2017 Oncology Nurse Navigator Core Competencies

2017 Oncology Nurse Navigator

Core Competencies

Project Team Members

Lori McMullen, RN, MSN, OCN®; Team Leader

Clinical and Program Manager, Cancer Services

Matthews Center for Cancer Care

University Medical Center of Princeton at Plainsboro

Plainsboro, NJ

Deborah Christensen, MSN, APRN, AOCNS®, HNB-BC

Oncology Nurse Navigator

Southwest Cancer Center

St. George, UT

Pamela J. Haylock, PhD, RN, FAAN

Adjunct Faculty, Sul Ross State University, Alpine, TX

Oncology Care Consultant, Educator

Medina, TX

Traudi Rose RN, BSN, MBA, OCN®

VISN20 Program Manager for the Cancer Care Navigation

Team

VA Portland Health Care System

Portland, OR

Jean B. Sellers, RN, MSN

Administrative Clinical Director–UNC Cancer Network

UNC Lineberger Comprehensive Cancer Center

Chapel Hill, NC

Dominique Srdanovic, RN, MA, OCN®

GU Oncology Nurse Navigator

Stamford Hospital, Bennett Cancer Center

Stamford, CT

ONS Sta

Kristen Baileys, MSN, CRNP, OCN®

Independent Contractor/Oncology APRN Consultant

Oncology Nursing Society

Pittsburgh, PA

Barbara Lubejko, RN, MS

Oncology Clinical Specialist

Oncology Nursing Society

Pittsburgh, PA

Table of Contents

Key Terms Used in Competencies ........................................................................................................... 4

Purpose of Competency Development.................................................................................................... 4

Denition of Oncology Nurse Navigator Core Competencies ............................................................ 4

Process of Competency Development .....................................................................................................5

Applicability and Dissemination .............................................................................................................. 6

Scope of ONN Practice .............................................................................................................................. 6

Summary ..................................................................................................................................................... 8

References ....................................................................................................................................................8

Competencies

A. Coordination of Care .................................................................................................................. 9

B. Communication .........................................................................................................................10

C. Education .................................................................................................................................... 10

D. Professional Role .......................................................................................................................11

E. Expert ONN ............................................................................................................................... 11

Photo credits: main image, © monkeybusinessimages/iStock/Thinkstock; from left to right, © jacoblund/iStock/Thinkstock; © Jose Luiz Pelaez

Inc./Blend Images/Thinkstock; © monkeybusinessimages/iStock/Thinkstock

2017 Oncology Nurse Navigator Core Competencies

Expert Reviewers

Karyl Blaseg, RN, MSN, OCN®

Director of Cancer Services, Integrative Medicine, and

Supportive Care

Billings Clinic

Billings, MT

Marie Borsellino, RN, MSN, OCN®

Program Manager, Oncology Nurse Navigator

Managing Cancer at Work

Kimmel Comprehensive Cancer Center

Johns Hopkins Hospital and Health System

Baltimore, MD

Gean Brown, MSN, RN, OCN®

Nurse Manager

Bennett Cancer Center

Stamford Hospital, CT

Cynthia (Cindi) Cantril, RN, OCN®, CBCN®, MPH

Director Cancer Support Services/Patient Navigation

Sutter Pacic Medical Foundation

Santa Rosa, CA

Rebecca Crane-Okada, PhD, RN, CNS, AOCN®

Director of Breast Cancer Navigation and Willow Sage

Wellness Programs

Margie Petersen Breast Center

Professor of Oncology

John Wayne Cancer Institute

Providence Saint John’s Health Center

Santa Monica, CA

Lori Hartinger, BSN, OCN®, CN-BN

Lead Navigator/Breast Cancer Navigator

Shady Grove Breast Center

Rockville, MD

Joy Hepkins, RN, BSN, OCN®

Oncology Nurse Navigator

Mercy Fitzgerald Hospital

Darby, PA

Carrie Lee, MSN, RN, OCN®

Genesis Cancer Care Center

Zanesville, OH

Diane McElwain, RN, OCN®, M.Ed

Retired Oncology Coordinator, York Cancer Center, WellSpan

Nurse Consultant

York, PA

Margaret Rummel, BSN, MHA, OCN®, NE-BC

Oncology Nurse Navigator

Abramson Cancer Center, Penn Medicine

Philadelphia, PA

Susan Scott, BSN, RN, OCN®

Oncology Nurse Navigator

Lung and Head and Neck Cancers

Burbank, CA

Lynsi Slind, RN, MN, OCN®

Cancer Care Navigation Team RN

VA Puget Sound Health Care System

Seattle, WA

Ruth Van Gerpen MS, RN-BC, APRN-CNS, AOCNS®

Oncology Nurse Navigator

Bryan Health

Lincoln NE

online, or otherwise reuse at your institution, please email [email protected].

2017 Oncology Nurse Navigator Core Competencies

Key Terms Used in Competencies

Oncology nurse navigator: An oncology nurse navigator

(ONN) is a professional RN with oncology-specic clinical

knowledge who oers individualized assistance to patients,

families, and caregivers to help overcome healthcare system

barriers. Using the nursing process, an ONN provides educa-

tion and resources to facilitate informed decision making and

timely access to quality health and psychosocial care through-

out all phases of the cancer continuum.

Lay navigator: A trained nonprofessional or volunteer who

provides individualized assistance to patients, families, and

caregivers to help overcome healthcare system barriers and fa-

cilitate timely access to quality health and psychosocial care

from prediagnosis through all phases of the cancer experience

(Oncology Nursing Society [ONS], 2010).

Novice ONN: A nurse who has worked two years or less in the

ONN role and is building upon his or her academic prepara-

tion, nursing knowledge, and oncology navigation experience

to develop in the ONN role.

Expert ONN: An ONN who has worked at least three years,

is procient in the role, and has the education and experience

to use critical thinking and decision-making skills pertaining

to the evolution of navigation processes and the individual

ONN.

Purpose of Competency Development

Core competencies refer to a specic area of expertise that is

vital to performing in a role (National Institute of Standards

and Technology, 2015). In 2011, ONS recognized that a grow-

ing number of oncology nurses identied ONN as their prima-

ry role function. Supported by data collected in the ONS Nurse

Navigator Survey, the rst ONN role delineation study (RDS)

(Brown et al., 2012), and anecdotal information from the ONS

Nurse Navigator Special Interest Group (SIG), ONS identied

the need to clearly dene the role of the ONN, as well as sup-

port growth and standardization of the role. is need led to

the ONS Board of Directors’ plan for the development of the

initial ONN competencies (ONS, 2013).

In 2015, the ONS Nurse Navigation SIG leadership team col-

laborated with the ONS Board of Directors to compose a po-

sition statement. e ONS Position on e Role and Quali-

cations of the Oncology Nurse Navigator highlights the ONN

role in supporting organizational strategies across the cancer

care continuum, necessitating the ONN to master knowledge,

skills, and tasks that allow him or her to inuence network sys-

tems and behaviors, community needs assessment, navigation

program development, marketing and outreach, understand-

ing and use of ONN-specic outcomes metrics, and identica-

tion of gaps in and strategies to meet continuum-based needs.

In addition, cancer survivorship planning is increasingly a

component in the navigator role expectations (Lubejko et al.,

2016; ONS, 2015).

As ONS continues work to rene and support the role of the

ONN, a second RDS was conducted in 2016 to determine

whether the ONN role was changing and whether there was

sucient information to support the development of an ONN

certication examination. Findings of this RDS (Lubejko et al.,

2016) revealed that, while the knowledge needed for each role

are similar, dierences exist between the focuses of the clinical

oncology nurse and ONN roles.

e practice focus of the ONN is on education and coach-

ing of colleagues about the navigation role, collaboration to

identify and learn best practices, marketing, and population

and systems-level tasks (Lubejko et al., 2016). e RDS re-

vealed that, although care coordination is an integral com-

ponent of oncology nursing in general, the clinical or sta

nurse usually focuses on meeting patients’ clinical needs in

one setting, whereas the ONN most oen provides care co-

ordination, guidance, education, and advocacy across care

settings (Lubejko et al., 2016). Also in 2016, the name of the

ONS Nurse Navigation SIG was broadened to the Navigation

and Care Coordination Community to acknowledge and

highlight that care coordination is a key component of the

ONN role.

Based on the RDS results and feedback from ONS member-

ship, a process was initiated to evaluate and update the ONN

core competencies developed in 2013. e ONN competen-

cies are meant to reect practice across most settings with

consideration of the context of the individual navigation pro-

gram.

Denition of Oncology Nurse Navigator

Core Competencies

e ONN competencies outline the fundamental and ad-

vanced knowledge, skills, and expertise needed to eectively

(a) coordinate the care of patients with a past, current, or po-

tential diagnosis of cancer; (b) assist patients with cancer, fam-

ilies, and caregivers to overcome healthcare system barriers;

and (c) provide education and resources to facilitate informed

deci sion making and timely access to quality health and psy-

chosocial care throughout all phases of the cancer care contin-

uum (CCC).

2017 Oncology Nurse Navigator Core Competencies

Process of Competency Development

ONS uses a multi-step process that starts with a literature re-

view and expert opinion to identify and compare common

competency themes and gaps and develop a preliminary list of

competencies. e dra competences are then vetted through

eld and expert review. is process is unchanged for the up-

dated ONN core competencies.

Before beginning the process of updating the competencies,

a project team was identied. e project team included six

ONS members and two ONS sta. e ONS members were

chosen because of their expertise related to the ONN role in

a variety of settings and areas of the country. ey were also

chosen because of their demonstrated leadership abilities.

Early in the process of ONN competency review, the project

team noted that most nurses currently in oncology naviga-

tion roles bring extensive oncology nursing experience and

a growing number have lengthy experience in navigation.

e data indicated the need to recognize progression in the

knowledge, skills, and tasks—the competencies—that dif-

ferentiate novice and experienced or expert ONNs. A pro-

gression in the current ONN core competency structure to

include a category detailing expert ONN core competencies

was included in the process of competency development and

vetting.

Step 1: Develop List of Core Competencies

e literature review included publications from 2013–2016

and focused on skill and knowledge requirements, position

descriptions, and the American College of Surgeons Com-

mission on Cancer (2016) guidelines. In addition, the project

team reviewed current ONS competency documents—the

Oncology Clinical Trials Nurse Competencies, the Oncology

Clinical Nurse Specialist Competencies, the Oncology Nurse

Practitioner Competencies, and the Leadership Competencies

(ONS, 2007, 2008, 2012, 2016)—to review the scope and pro-

cess involved in professional competency development. It was

also pertinent that the project team reviewed the 2016 ONN

RDS. is study evaluated the nursing tasks that are more of-

ten the responsibility of the ONN as opposed to the clinical/

sta oncology nurse (Lubejko et al., 2016).

A brainstorming session resulted in revisions to the key terms

used to dene navigators in the 2013 document: ONN, lay

navigator and novice navigator. Based on the evidence and

Benner’s (1984) theory From Novice to Expert: Excellence and

Power in Clinical Nursing Practice, the project team added

“procient” ONN to the list of key terms used to dene types

of navigators. Ultimately, procient was changed to “expert” to

align with the recommendations of the expert reviewers.

e denition of a novice ONN remains unchanged from the

original competencies.

An oncology nurse navigator is a professional registered

nurse with oncology-specic clinical knowledge who of-

fers individualized assistance to patients, families, and

caregivers to help overcome healthcare system barriers.

Utilizing the nursing process, an oncology nurse navigator

provides education and resources to facilitate informed

decision making and timely access to quality health and

psychosocial care throughout all phases of the cancer con-

tinuum (ONS, 2013).

Having a clear denition of an ONN allows for a uniform un-

derstanding of who lls the role of ONN and dierentiates the

ONN from the lay navigator.

A denition for an expert ONN was added:

An ONN who has worked at least three years, is procient

in the role and has the education and experience to use

critical thinking and decision-making skills pertaining to

the evolution of navigation processes and the individual

ONN.

e 2013 project team divided the knowledge base and func-

tion of the ONN into four categories: professional role, edu-

cation, coordination of care, and communication. e catego-

ries were reordered by the 2016 project team to coordination

of care, communication, education, and professional role to

highlight the operational focus of the ONN.

Aer review of the 2013 competencies, the literature and their

knowledge of the ONN role, the project team agreed on 42

novice ONN competencies and 9 expert ONN competencies,

for a total of 51 competencies. e expert competencies were

added to demonstrate an advanced level of knowledge of ONN

practice, process improvement, decision making, and critical

thinking skills.

e ONN professional practice framework, originally devel-

oped by the 2013 project team, was enhanced to reect the

core competency categories within the rst circle of ONN

practice. In addition, because of the complexity and durability

of the ONN role across the cancer continuum, the project team

added an ONN care model. is model will be discussed later

in this document.

Step 2: Field Review

To validate the revised competencies, a eld review was then

conducted. Field reviewers were asked to comment on clarity

and accuracy of the key denitions of a navigator and if the

list of requirements were appropriate for an ONN. e eld

2017 Oncology Nurse Navigator Core Competencies

reviewers were then asked to comment on whether each nov-

ice and procient competency should be included in the nal

ONN core competencies document and to make suggestions

on competencies that might be included.

e eld review survey was sent to all ONS Nurse Naviga-

tor SIG members, as well as all ONS members who reported

their primary work function to be nurse navigation, for a total

of 5,137 nurses. A total of 148 responses were received. e

responses represented all regions of the country and a wide

variety of practice settings. Participants reected diversity in

educational levels, years of practice as a nurse, and tumor sites

navigated.

Based on eld review ratings and individual comments, edits

were made to the key denitions of the ONN, initial require-

ments for an ONN, as well as novice and expert competencies.

e edits were made to reduce redundancy, clarify competen-

cies, and appropriately classify novice and expert competen-

cies: one novice competency was moved to the expert category

and two additional expert competencies were created for a to-

tal of 53 competencies.

Step 3: Expert Review

Twelve expert reviewers were identied and agreed to com-

plete a review of the ONN core competencies. ese experts

were chosen based on their years of experience and leadership

roles in ONN. e expert reviewers were asked to comment

on the ow, clarity, completeness, and appropriateness of the

overall novice and expert competencies, as well as to provide

feedback on individual statements. Based on their feedback,

additional edits were made and a nal count of 53 core compe-

tencies was nalized: 41 novice and 12 expert.

To provide a foundation for ONNs and to clearly portray

where the ONN role ts within their organization and with

their patients, the ONN Project Team relied on their extensive

review of the literature to develop an organizing framework

for the ONN. e framework articulates ONN practice and

role function, thereby providing support for the development

of the competencies (see Figure 1). e dening feature for the

ONN is the ability to deliver care using the steps of the nursing

process: assess, plan, implement, and evaluate. In practice, the

ONN demonstrates the functional skills to coordinate, com-

municate, educate, collaborate, and advocate, all within the

context of cultural sensitivity. e core of the framework, and

key element in understanding the function of the ONN, is the

concept of working for and within two operational domains:

the patient and the healthcare system. e ONN works to in-

uence positive patient outcomes but also to promote positive

system outcomes through improved interdisciplinary commu-

nication, patient retention, and downstream revenues (Desi-

mini et al., 2011; Fillion et al., 2012).

Applicability and Dissemination

e intent of the development of these core competencies was

to assist with rening the role of the ONN based on published

evidence. However, because the ONN can function in any or all

phases of the cancer continuum, it can be dicult to visualize

where the ONN can have an impact on patient care and out-

comes. To more clearly depict the broad impact of the ONN,

an Oncology Nurse Navigation Care Model (ONNCM) was

developed to visually represent how an ONN can aect each

phase of the CCC (see Figure 2). ese phases are well dened

in the literature and include: prevention and screening, diagno-

sis, treatment, survivorship, and end-of-life care (Levit, Balogh,

Nass, & Granz, 2013). e ONN competency project team add-

ed advanced and metastatic cancer as an additional phase where

an ONN can continue to guide and support patients. Feedback

requested during eld and expert review supported the clarity

and accuracy of the ONNCM.

Scope of ONN Practice

Oncology survivors do not necessarily move in a linear fashion

through the phases of the CCC. erefore, ONN interventions

are portrayed as encircling the phases of the CCC. e ONN

care model depicts ONN interventions in a broad sense in

each of the following categories.

• Assess and address barriers to care: Barriers to quality can-

cer care dier among diagnoses, phase of the CCC, and from

Figure 1. Professional Practice Framework

Note. From “Oncology Nurse Navigator Core Competencies,” by

Oncology Nursing Society, 2013. Retrieved from https://www.ons

by Oncology Nursing Society. Reprinted with permission.

Patient Organization

Advocate

Culturally sensitive

Communicate

Educate

Plan

Evaluate

Implement

Assess

Oncology

Nurse

Navigator

Coordinate

Improved outcomes

2017 Oncology Nurse Navigator Core Competencies

patient to patient. e role of the ONN is to carefully assess

patients for their unique barriers and to address those barri-

ers in an individual way.

• Provide education, resources, and referrals: Providing

education, resources, and referrals to local and national re-

sources (i.e., physical/occupational therapy, dietitians, home

health, nancial counselors, and foundations) are at the

heart of the ONN role.

• Facilitate shared decision making: Shared decision making

involves ensuring that patients are fully informed of risks

and benets of treatment options and that their values and

preferences are integrated into treatment decisions (Katz,

Balkora, & Elwyn, 2014). e ONN can facilitate shared de-

cision making and engage patients in their care by forming

trusting relationships and addressing patients’ communica-

tion and health literacy needs at all phases of the CCC.

• Promote advance care planning: e ONN can promote

advance care planning by encouraging patients to talk about

their treatment wishes and overall goals of care. e ONN

can help patients formulate questions to discuss with their

healthcare providers

• Support palliative care: e ONN can support patients’ use

of palliative care services by assessing for late and long-term

side eects and other physical barriers to patients’ quality of

life. e ONN can also be instrumental in helping patients

understand the dierence between palliative care and hospice.

In addition, because the role of the ONN is operationalized

dierently across institutions, the competencies are intended

to provide a basic framework for the ONN role and responsi-

bilities. e competencies can be used in many ways, including

but not limited to the following (McMullen et al., 2016):

• Developing the role of the ONN

• Assist with job description development.

• Providing managers with information to successfully screen

applicants for ONN positions

• Developing orientation programs

• Providing guidance for preceptorship of new ONNs

• Developing competency checklists

• Contributing toward the evaluation of a navigation program

• Promoting the role of the ONN

• Assist an organization in the identication of resources that

may be needed to help novice ONNs mature professionally

and be successful in their role.

• Improve retention of ONNs as the result of clearer denition

and expectations of the role.

• Assist with the identication of ONN strengths and profes-

sional development needs.

• Use to establish performance and developmental goals with

the ONN.

• Assist managers, who may have a broad variety of professional

backgrounds, in the overall evaluation of the ONN program.

• Assist in the promoting and education of the role of the ONN

in the professional community and community at large.

Knowledge and Skills Requirements for the ONN

e ONN plays a vital role in achieving successful outcomes

for patients with cancer and their families/caregivers. Research

has clearly shown improved patient outcomes that resulted

from the presence of an ONN (Case, 2011). To achieve suc-

cessful patient outcomes, the ONN must possess a certain skill

set. If the ONN does not posses this knowledge and skill set

initially, engagement in professional development opportuni-

ties would be benecial. ese skills may include but are not

limited to,

• Strong oncology knowledge. Certications like OCN®,

AOCN®, AOCNS®, AOCNP®, and CHPON® all demonstrate

specic knowledge of cancer care for a specic patient popula-

tion (i.e., adult or pediatric). Additional certications, such as

CBCN® and and BMTCN®, speak to the unique care needs and

requirements of even more specic patient populations and

may be benecial for ONNs working in those sub-specialties.

• Basic knowledge of insurance reimbursement systems

• Working knowledge of nancial hardships and payer coverage

• Working knowledge of national, regional, and community

resources

• Knowledge of self-care strategies and resources

• Critical-thinking skills

• Strong leadership skills

Figure 2. Oncology Nurse Navigation Care Model

Assess and address barriers to care

Provide education, resources, and referrals

Prevention and

screening

Diagnosis

Treatment

Survivorship

Advanced and

metastatic cancer

End of life

Facilitate shared decision making

Promote advanced care planning

Support palliative care

2017 Oncology Nurse Navigator Core Competencies

• Strong interpersonal skills

• Ability to develop collaborative relationships both internally

and externally

• Ability to work in teams

• Ability to work autonomously

• Strong verbal and written communication skills

• Strong organizational skills

• Ability to prioritize and reprioritize quickly

• Basic computer skills

Summary

e process to identify ONN core competencies and behaviors

was supported by evidence-based practice and validated by a

consensus-driven, peer-review process. e ONN Professional

Practice Framework highlights a bi-dimensional accountability

because the ONN not only promotes timely access to care (Des-

imini et al., 2011; Fillion et al., 2012; Wilcox & Bruce, 2010),

but also supports improved communication and continuity of

cancer services across the organization for patients, the cancer

care team, and the healthcare system. e ONN Care Model

provides a visual expression of how an ONN can aect each

part of a patient’s cancer journey. e competencies outlined in

this document will provide novice and expert ONNs, practicing

across any tumor site, patient population, or healthcare setting,

as well as their employers, foundational concepts to establish

and expand programs by supporting the care coordination,

functional role, and job responsibilities that are determined by

the needs of the patient, the community, and the organization

(Pedersen & Hack, 2010; Wilcox & Bruce, 2010).

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doi:10.1188/10.ONF.55-60

Wilcox, B., & Bruce, S. (2010). Patient navigation: A “win-win” for all involved.

Oncology Nursing Forum, 37, 21–25. doi:10.1188/10.ONF.21-25

2017 Oncology Nurse Navigator Core Competencies

Competency Statements: Introductory Statement

e oncology nurse navigator (ONN) demonstrates critical thinking and uses the nursing process to assess and meet the needs of

patients and their families/caregivers by providing care coordination throughout the cancer continuum. e ONN works between

the domains of the patient and family unit and the healthcare delivery system to improve health, treatment, or end-of-life outcomes.

is is accomplished through competent practice in the following functional areas.

Competency Category 1: Coordination of Care

e ONN facilitates the appropriate and ecient delivery of healthcare services, both within and across systems, and serves as the

key contact to promote optimal outcomes while delivering patient-centered care. e ONN,

Novice ONN

Assesses patient needs upon initial encounter and periodically throughout navigation, matching unmet needs with appropriate services and

referrals and support services, such as palliative care, dietitians, medical providers, social work, pre/rehabilitation, and legal and ﬁnancial

services

Identiﬁes potential and realized barriers to care (e.g., transportation, child care, elder care, housing, language, culture, literacy, role disparity,

psychosocial, employment, ﬁnancial, insurance) and facilitates referrals as appropriate to mitigate barriers

Develops knowledge of available local, community, or national resources and the quality of services provided; also establishes relationships

with the providers of these services

Develops or uses appropriate screening/assessment tools and methods (e.g., Distress Thermometer, pain scale, fatigue scale, performance

status, motivational interviewing, ﬁnancial) to promote a consistent, holistic plan of care

Facilitates timely scheduling of appointments, diagnostic testing, and procedures to expedite the plan of care and to promote continuity of

care

Participates in coordination of the plan of care with the multidisciplinary team, promoting timely follow-up on treatment and supportive care

recommendations (e.g., cancer conferences/tumor boards)

Facilitates individualized care within the context of functional status, cultural consideration, health literacy, psychosocial, reproductive/fertility,

and spiritual needs for patients, families, and caregivers

Applies knowledge of clinical guidelines (e.g., National Comprehensive Cancer Network, American Joint Committee on Cancer) and specialty

resources (e.g., ONS Putting Evidence into Practice resources) throughout the cancer continuum

Assists in the identiﬁcation of candidates for molecular testing and/or genetic testing and counseling, and facilitates appropriate referrals

Supports a smooth transition of patients from active treatment into survivorship, chronic cancer management, or end-of-life care

Assists patients with cancer with issues related to treatment goals, advance directives, palliative care, and end-of-life concerns using an ethi-

cal framework that is nonjudgmental and nondiscriminatory

Ensures documentation of patient encounters and provided services

Applies knowledge of insurance processes (e.g., Medicare, Medicaid, third-party payers) and their impact on staging, referrals, and patient

care decisions toward establishing appropriate referrals, as needed.

2017 Oncology Nurse Navigator Core Competencies

Competency Category 2: Communication

e ONN demonstrates interpersonal communication skills that enable exchange of ideas and information eectively with pa-

tients, families, and colleagues at all levels. is includes writing, speaking, and listening skills. e ONN,

Novice ONN

Builds therapeutic and trusting relationships with patients, families, and caregivers through effective communication and listening skills

Acts as a liaison between the patients, families, and caregivers and the providers to optimize outcomes

Advocates for patients to promote patient-centered care that includes shared decision making and patients goals of care with optimal out-

comes

Provides psychosocial support to and facilitates appropriate referrals for patients, families, and caregivers, especially during periods of high

emotional stress and anxiety

Empowers patients and families to self-advocate and communicate their needs

Adheres to established regulations concerning patient information and privacy

Promotes a patient- and family-centered care environment for ethical decision making and advocacy for patients with cancer

Ensures that communication is culturally sensitive and appropriate for identiﬁed level of health literacy

Facilitates communication among members of the multidisciplinary cancer care team to prevent fragmented or delayed care that could ad-

versely affect patient outcomes.

Competency Category 3: Education

e ONN provides appropriate and timely education to patients, families, and caregivers to facilitate understanding and support

informed decision making. e ONN,

Novice ONN

Assesses educational needs of patients, families, and caregivers by taking into consideration barriers to care (e.g., literacy, language, cultural

inﬂuences, comorbidities)

Provides and reinforces education to patients, families, and caregivers about diagnosis, treatment options, side effect management, and

post-treatment care and survivorship (e.g., survivorship care plan, treatment summary)

Educates patients, families, and caregivers on the role of the ONN

Orients and educates patients, families, and caregivers to the cancer healthcare system, multidisciplinary team member roles, and available

resources

Promotes autonomous decision making by patients through the provision of personalized education and support

Educates and reinforces the signiﬁcance of adherence with the patients, families, and caregivers regarding treatment schedules, protocols, and

follow-up

Assesses and promotes healthy lifestyle choices and self-care strategies through education and referrals to ancillary services

Provides anticipatory guidance and manages expectations to assist patients in coping with the diagnosis of cancer and its potential or expected out-

comes

Promotes awareness of clinical trials to patients, families, and caregivers

Obtains or develops oncology-related education materials for patients, staff, and community members as appropriate

Provides education on genomic and molecular testing and the implication of the results.

2017 Oncology Nurse Navigator Core Competencies

Competency Category 4: Professional Role

e ONN works to promote and advance the role of the ONN and takes responsibility to pursue personal professional growth

and development. In addition, the ONN facilitates continual promotion and quality improvement of the organization’s navigation

program to best meet the needs of their community. e ONN,

Novice ONN

Promotes lifelong learning and evidence-based practice to improve the care of patients with a past, current, or potential diagnosis of cancer

Demonstrates effective communication with peers, members of the multidisciplinary healthcare team, and community organizations and resources

Contributes to ONN program and role development, implementation, and evaluation within the healthcare system and community

Participates in the tracking and monitoring of metrics and outcomes, in collaboration with administration, to document and evaluate out-

comes of the navigation program and report ﬁndings to the cancer committee

Collaborates with the cancer committee and administration to perform and evaluate data from the community needs assessment to identify areas

of improvement that will affect the patient navigation process and participate in quality improvement based on identiﬁed service gaps.

In collaboration with other members of the healthcare team, builds partnerships with local agencies and groups that may assist with cancer

patient care, support, or educational needs

Establishes and maintains professional role boundaries with patients, caregivers, and the multidisciplinary care team in collaboration with

manager, as deﬁned by job description.

Competency Category 5: Expert Oncology Nurse Navigator

e expert ONN is procient in the role and has the education, knowledge, and experience to use critical thinking and decision

making skills pertaining to the evolution of the ONN role and process improvement in the navigation processes. e expert ONN,

Expert ONN

Contributes to development of the cancer program community needs assessment and makes suggestions to the cancer committee on navi-

gation program changes related to community assessment outcomes and cancer program strategic plan

Assists in gap analysis, quality improvement, and process improvement measures, data analysis, and makes recommendations to the cancer

committee for appropriate navigation program changes related to the data

Develops and promotes pathways for ONN patient recruitment by collaborating with internal and external stakeholders

Tracks use of internal and external resources of staff and patients, and makes recommendations for appropriate or improved use as needed

Expands current or develops new processes to survey patient and/or caregiver satisfaction related to navigation services, collects results, and

reports to cancer committee

Contributes to program growth through collaboration with cancer program administration to develop a marketing strategy to support the

navigation program

Contributes to the knowledge base of the healthcare community and in support of the ONN role through activities such as involvement in pro-

fessional organizations, presentations, publications, and research

Disseminates information about the ONN role to other healthcare team members through peer education, mentoring, and preceptor experiences

Collaborates with treating physician(s) and support staff to prevent unnecessary hospitalizations or clinic visits, and improved adherence to

treatment through the design and implementation of appropriate patient education and follow-up

Orients, mentors, and guides novice ONNs

Collaborates with cancer program administration and cancer committee to develop strategies to fulﬁll the requirements and standards of the

American College of Surgeons Commission on Cancer

Contributes to program sustainability, improvement, and/or development through collaboration with the institutional foundation in grant writ-

ing and philanthropy.

Oncology Nursing Society

125 Enterprise Drive

Pittsburgh, PA 15275

412-859-6100