Intervention strategies oncology nurse navigators use to negotiate cancer care barriers

Nurse Navigation programs have evolved to help patients traverse the cancer treatment systems across the cancer care continuum; however, the oncology nurse navigator (ONN) role and daily nursing interventions used by such nurses are not clearly defined in the published literature. This qualitative research study was conducted to describe the ONN role and to identify currently employed nursing interventions used to assist patients in negotiating the barriers inherent to cancer care. Content analysis was conducted on the ONN interview transcripts. The study findings included theme descriptions of the ONN role and of nursing interventions, as perceived by study participants, used when helping patients overcome barriers to healthcare services along the cancer continuum. The participating ONNs functioned in eight different role dimensions which required a certain skill set. The perceived skill set included: professional expertise, functional and foundational knowledge, and continuing role development. The participating ONNs identified two main levels of barriers to healthcare: patient-level and healthcare system-level. The nine sub-level barriers to cancer care identified in this study showed similarities to the barriers contained in the published literature. The ONN’s perceived impact on timely cancer care was addressed at both the patient-level and healthcare system-level. Published studies affirm that nurse navigation programs improve cancer care and patient outcomes through education and assistance from initial screening through diagnosis and treatment. Existing empirical evidence documents the effectiveness of patient navigator programs, but provides few insights into actual nursing interventions used by ONNs. This study identifies nursing interventions currently used by participating ONNs who assisted patients in accessing necessary healthcare services along the cancer continuum. This study postulates that clearly defined, widely understood and purposefully applied role dimensions and interventions for ONNs have the potential to minimize, or possibly eradicate, common barriers to cancer care. Based upon study findings, the researcher proposes a comprehensive ONN job description which incorporates the role dimensions, skill set parameters, and nursing interventions. These interventions may be applied to Andersen’s (1995) Behavioral Model and Access to Medical Care to describe the actions of ONNs in guiding a patient receiving cancer care.;Keywords: oncology nurse navigator, navigation programs, nurse navigator interventions, healthcare access.