| Sumario: | Significance & Background: The demand for rituximab infusions for non-oncology indications has risen sharply, particularly within neurology, rheumatology, transplant, and nephrology service lines. Rituximab, a monoclonal antibody initially developed for oncology, is now widely used to treat autoimmune and inflammatory conditions, leading to a rapid expansion of its use outside traditional oncology settings. Historically, oncology-credentialed nurses have administered rituximab infusions due to their specialized training in chemotherapy and immunotherapy. While this practice has ensured safe delivery, the growing reliance on oncology nurses has resulted in operational strain, scheduling delays, and an unsustainable burden on oncology resources. These challenges not only affect timely patient care but also impact oncology nurses' ability to focus on cancer-specific populations. As the need for rituximab infusions continues to expand across non-oncology units, a sustainable, evidence-based approach to broaden the pool of credentialed nurses became essential to ensure patient safety, optimize workflow efficiency, and distribute workload equitably across specialties. Purpose: This project aimed to design and implement a structured training and credentialing program for non-oncology registered nurses (RNs) to safely administer rituximab. Goals included maintaining safety standards, reducing dependency on oncology nurses, and improving infusion efficiency across departments. Interventions: Eligible non-oncology RNs participated in a multi-step program beginning with the ONS Fundamentals of Chemotherapy and Immunotherapy online course. This was followed by an in-person class covering rituximab pharmacology, infusion protocols, and adverse event management, including scenario-based simulations. Hands-on clinical validation occurred during live rituximab administration with an experienced chemo-credentialed RN. Standardized workflows, documentation guidelines, and a competency checklist supported the process. Pre- and post-training assessments measured knowledge, skill, and confidence. Oncology nurses remained available for clinical support during the pilot. Results: Twenty-Seven nurses enrolled, exceeding the initial goal of 20. The target is for at least 60% to complete credentialing by December 2025. Staff interest was high, with strong voluntary participation. Early feedback from participants and unit leaders has been positive, citing improved confidence and enthusiasm. Discussion: This program demonstrates a scalable, sustainable approach to expand infusion services outside oncology. By training non-oncology nurses, the initiative strengthens workforce flexibility, reduces oncology nurse burden, and ensures timely access to rituximab therapy. The initiative promotes equitable workload distribution, supports timely access to care, and enhances staff engagement. Future steps include program expansion, outcome monitoring, and ongoing competency validation to ensure sustainability.
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