The Process of Oncology Nurse Practitioner Patient Navigation: Triage an Essential Process

Abstract

Frances Mary Johnson

One of the most daunting challenges faced in the health care delivery system is the complexity of cancer care, and the process of care coordination, a subcomponent of patient navigation. A study was undertaken to identify a central navigation process utilized by nurse practitioners practicing oncology. The data in this article is a component of a larger study entitled: The Process of Oncology Nurse Practitioner Patient Navigation: A Grounded Theory Approach. Utilizing a grounded theory approach N = 20 oncology nurse practitioners (ONP) were recruited. To be eligible for the study the ONP had to have a: 1) license to practice in their respective state; 2) certification to practice as an oncology nurse; 3) minimum of 5 years full time experience in oncology nursing; and 4) English speaking. The participants were recruited by: 1) word of mouth networking with peers: 2) Soliciting volunteers through public announcements at professional nursing conferences; 3) Contacting authors of oncology NP navigation articles or convention pamphlets via telephone or e-mail; 4) Posting information soliciting oncology NP volunteers on blogs or websites of professional organizations with organizational director approval; and, 5) Recruiting by snowball sampling. Telephone interviews were conducted utilizing an open-ended questionnaire. Data analysis and coding revealed the central navigation processes. The triage process was carried out in a variety of unique settings, and utilized in some instances within navigation subsystems. Key triage paths were identified along the cancer continuum; documenting the need for ONP navigators to strategically place these systems in areas along the cancer continuum, to expedite timely delivery of patient care. Literature search revealed that cancer specific triage tools are lacking. Implications for research and practice include the development of these tools for cancer care. Of critical importance is the need to identify service gaps in cancer care, and strategically place triage systems, to offset these service gaps. Practical application of the research findings in relationship to current literature is integrated for discussion.

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