Beyond Chemotherapy: Mastering the New ASCO-ONS Antineoplastic Safety Standards With MiKaela Olsen

In this episode of Onc Nurse on Call, hosts Patricia Jakel, MN, RN, AOCN, and Stephanie Desrosiers, DNP, MSN, RN, AOCNS, BMTCN sit down with MiKaela M. Olsen, DNP, APRN-CNS, AOCNS®, FAAN, clinical program director for oncology at Johns Hopkins Health System and the nurse co-chair for the updated standards.

MiKaela’s career in oncology nursing began unexpectedly as a new graduate during Desert Storm when she was assigned to a pediatric oncology unit. Since that pivotal start, she has dedicated her career to advancing evidence-based practice and has become a fierce advocate for both patient and staff safety, consistently championing the importance of protecting healthcare workers from the risks associated with handling hazardous drugs.

MiKaela’s profound impact on clinical practice is most notably highlighted by her leadership in the ASCO-ONS standards. After serving on the expert panel for the 2016 standards, she became the nurse co-chair for the milestone 2024 update of the Antineoplastic Therapy Administration Safety Standards for Adult and Pediatric Oncology: ASCO-ONS Standards. Working alongside physician co-chair Robert D. Siegel, MD, FASCO, FACP, of Bon Secours St Francis Cancer Center, she helped lead the review of extensive clinical literature to craft a robust framework that minimizes operational variability and protects against preventable medication errors.

Under her leadership, the standards introduced several major changes to reflect the modern realities of cancer treatment. Most notably, the update shifted fundamental terminology from "chemotherapy" to "antineoplastic therapy" to accurately encompass targeted therapies, immunotherapies, and cellular therapies. MiKaela has also pushed heavily for safety standards to apply universally across all care settings, advocating that patients receive the same high level of care whether they are treated in a major medical center or in the comfort of their own home.

The topics in this episode include:

• The Shift to "Antineoplastics": Why the traditional word "chemotherapy" is no longer inclusive of modern targeted agents, immunotherapies, and cellular therapies.
• Safety Across All Settings: How the new standards apply universally, whether you are administering treatment in a major hospital, an outpatient clinic, or a patient's home.
• The 4-Step Verification Process: A breakdown of Domain 3, detailing the independent safety checks required by both pharmacy and nursing before a drug reaches the patient.
• Standard 1.7 (The Metric Rule): Why locking scales into kilograms and centimeters and requiring dual-verification for new treatment plans is the new gold standard for preventing dosing errors.
• Focus on Equity and Caregivers: How Domain 4 introduces language addressing social determinants of health and keeping home caregivers safe.

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