title: Advanced practice issues: results of the ONS Advanced Practice Nursing survey.
abstract: OBJECTIVE
  To ascertain the critical issues in current advanced practice nurse (APN) roles in oncology.
  
  
  METHODS
  Descriptive.
  
  
  METHODS
  National.
  
  
  METHODS
  368 Oncology Nursing Society (ONS) APNs in oncology practice.
  
  
  METHODS
  Subjects completed an 11-page self-administered questionnaire comprised of 62 multiple-choice and open-ended questions. Subjects were asked to identify level of importance for ONS to address selected issues in each section.
  
  
  METHODS
  Demographic information and APN issues regarding practice, outcomes, prescriptive authority, reimbursement, education, continuing education, licensure and certification, legislation, and challenges facing oncology APNs.
  
  
  RESULTS
  The majority of APNs were nurse practitioners working in a hematology/oncology practice in an urban setting providing direct patient care. Priority practice issues were lack of agreement among state boards of nursing related to privileges, lack of understanding of the role by patients and healthcare professionals, and lack of an APN definition. Important APN outcomes were symptom management, quality of life, patient/family satisfaction, and cost of care. Priority educational topics were oncology disease management, pharmacology, advanced physical assessment, and reimbursement. Challenges facing oncology APNs were lack of an APN definition, reimbursement issues, documentation of outcomes, prescriptive authority, variance in education, merging of current roles, certification, loss of cancer specialty, and second licensure.
  
  
  CONCLUSIONS
  Numerous APN issues continue to be unresolved. APN outcomes research is needed to validate the oncology APN role in cancer care.
  
  
  CONCLUSIONS
  Survey results and specific recommendations have been forwarded to the ONS Steering Council and Board of Directors for implementation decisions.
authors.affiliation: Joan Karnell Cancer Center, Pennsylvania Hospital, Philadelphia, USA. lynchmp@pahosp.com
authors.forename: M P
authors.initials: MP
authors.lastname: Lynch
authors.forename: D G
authors.initials: DG
authors.lastname: Cope
authors.forename: K
authors.initials: K
authors.lastname: Murphy-Ende
mesh_terms: D001291:Attitude of Health Personnel; D001294:Attitude to Health; D002568:Certification; D011307:Drug Prescriptions; D004509:Education, Nursing, Continuing; D004511:Education, Nursing, Graduate; D006801:Humans; D007587:Job Description; D008008:Licensure, Nursing; D020380:Needs Assessment; D009720:Nurse Clinicians / Q000193:education / Q000458:organization & administration* / Q000523:psychology; D009722:Nurse Practitioners / Q000193:education / Q000458:organization & administration* / Q000523:psychology; D024802:Nurse's Role; D015403:Nursing Evaluation Research; D009859:Oncology Nursing / Q000193:education / Q000458:organization & administration*; D017063:Outcome Assessment, Health Care; D017009:Professional Autonomy; D011639:Public Opinion; D012051:Reimbursement Mechanisms; D012956:Societies, Nursing; D011795:Surveys and Questionnaires; D014481:United States