At the 51st Annual Oncology Nursing Society (ONS) Congress, Courtney Covert, MSN, RN, AGCNS-BC, BMTCN, highlighted the crucial role of multidisciplinary communication and structured coordination in administering a novel mitomycin gel (Jelmyto) to patients with urothelial cancer. Because the therapeutic agent is highly time sensitive once removed from cold storage, successful delivery requires a precisely orchestrated timeline across pharmacy, nursing, and patients.
Covert emphasized that pharmacy teams require advanced scheduling notice to execute compounding steps, while nursing staff must utilize comprehensive skills checklists to verify treatment parameters—such as nephrostomy tube patency—before pulling the drug off ice. This systematic approach allows nurses to safely delegate other clinical responsibilities, preventing treatment delays and mitigating the risk of costly medication waste. Ultimately, establishing a shared understanding of timing and equipment readiness among all stakeholders, including the patient, ensures optimal safety and safeguards the integrity of this specialized oncologic intervention.
Covert is an oncology clinical nurse specialist at Johns Hopkins Sibley Memorial Hospital.
Transcript:
From the pharmacy perspective, the biggest thing is, first, did they have the medication? Second, did they know the time? They don’t want to know 30 minutes before the patient [arrives]; they need to know ahead of time. They usually have the same schedule [nurses] do, so they have the same patient list that tells them the exact time patients are coming in. From their perspective, they needed to know the time to know the steps and how many hours ahead they needed to start preparing.
From the nursing perspective, it is again about knowing the time the patient is going to come in. Since this is a new procedure, they needed to be aware that if they had other patients with critical needs, they might need to delegate to another individual or talk to their peers and say, “Hey, I’m doing this new procedure, can you cover my other patients for me? I might [take] 30 minutes to an hour. If there’s an emergency, just come let me know.”
Also, it is just about having confidence and having the skills checklist to know what they are doing beforehand. As I said, as soon as that medication comes off ice, your timer is starting. There is no putting the medication back in the vial and saying, “Oh, it’s okay.” You needed to confidently know how much you are administering, whether the nephrostomy tube is working, and if the patient had any symptoms that would stop them from getting treatment. Do we have the medication in house? All those types of checklist items need to be ensured beforehand.
Our checklist covered all those items to make sure that when they put the vial on ice, the time is done, and they pull it off ice, they know, “I have all my items, and there is no doubt in my mind that we can give this medication.” Ultimately, that ends in safer outcomes and [higher] patient satisfaction. Patients do not want to be told, “Yeah, your medication had to be wasted because the nurse accidentally messed something up.” That would obviously be [quite] upsetting for the patient, and then they are going to have to come back, [leading to all the issues] that come after having to reschedule a patient.
It requires a lot of coordination. The patients themselves also need to know what time they need to be here. If a patient does not show up for their appointment, that could also be devastating. We have this medication that has been shipped and is ready for them, and they are the only one who can receive this drug; we cannot use it for another patient. Everyone, including the patient themselves, had to be on board with the timing, the skill itself, the equipment, [et cetera].
Reference
Covert C, Olsen M. Mitomycin mastery building nursing competency in Jelmyto (mitomycin) administration via nephrostomy tube for urothelial cancer. Presented at: 51st Annual Oncology Nursing Society (ONS) Congress; May 13-17, 2026; San Antonio, TX. Poster 117
