Educational Needs Related to Nursing Skill Level and Awareness of Navigating the Complexities of the Cancer Care Continuum

November 2017 Vol 8, No 11
Sharon Gentry, RN, MSN, CBCN, CBEC, ONN-CG
Breast Nurse Navigator
Novant Health Derrick L. Davis Cancer Center
Winston-Salem, North Carolina
Lillie D. Shockney, RN, BS, MAS, ONN-CG
Program Director and Co-Founder, AONN+; University Distinguished Service Professor of Breast Cancer, Departments of Surgery and Oncology; Administrative Director, The Johns Hopkins Breast Center; Director, Cancer Survivorship Programs at the Sidney Kimmel Cancer Center at Johns Hopkins; Professor, JHU School of Medicine, Departments of Surgery, Oncology, Gynecology & Obstetrics - Baltimore, MD

Background: The Academy of Oncology Nurse & Patient Navigators conducted a 1.5-day live conference April 27-29, 2017, in Phoenix, AZ.

Objectives: To provide education, promote discussion, and identify strategies to assist patients in navigating the complexities of the cancer care continuum, including financial considerations, access to screening and treatment, and the impact of personalized care, psychosocial considerations, and the challenges of various healthcare delivery models.

Methods: Practitioners completed pre- and post-meeting assessments as well as a 3-month follow-up. Data analysis is ongoing.

Results: The meeting was attended by 213 practitioners from 15 states; 88% of these were nurse navigators involved in providing navigation and survivorship care services for patients with cancer. Fifty-one percent of practitioners completing the survey stated that they had worked with oncology patients in their present position for 0 to 5 years. Sixty-three percent of attendees stated that they were somewhat familiar or not familiar at all with the Oncology Patient Navigator Core Competencies and principles of patient navigation prior to attending the meeting. Only 20% of attendees stated that they were very familiar and 17% were familiar with these competencies. When surveyed, 86% of practitioners stated that they encountered healthcare system barriers that presented a challenge to oncology patients seeking care. These barriers included financial obstacles related to a lack of insurance, transportation, child care, copays; communication/information barriers; medical system barriers (making appointments, finding physicians, referrals, authorizations); fear/distrust; and emotional barriers. As a result of their participation in this activity, 63% of participants strongly agreed and 37% agreed that they were better able to incorporate information regarding various navigation models and best practices to improve the quality of cancer patient care.

Implications for Nursing: Despite the history of navigation reflecting 2 decades of evolution, the role of oncology navigation remains a relatively new professional field with consistent growth in the novice population. In 2015, the Commission on Cancer, a part of the American College of Surgeons, required cancer centers to provide patient navigation services to meet accreditation requirements.

Conclusions: These analyses suggest there are significant differences in navigation skill level and awareness of this emerging field. Navigation continues to recognize barriers to care as was the original intent but has evolved to promote quality outcomes throughout the cancer care continuum. The educational intervention was effective in improving clinical judgment skills and awareness, and future programs will need to acknowledge this novice population as well as plan for advanced evidence-based outcome sessions for the more experienced navigators.

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Last modified: June 11, 2018

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