Evidence Based Practice Clinical Guideline Review

From the Children’s Oncology Group: Evidence Based Practice Recommendations for Peg-Asparaginase Nurse Monitoring, Hypersensitivity Reaction Management, and Patient/Family Education

Author(s): Deborah Woods, MSN RN CPNP; Kari Winchester, BSN RN CPHON®; Alison Towerman, MSN RN, CPNP; Katie Gettinger, MSN RN CPNP-PC; Christina Carey, BSN RN; Karen Timmermann, BSN RN; Rachel Langley, PharmD BCPPS; and Emily Browne, DNP RN CPNP.


Method of Review: A subcommittee of the Evidence Based Practice and Research Committee of the Association of Pediatric Hematology/Oncology Nurses conducted a group review of the clinical recommendations using the AGREE II criteria1. The committee had an overall assessment of approval for endorsement.

Review Summary: PEG-Asparaginase and other drugs with a potential to cause hypersensitivity reactions always concern nurses during clinical practice. Despite not meeting all the usual criteria for Guidelines, this is a well conducted systematic review that used reliable criteria to evaluate the selected studies, and suggests some recommendations based on the literature that was found. The authors have reported some limitations, especially regarding low-quality evidence to support the recommendations. Considering all the limitations and the lack of studies about this subject, this is an updated and relevant summary of recommendations andcan certainly fill an important gap in pediatric oncology nursing practice.

Recommendation for use: Recommended for use in pediatric oncology.

Disclaimer: These are not Evidence Based Practice (EBP) guidelines but are a systematic review of literature with EBP recommendations. Not all components of the AGEE II review instrument are met. The instrument is designed specifically for guideline review. The AGREE II instrument does allow for an objective assessment of quality. The EBP/Nursing Research Committee agrees that the value of these pediatric oncology EBP recommendations merit their posting on the APHON website.


1AGREE Next Steps Consortium (2009). The AGREE II Instrument [Electronic version]. Retrieved May, 2018, from http://www.agreetrust.org.