Chemotherapy standards for hospital in the home: how useful?

The process of developing practice standards is complex and resource intensive. The aim is to produce standards that meet the practicalities of clinical practice, are meaningful and achievable and that enhance the quality of patient care. This article details the process of developing chemotherapy standards for Hospital in the Home (HITH) and describes the results of a pilot project and the implications for nursing practice in this relatively new area of care delivery. Five Melbourne metropolitan Hospital in the Home (HITH) programs participated in the pilot process and evaluated the standards against their own programs. There was a wide variation in the skill sets nurses required depending on the structure of the HITH program. There were differences between programs in the nature of the interventions provided at home, documentation of treatments and points of contact for patients out of hours. Areas of concern identified by staff in the participating programs included the level of detail the standards required for assessment of the patients' home as an appropriate site to administer chemotherapy and the qualifications required by staff managing HITH chemotherapy patients.