas: [Measure whether a video second check before chemotherapy at home is as safe as two nurses in the room](https://onco.cc/ideas/idea-upgrade-video-second-check-safety-study/)

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