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Contemporary cancer treatment requires a multidisciplinary approach in order to ensure the safe prescribing and administration of chemotherapy. The increasing complexity of drug regimens and the introduction of new cytotoxic agents, combined with the inexperience of medical staff in this area, highlighted the need for a comprehensive educational reference tool. Our experience highlighted inconsistencies in prescribing anti-emetics and hydration regimens and the need for ongoing education.1 A multidisciplinary team was established to address these issues and develop a Chemotherapy Practice Manual which consists of chemotherapy protocols, administration guidelines including cost-effective premedication recommendations and supportive therapy such as hydration regimens. It also includes patient monitoring parameters for before, during and after treatment and protocol specific patient education. Preprinted prescription charts were designed to aid the medical officer in prescribing the chemotherapy and include discharge medication to ensure appropriate post treatment therapy. These have been incorporated into a computer-generated prescribing program. The introduction of the manual to the oncology unit has proved beneficial: prescriptions are legible and include all supportive treatment and follow up medication. The nursing staff now have guidelines regarding chemotherapy administration and patient education. By working together and combining our knowledge we have provided a complete package that ensures safety in prescribing and administration of chemotherapy as well as an educational reference tool. Other benefits include both time and cost savings.

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may not accurately reflect ED patient acuity, ED critical care delivery, or ED critical care education. Future studies may examine alternative metrics to better quantify and describe the ED critical care experience.