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  • 1. Oncology Clinical Nurse Specialists Cyndi Miller Murphy, RN, MSN, CAE Oncology Nursing Certification Corporation Executive Director
  • 2. Historical Perspective 1968 University of Pittsburgh offered an oncology tract in the medical-surgical master’s degree program in nursing 1974 First oncology graduate program in nursing offered at Rush University 1990 44 graduate programs in oncology nursing in USA
  • 3. Historical Perspective 1990 Oncology Nursing Society (ONS) published the Standards of Advanced Practice in Oncology Nursing – defined the structure, process, and outcome criteria for advanced practice nursing Oncology Nursing Certification Corporation (ONCC) survey of ONS members with graduate education indicated that 69% were interested in obtaining advanced oncology certification
  • 4. Historical Perspective 1993-1994 First role delineation study (RDS) of advanced clinical oncology nursing practice was conducted by ONCC • 1,349 master’s prepared ONS members in clinical roles were surveyed • Instrument based on the CNS role • Responses CNS 58% NP 6% Other 36%
  • 5. Historical Perspective 1995 First AOCN® Certification Examination Administered First ONS Position Statement on Advanced Oncology Nursing Practice published 1997 ONS published Statement on the Scope and Standards of Advanced Practice in Oncology Nursing
  • 6. Historical Perspective 1998 Second RDS of Advanced Oncology Nursing Practice conducted by ONCC Significant shift in roles of Oncology APN
  • 7. ONS Membership CNS NP 1994 1660 269 1998 1417 633
  • 8. Historical Perspective 1998 Second RDS of Advanced Oncology Nursing Practice 1200 Oncology APN surveyed1200 Oncology APN surveyed 1998 1994 NP 41% 6% CNS 36% 58% Combined 11% Other 12% 36%
  • 9. Historical Perspective • Significant changes in practice from 1994 • Significant changes to the Test Blueprint • Few significant differences were found between the NP and CNS groups with regard to knowledge and job responsibilities (< 10% items) 1998 RDS
  • 10. Historical Perspective 1999 Revised AOCN® Certification Examination administered
  • 11. Historical Perspective 2003 ONS Position on The Role of the Advanced Practice Nurse in Oncology Care revised Third RDS of Advanced Oncology Nursing Practice conducted by ONCC • Response to changing demographic
  • 12. ONS Membership CNS NP 1994 1660 269 1998 1417 633 2004 833 1283
  • 13. Results of Third RDS 2003 Oncology CNS and Oncology NP share a substantial core of knowledge important to both roles. However, there are discernable differences in work responsibilities for NP and CNS in oncology.
  • 14. Results of Third RDS 2003 Task-knowledge linkages were used to develop relative weights of the test specifications (blueprints) for separate role specific examinations.
  • 15. AOCNS, AONP Test Blueprints Topic Weight I. Cancer Screening, Prevention, Early Detection, and Genetic Risk II. Cancer Diagnosis and Staging III. Cancer Treatment Modalities IV. Acute, Chronic, and Late Symptom Management V. Oncologic Emergencies VI. Psychosocial Management VII. Coordination of Multidisciplinary Care VIII. Professional Practice IX. End of Life Care X. Research Utilization X. Roles of the CNS NP 4% 8% 20% 19% 12% 15% 5% 9% 5% 3% CNS 4% 3% 14% 13% 11% 17% 9% 13% 5% 12%
  • 16. 2005 Administration of new AOCNS, AOCNP Certification Examinations
  • 17. Care Setting 1994 1998 2003 In Patient 58% 34% 31% Out Patient 37% 63% 61% Home 5% 3% 1% Other 7%
  • 18. AOCN® Certified Nurses NP 470 CNS 436 Administrator 196 Educator 133 Other 250
  • 19. AOCN® Certification Recognized for CNS Role in 13 states
  • 20. Specialization vs. Subspecialization Oncology meets the ABNS definition of a specialty and all related ABNS standards •Definition and Scope of Nursing Specialty •Research Based Body of Knowledge
  • 21. Specialization vs. Subspecialization Specialty : Oncology Examples of Subspecialties within oncology •Specific diseases or categories of diseases Leukemias Gynecologic Cancers CNS Tumors Endocrine Tumors •Specific treatment entities Blood and Marrow Transplantation Radiation Oncology Surgical Oncology