SIOP PODC Nursing Working Group: Baseline Nursing Standards

Nurses are one of the most important members of the healthcare team for children with cancer. In many ways, nurses are the final common pathway for providing care in both inpatient and outpatient settings.  Oftentimes in low- and middle-income countries (LMIC), healthcare systems do not emphasize nursing education and standards for nursing care are poorly defined.  To meet this need, the International Society of Pediatric Oncology (SIOP) Pediatric Oncology in Developing Countries (PODC) Nursing Working group has published baseline nursing standards that describe the minimum requirements for nurses to deliver safe and effective care to pediatric oncology patients.  We’ll hear from three experts from the Nursing Working Group, Lisa Morrissey, Glenn Mbah, and Julia Challinor, all of whom are highly involved in the developing and dissemination of the standards.

Baseline Nursing Standards

Standard 1: Staffing plans based on patient acuity. A nurse to patient ratio of 1:5 for paediatric oncology units and 1:2 for critical care and transplant units is recommended. Nurses trained and experienced in oncology should remain within the service and not rotate.

Standard 2: A formalized paediatric oncology orientation programme for new nurses. A minimum of 2 weeks theory/skills training in key topic areas and 3-4 weeks clinical observation is required.

Standard 3: Continuing education and training to increase paediatric oncology clinical skills and knowledge. A minimum of 10 hours a year is recommended.

Standard 4: Acknowledgment of nurses as core members of the multidisciplinary paediatric oncology team. A nurse should be included in patient rounds and all meetings with patients and parents/caregivers regarding diagnosis and treatment plans.

Standard 5: Available resources for safe paediatric oncology care. These include intravenous pumps and hand washing facilities. Nurses should prepare chemotherapy drugs only if a pharmacist is not available and when provided with personal protective equipment.

Standard 6: Evidence-based paediatric oncology nursing policies and procedures to guide the delivery of quality nursing care. Because of the lack of nursing research in LMICs, funding for locally directed research is the next step to creating relevant nursing policies and procedures.


1. The baseline standards: Paediatric Oncology Nursing Care in Low- and Middle-Income Countries: A need for baseline standards

2.  Survey findings: Disparities in the delivery of pediatric oncology nursing care by country income classification: International survey results

3.  Further survey findings: Predictors of Hospitals’ Nonachievement of Baseline Nursing Standards for Pediatric Oncology

4.  Find out more about the baseline standards and how to implement them: SIOP PODC Nursing Baseline Standards page

Guest Biographies (from left to right in post picture)

Lisa Morrissey, MPH MSN RN CPHONis a nurse leader in the Dana-Farber/Boston Children’s Hospital (DF/BCH) Cancer and Blood Disorders Program in Boston, MA. She holds an MSN degree in Nursing Administration from Northeastern University, and a MPH in Healthcare Management from Harvard School of Public Health. Lisa is the Nurse Manager for the Inpatient Hematology/Oncology/Research at BCH, and Director of the BCH Global Nurse Fellowship program. She has led several nursing global partnerships in resource-limited countries including Ghana, the Dominican Republic and Myanmar, promoting education, professionalism and collaboration for pediatric oncology nurses. Lisa is chair of the SIOP Nursing Committee and an active member of the SIOP Nursing Baseline Standards taskforce.

Glenn Mbah Afungchwi, RN, MPH, is the programme coordinator for World Child Cancer in Cameroon and projects coordinator for the Cameroon Paediatric Oncology Group. He is the current nurse representative at the board of SIOP Africa, co-chair of the SIOP Pediatric Oncology in Developing Countries (PODC) Traditional and Complementary Medicine (T&CM) working group, and co-coordinator of the Supportive Care for Children with Cancer in Africa (SUCCOUR) project. He is involved in the WHO Global Initiative for Childhood Cancer. Glenn is also studying for a PhD at Stellenbosch University, South Africa, with a research interest in improving access to care for children with cancer.

Julia Challinor, RN, PhD, MS in Education and MS in Med Anthropology, is a graduate of Wheelock College, Boston, MA; San Francisco State University, CA; the University of California, San Francisco, CA; and the University of Amsterdam, The Netherlands. A former teacher, Julia was the Educational Liaison for children with cancer and those who had survived their disease at the University of California, San Francisco from 1993-2003. During 1994-2006, she also headed A Tomorrow for Children Foundation and worked in partnership with pediatric oncology centers in Latin America. As an international nursing consultant for oncology with an anthropological perspective, Julia seeks to strengthen nursing resources and opportunities in countries with limited resources. From 2011-2017, Julia’s professional focus focused on mentorship of pediatric oncology nurses in Ethiopia and she has a current nursing collaboration in India (started in 2016). Julia works to develop an interconnected multidisciplinary approach to cancer care that acknowledges nurses and parents as key partners.