Advancing in Oncology Nursing: Exploring CNS Roles and their Impact on Patient Outcomes

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Advancing in Oncology Nursing: Exploring CNS Roles and their Impact on Patient Outcomes Barbara Wenger MS, RN, AOCNS, CRNI Oncology/ BMT CNS University of Colorado Hospital Aurora, Colorado September 23, 2016

Objectives 1. Describe the various roles of the Clinical Nurse Specialist (CNS). 2. Discuss how the CNS role influences both nursing practice and system changes to improve patient outcomes

What is a Clinical Nurse Specialist (CNS)?

Spheres of Influence http://www.nacns.org/docs/cnscorecompetenciesbroch.pdf

Direct Care Competency

Systems Leader Competency

Consultant Competency

Collaboration Competency

Coaching Competency

Research Competency

Ethical Decision Making, Moral Agency and Advocacy Competency

Independent Practice - CNS

Independent Prescribing - CNS

Current Specialty Programs Adult Health CNS Adult Gerontology CNS Adult Psychiatric Mental Health CNS Home Health CNS Pediatric CNS Public/ Community Health CNS Child/ Adolescent Psychiatric Mental Health CNS

Oncology Certifications Clin J Oncol Nurs. Author manuscript; available in PMC 2013 Jun 10. Published in final edited form as: Clin J Oncol Nurs. 2008 Oct; 12(5): 703 705.doi: 10.1188/08.CJON.703-705

NACNS Position Paper

References Beavor, C., Magnan, M.A., Henderson, D., DeRose, P., Carolin, K. & Bepler, G. (2016). Standardizing assessment of competences and competencies of oncology nurses working in ambulatory care, Journal of Nurses in Professional Development, 32(2), 64-73. doi: 10.1097/NND.0000000000000250 Blackburn, R., Presson, K., Laduman, R., Tomczak, N. & Brassil, K.F. (2016). Establishing an inpatient gym for recipients of stem cell transplantation: A multidisciplinary collaborative, Clinical Journal of Oncology Nursing, 20(1), 66-71. doi: 10.1188/16.CJON.66-71. Carreon, N., Sugarman, C., Beener, E. & Agan,D. (2015). Creating and standardizing annual chemotherapy competencies throughout a healthcare system. Journal for Nurses in Professional Development, 31(1), 35-39. doi: 10.1097/NND.0000000000000131. Eisenberg, S. (2016). A call to action for hazardous drug safety: Where we have been and where we are now, Clinical Journal of Oncology Nursing, 20(4), 377-384. doi: 10.1188/16.CJON.20-04AP. Garzo-Saria, M., Stone, A., Walton, A.L., Brown, G., Norton, B. & Barton-Burke, M. (2014). Voices of ONS members matter in advoccy and decisions related to U.S. health policy, Clinical Journal of Oncology Nursing, 18(6), 719-721. doi: 10.1188/14.CJON.719-721. Houlihan, N.G. (2015). A review of challenging situations when administering palliative chemotherapy- a nursing perspective. Oncology Nursing Forum, 42(3), 319-320. doi: 10.1188/15.ONF.319-320. Kim, M.Y.(2011). Effects of Oncology Clinical Nurse Specialists interventions on nursing sensitive outcomes in South Korea, Clinical Journal of Oncology Nursing, 15(5), E 66-74. doi: 10.1188/11.ONF.E66-E74.

References Knobf, M.T., Cooley, M.E., Duffy, S., Doorenbos, D., Eaton, L., Given, B., Mayer, D.K Mallory, G. (2015). The 2014-2018 Oncology Nursing Society research agenda, Oncology Nursing Forum, 42(5), 45-465. doi: 10.1188/15.ONF.450-465. Leak, A & Spruil, A. (2013). Oncology Certification: What Is in It for You? Retrieved fromhttp://dx.doi.org/10.1188%2f08.cjon.703-705. Maloney, K.W., Denno, M., Kider, T., McCintock, K., Moore, A., Rutyna, T., Wiley, K.& Sullivan, M.D. (2013).The oncology phone: An innovative program for the management of the oncology population in an academic medical center. Clinical Journal of Oncology Nursing, 17(4), 387-392. doi: 10.1188/13.CJON.17-04AP. Moore, S. (2012). Heart failure in a breast cancer survivor, Oncology Nursing Forum, 39(2), 147-150. doi: 10.1188/12.ONF.147-150. NACNS. (2010). CNS scope of practice and prescriptive authority. Retrieved from http://www.nacns.org/html/prescrauthority.php NACNS. (2010). CNS core competencies. Retrieved from http://www.nacns.org/docs/cnscorecompetenciesbroch.pdf NACNS. (2015). Key findings from the 2014 Clinical Nurse Specialists census. Retrieved from http://www.nacns.org/docs/censusinfographic.pdf NACNS. (2015). NACNS Position Statement on the Doctor of Nursing Practice. Retrieved from http://www.nacns.org/docs/dnp-statement1507.pdf

References NCSBN. (2016). CNS Independent Prescribing Map. Retrieved from https://www.ncsbn.org/5410.htm NCSBN. (2016). CNS Independent Practicing Map. Retrieved from https://www.ncsbn.org/5406.htm Olsen, M., Mooney, K.,& Evans, E. (2016). Implementation of an early warning scoring system to identify patients with cancer at risk for deterioration. Clinical Journal of Oncology Nursing, 20(4), 374-376. doi: 10.1188/16.CJON.374-376. ONS. (2004). ONCC Announces New Certification Options for Advanced Practice Nurses. Retrieved from http://onsopcontent.ons.org/publications/chapter/june04/oncc.html Overcash, J. (2015). Integrating geriatrics into oncology ambulatory clinics, Clinical Journal of Oncology Nursing, 19(4), E80-86. doi: 10.1188/15.CJON.E80-E86 Sanares-Carreon, E., Comeau, O., Heliker, D., Marshall, D., Machner, C., Bell, L., Brumfield, J Sandridge, J. (2015).An educational pathway to fast track evidence-based practice at the bedside. Journal for Nurses in Professional Development, 31(1), E 1-6. doi: 10.1097/NND.0000000000000113. Yarom, N., Arkyawardand, A., Hovan, A., Barasch, A., Jarvis, V., Jensen, S.B., Zadik, Y Lalla, R.V. (2013). Systematic review of natural agents for the management of oral mucositis in cancer patients, Supportive Care in Cancer, 21, 3209-3221. doi: 10.1007/s00520-013-1869-5