The Critical Role of Oncology Nurse Practitioners in Cancer Care: Future Implications

One of the most daunting challenges faced in the health care delivery system is the complexity of cancer care, and the process of care coordination, a subcomponent of patient navigation. A study was undertaken to identify a central navigation process utilized by nurse practitioners practicing oncology. The data in this article is a component of a larger study entitled: The Process of Oncology Nurse Practitioner Patient Navigation: A Grounded Theory Approach. Utilizing a grounded theory approach N = 20 oncology nurse practitioners (ONP) were recruited. To be eligible for the study the ONP had to have a: 1) license to practice in their respective state; 2) certification to practice as an oncology nurse; 3) minimum of 5 years full time experience in oncology nursing; and 4) English speaking. The participants were recruited by: 1) word of mouth networking with peers: 2) Soliciting volunteers through public announcements at professional nursing conferences; 3) Contacting authors of oncology NP navigation articles or convention pamphlets via telephone or e-mail; 4) Posting information soliciting oncology NP volunteers on blogs or websites of professional organizations with organizational director approval; and, 5) Recruiting by snowball sampling. Telephone interviews were conducted utilizing an open-ended questionnaire. Data analysis and coding revealed the central navigation processes. The triage process was carried out in a variety of unique settings, and utilized in some instances within navigation subsystems. Key triage paths were identified along the cancer continuum; documenting the need for ONP navigators to strategically place these systems in areas along the cancer continuum, to expedite timely delivery of patient care. Literature search revealed that cancer specific triage tools are lacking. Implications for research and practice include the development of these tools for cancer care. Of critical importance is the need to identify service gaps in cancer care, and strategically place triage systems, to offset these service gaps. Practical application of the research findings in relationship to current literature is integrated for discussion.

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On the uniqueness of, and diversity within, cancers: A commentary on Kangas and Gross 2018

Journal of Health Psychology ◽

10.1177/1359105318781947 ◽

2018 ◽

Vol 25 (1) ◽

pp. 26-30

Author(s):

Wolfgang Linden ◽

Andrea Vodermaier

Keyword(s):

Gender Differences ◽

Cancer Care ◽

Critical Role ◽

Tumor Stage ◽

Phase Model ◽

Fear Of Recurrence ◽

Coping Process ◽

Emotion Coping ◽

And Gender

This commentary accompanies publication of Kangas and Gross’ phase model of emotion coping throughout the process of cancer care. While supporting the model, this commentary additionally highlights the already existing knowledge about the critical role of tumor stage, patient age, uncertainty and fear of recurrence, and gender differences. It is briefly described how all of these factors moderate and mediate the emotion coping process.

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Are oncologists involved in cancer biomarker decisions at their institutions?

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.6617 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 6617-6617 ◽

Cited By ~ 1

Author(s):

Christine B. Weldon ◽

Julia R. Trosman ◽

Al Bowen Benson ◽

Gregory J. Tsongalis ◽

Kalliopi P. Siziopikou ◽

...

Keyword(s):

Decision Making ◽

Cancer Care ◽

Critical Role ◽

Testing Methods ◽

Exact Test ◽

Cancer Centers ◽

Individual Perception ◽

Biomarker Testing ◽

Survey Responses

6617 Background: Biomarkers play a critical role in oncology, but differences in accuracy and quality exist between different testing methods for specific markers. ASCO/CAP guidelines call for oncologists, on behalf of patients, to seek information on testing quality and to obtain assurance that testing laboratories are appropriately accredited (Wolff et al, JCO, 2007). We surveyed oncologists and pathologists from the NCI designated cancer centers to collect individual perception of their institution’s decision making on biomarkers, and awareness of lab quality accreditation. Methods: We conducted an IRB approved web survey of pathologists and oncologists at the 58 NCI designated cancer centers providing adult breast, gastric, esophageal and non small cell lung cancer care. The survey included 12 questions on institutional decision processes and lab quality accreditation. We analyzed results using simple frequencies and the Fisher's exact test. Results: The study achieved a response rate of 98% (57/58 sites), with survey responses from 115 pathologists and 156 oncologists. The perception that their institution uses a formal organizational review and decision process on new biomarker tests was reported by 47% (54/115) of pathologists and 31% (48/156) of oncologists (p= .0078). 22% (33/153) of oncologists report they are always involved in institutional decision making on biomarker method selection for their specialty. Awareness of CAP certification status for their institutional laboratory was reported by 88% (99/112) of pathologists and 46% (65/142) of oncologists (p <0.0001). Awareness of whether their institutional laboratory underwent CAP HER2 IHC and/or FISH proficiency testing was reported by 70% (53/76) of pathologists and by 21% (13/63) of oncologists who treat breast cancer (p<.0001). Conclusions: Oncologists are typically not actively involved in their institution’s decision making process to select biomarker testing methods, nor are many of them aware of their institutional lab’s quality accreditation. With the ever increasing role of biomarkers in cancer care, oncologists’ awareness of biomarker testing performance and their participation in decision making related to biomarkers will become critical.

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Primary care nurse practitioners providing survivorship cancer care.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.3_suppl.14 ◽

2016 ◽

Vol 34 (3_suppl) ◽

pp. 14-14

Author(s):

Margaret Quinn Rosenzweig ◽

Sara Klein ◽

Mary Connolly ◽

Rose Hoffmann

Keyword(s):

Primary Care ◽

Nurse Practitioners ◽

Nurse Practitioner ◽

Cancer Care ◽

Hospice Care ◽

Course Evaluation ◽

Care Nurse ◽

Primary Care Nurse ◽

Oncology Nurse ◽

Oncology Practice

14 Background: The Oncology Nurse Practitioner Web Education Resource (ONc-PoWER) is an online course developed specifically for nurse practitioners (NPs) in their first year of oncology practice paired with an onsite mentor (physician, nurse practitioner or physician assistant). Based on the Oncology Nursing Society’s Competencies for Entry to Practice, the course consists of 5 interactive modules: 1) the new patient visit 2) presenting a patient with cancer 3) cancer visits across the continuum of care 4) palliative and hospice care 5) self-care and professional development. The purpose of this study was to examine the NPs and mentors experience with the learning activities and to what degree the learning objectives were met. Methods: Dyads of NPs and mentors completed the course over 4-6 months. There are items for course evaluation with Likert scaled responses of 1) did not meet objective 2) somewhat met objective 3) met objective 4) more than met objective 5) exceeded objective expectation. Results: Enrollment is ongoing. Thirty NPs new to practice and 22 oncology mentors have completed evaluations thus far. Responses overall are favorable. Conclusions: The ONcPoWER web enhanced oncology orientation program was favorably evaluated by nurse practitioners new to cancer care and their mentors. This method of electronic orientation could standardize the exposure of essential basic cancer care competencies at entry to oncology nurse practitioner practice and, with some edits to content, for community based primary care nurse practitioners caring for cancer survivors. [Table: see text]

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