title: Oncology Nursing Society position paper on quality cancer care.
abstract: The cost-reduction emphasis in healthcare restructuring threatens the delivery of quality cancer care. A primary focus on cost by payors and delivery systems signals an onerous intention to limit access to essential components of cancer care. This is exemplified in recent trends including that Payors restrict access to specialty oncology care. Payors impose limitations on selection of treatment options and access to supportive-care services. Registered nurses are encouraged to generalize rather than specialize in oncology. Experienced oncology registered nurses, including expert advanced practice nurses and senior nurse executives, have lost jobs. Specialized oncology units have dissolved or combined with non-specialty units. Chemotherapy drugs are administered either by nurses lacking oncology knowledge and chemotherapy competencies or lesser-skilled assistive personnel. The oncology registered nurse role in the multidisciplinary team is pivotal in creating an environment conducive to quality patient care. Therefore, it is the position of the Oncology Nursing Society that Quality cancer care is a right of all citizens. Quality cancer care entails timely access to and reimbursement for a coordinated, comprehensive approach to care provided by a multidisciplinary team throughout the cancer trajectory that includes prevention, early detection, treatment, supportive care, long-term follow-up, and end-of-life care. Quality cancer care is culturally competent, ethical, and cost-effective. Quality cancer care incorporates the individual with cancer (and the family) as fully-informed partners and decision-makers. Quality cancer care is coordinated and delivered by competent cancer care providers. Accountability and coordination of quality cancer care is best accomplished by registered nurses who have been educated and certified in the oncology specialty. Oncology advanced practice nurses should be utilized in all cancer care delivery systems. Oncology nursing must be included with equal parity to that of medicine and other disciplines in the planning and implementation of cancer care services.
mesh_terms: D003363:Cost Control; D003695:Delivery of Health Care / Q000191:economics* / Q000458:organization & administration; D006297:Health Services Accessibility; D006801:Humans; D009369:Neoplasms / Q000451:nursing* / Q000517:prevention & control; D009859:Oncology Nursing; D011787:Quality of Health Care; D014481:United States