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Oncology Clinical Nurse Specialists
Cyndi Miller Murphy, RN, MSN, CAE
Oncology Nursing Certification Corporation
Executive Director
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
Historical Perspective1990 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
Historical Perspective1993-1994 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%
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
Historical Perspective
1998 Second RDS of Advanced Oncology Nursing Practice conducted by ONCC
Significant shift in roles of Oncology APN
ONS Membership
CNS NP
1994 1660 269
1998 1417 633
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%
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
Historical Perspective
1999 Revised AOCN® Certification Examination administered
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
ONS Membership
CNS NP
1994 1660 269
1998 1417 633
2004 833 1283
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.
Results of Third RDS
2003
Task-knowledge linkages were used to develop relative weights of the test specifications (blueprints) for separate role specific examinations.
AOCNS, AONP Test BlueprintsTopic 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%
2005
Administration of new AOCNS, AOCNP Certification Examinations
Care Setting
1994 1998 2003
In Patient 58% 34% 31%
Out Patient 37% 63% 61%
Home 5% 3% 1%
Other 7%
AOCN® Certified Nurses
NP 470
CNS 436
Administrator 196
Educator 133
Other 250
AOCN® Certification Recognized for CNS Role in 13 states
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
Specialization vs. Subspecialization
Specialty : Oncology
Examples of Subspecialties within oncology•Specific diseases or categories of diseases
LeukemiasGynecologic Cancers
CNS TumorsEndocrine Tumors
•Specific treatment entitiesBlood and Marrow TransplantationRadiation OncologySurgical Oncology