Advancing in Oncology Nursing:

Exploring CNS Roles and their Impact

on Patient Outcomes

Barbara Wenger MS, RN, AOCNS, CRNIOncology/ BMT CNS

University of Colorado HospitalAurora, 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 CompetencyIndependent Practice - CNS

Independent Prescribing - CNS

Current Specialty Programs

• Adult Health CNS

• Adult Gerontology CNS

• Adult Psychiatric Mental

Health CNS

• Child/ Adolescent

Psychiatric Mental Health

CNS

• Home Health CNS

• Pediatric CNS

• Public/ Community 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/prescr-authority.php

NACNS. (2010). CNS core competencies. Retrieved fromhttp://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