Using SACT passports in children’s cancer services
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Using SACT passports in children’s cancer services

Lynne Pearce Health writer

Standardised training helps nurses administer systemic anticancer therapy for children and young people

A new education and training tool has been introduced for nurses who administer systemic anticancer therapy (SACT) in children and young people’s cancer services. The so-called SACT passport for children and young people cancer services follows on from the adult services version, introduced six years ago, and aims to standardise training, education and practice across trusts. It could have benefits for patients and nurses alike.

Nursing Children and Young People. 35, 3, 11-12. doi: 10.7748/ncyp.35.3.11.s4

Published: 04 May 2023


Picture credit: iStock

What is the background to the new systemic anticancer therapy passport for children and young people?

The UK Oncology Nursing Society (UKONS) produced the first SACT passport for adult cancer services in 2017.

Launched in December 2022, the new passport for children and young people’s cancer services is the result of a collaboration between a working group of the Children and Young People Oncology Nurse Educators, part of the Children’s Cancer and Leukaemia Group (CCLG), and UK Oncology Nursing Society. They have worked together to adapt the adult passport, so it reflects the types of SACT agents used for treating children, alongside SACT practice in children’s cancer services.

‘SACT treatment can be complex and put patients at risk of significant and potentially fatal toxicities,’ says the CCLG. ‘There are also risks to those who handle SACT from occupational exposure, if control measures are inadequate. It is essential that staff are trained and assessed as competent to safely administer SACT.’

What are the benefits of this new resource?

The passport provides national standardisation of education and assessment for the skills and knowledge needed to administer SACT safely, says the CCLG. It is designed for practitioners who are treating children and young people in principal treatment centres, paediatric oncology shared care units and community services.

Among the advantages for nurses is it that it allows those who change jobs to transfer their competency across different NHS trusts. ‘We wanted to make education more seamless and streamlined,’ explains Louise Ollett, a paediatric oncology clinical educator, who conceived the idea and led the project.

While centres have always had their own SACT education programmes and workbooks, invariably they included the same themes and processes. ‘Yet when people moved trust, they had to repeat this education and training,’ she says.

For children, young people and their families, the CCLG believes this passport will improve confidence that nurses’ training is consistent, evidence-based and meets nationally agreed standards.

How does it work?

To attain competency, initially clinicians must complete the first section of the passport document, which looks at theory, and is expected to take about 15 hours.

In answering the questions, clinicians are expected to use a variety of resources, such as local policies, alongside collaborating with experienced SACT staff. Topics range from the safe handling of SACT, and patient education, to oncology emergencies, and complications.

Questions include:

  • » Name three conditions that are treated with SACT medications?

  • » Explain the process that should be undertaken if a child, or their parent or carer, refuses SACT?

  • » Describe what SACT cytotoxic waste is?

Next is the clinical practice assessment section, in which individuals demonstrate their safety and skills in handling and administering SACT, while being directly supervised by a clinician on the SACT register.

Once these two steps are completed, the clinician’s name can be added to the SACT register. The final step is yearly reaccreditation, with an annual competency review recommended.

What training is available?

All centres that carry out SACT are linked to a clinical educator, who will be able to advise on the local training and steps needed to successfully complete the passport, says Ms Ollett. Throughout February and March, she has been running ‘train the trainer’ sessions, to help those who will be assessing the completed passports.

What has been the feedback been so far?

Through the pilot scheme, there is already evidence that the passport is working as it should, says Ms Ollett. ‘We had one nurse who moved from a trust in the Midlands to another in the North East when she was halfway through completing her passport. We were able to continue that training,’ she says. ‘It’s made it a much quicker process, saving her having to repeat things.’

Over the next year, the project hopes to collate further feedback from users, looking at how much time has been saved for staff who administer SACT and nurse educators involved in assessment.

SACT tips: use trust protocols, find reliable resources and ask for help

Macmillan systemic anticancer therapy specialist nurse Amelia Weston has been using the adult version of the passport since she returned to work following maternity leave in 2020.

‘It’s good, especially from a standardisation point of view,’ says Ms Weston, who works at the University Hospital Southampton NHS Foundation Trust.

‘All nurses are singing from the same hymn sheet, which means patients receive continuity of care, with the most up-to-date and relevant advice and information. It will be beneficial for paediatric colleagues to have their own version.’

At her trust, nurses have a couple of in-house study days and are then given about two months to complete the passport workbook. Her top tips for nurses include getting organised and starting the process as early as possible.

‘Speak to your senior colleagues for help, use your trust’s protocols and find reliable resources,’ she suggests.

Further information

Children’s Cancer and Leukaemia Group (2022) Systemic Anti-Cancer Therapy (SACT) Passport.

UK Oncology Nursing Society (2019) Systemic Anti-Cancer Therapy (SACT) Competency Passport.

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