High qualified specialized oncology nurses are considered the backbone in any chemotherapy 
administration agency. Using standardized protocol for administration of chemotherapy is a 
pressing demand for prevention of medication errors with promotion of patients' safety and 
satisfaction. Aim: Evaluate the effect of chemotherapy nursing protocol application on 
patients' care competency, safety, and satisfaction. Design: Quasi experimental design. 
Setting: Oncology institution of Menoufia University. Subjects: A convenience sample of 
44 oncology nurses and 36 patients receiving chemotherapy. Tools: Socio-demographic 
questionnaire, Oncology Nurses' knowledge questionnaire, Self-assessment chemotherapy 
related clinical competency questionnaire, Patient safety culture questionnaire and patients' 
satisfaction questionnaire. Results: The number of reported errors decreased throughout 
study phases with high statistically significant difference. The total knowledge score of 
studied nurses was improved from 7.75 pre protocol application to 21.45 immediately post 
protocol application with high statistically significant difference. The total nurses' 
competency score was improved from 48.79 to 88.50 then 87.57 respectively with high 
statistically significant difference. The total patients' satisfaction score was improved from 
10.61 to 25.29 then 25.09 respectively with high statistically significant difference. 
Conclusion: A considerable improvement was observed in oncology nurses' knowledge, 
clinical competency and patients' safety and satisfaction after chemotherapy nursing protocol 
application. In addition, there was positive correlation between nurses' knowledge and 
competency and both patients' safety and satisfaction. Recommendation: Application of 
chemotherapy nursing protocol is recommended routinely for managing all chemotherapy 
patients.