Advanced Practice Issues: Results of the ONS Advanced Practice Nursing Survey

Purpose/Objectives: To ascertain the critical issues in current advanced practice nurse (APN) roles in oncology.

Design: Descriptive.

Setting: National.

Sample: 368 Oncology Nursing Society (ONS) APNs in oncology practice.

Methods: Subjects completed an 11-page self-administered questionnaire comprised of 62 multiple-choice and open-ended questions. Subjects were asked to identify level of importance for ONS to address selected issues in each section.

Main Research Variables: Demographic information and APN issues regarding practice, outcomes, prescriptive authority, reimbursement, education, continuing education, licensure and certification, legislation, and challenges facing oncology APNs.

Findings: The majority of APNs were nurse practitioners working in a hematology/oncology practice in an urban setting providing direct patient care. Priority practice issues were lack of agreement among state boards of nursing related to privileges, lack of understanding of the role by patients and healthcare professionals, and lack of an APN definition. Important APN outcomes were symptom management, quality of life, patient/family satisfaction, and cost of care. Priority educational topics were oncology disease management, pharmacology, advanced physical assessment, and reimbursement. Challenges facing oncology APNs were lack of an APN definition, reimbursement issues, documentation of outcomes, prescriptive authority, variance in education, merging of current roles, certification, loss of cancer specialty, and second licensure.

Conclusions: Numerous APN issues continue to be unresolved. APN outcomes research is needed to validate the oncology APN role in cancer care.

Implications for Nursing Practice: Survey results and specific recommendations have been forwarded to the ONS Steering Council and Board of Directors for implementation decisions.