Ch. 5 Navigation Across the Cancer
Continuum
Harold Freeman, in 1990, developed the first patient navigation program for
underserved patients in the Harlem neighborhood of New York City. The goal of the first
patient navigation program was to reduce mortality in women with which of the following
types of cancer?
A. Breast
B. Cervical
C. Colon
D. Melanoma - answerA. Breast
Rationale: Created by D. Harold Freeman in New York City in 1990, the first patient
navigation program targeted women with breast cancer. Fifty percent of these women
were uninsured. Many of these women were black. Today navigators work with
oncology patients with a variety of diagnoses.
Which of the of the following is a goal of a patient navigation service?
A. Identify and resolve barriers to care
B. Care of patients at end of life
C. Supply medical advice by phone
D. Provide telehealth services - answerA. Identify and resolve barriers to care
Rationale: The goals are to: serve as a patient's advocate, identify and resolve barriers
to care, provide education about treatment plan that empowers patients to actively
engage in decision-making and self-care, provide education on symptom and side effect
management to reduce early and late treatment associated complications, reduce
distress, and provide psychosocial support. This care can occur throughout the cancer
trajectory and can be in person or by other communication methods. Only answer A
represents a goal of care.
In 2012, a role delineation study (RDS) was conducted by the Oncology Nursing Society
(ONS) to clearly define the role of the nurse navigator. This study led to the
development of which one of the following?
A. The study led to changes to breast screening guidelines.
B. The study led to improved guidelines for the use of personal protective equipment.
C. The study lead to improved staffing ratios on inpatient bone marrow transplant (BMT)
units
D. The study led to the development of the oncology nurse navigator (ONN) core
competencies. - answerD. The study lead to the development of the oncology nurse
navigator (ONN) core competencies.
Rationale: The ONN Core Competencies describe the role of the navigator in five
categories: coordination of care, communication, education, professional role, and
oncology nurse navigator and core competencies. In 2016, a second RDS identified
, differences between a clinical oncology nurse and an ONN. Navigators help assure
screening guidelines are implemented but do not change the guidelines. The same is
true of guidelines for protective equipment. While navigators might support improved
staffing rations, they are not responsible for implementing them.
According to the Cancer Care Continuum Model, a trained non professional or volunteer
who provides individualized assistance to patients, families and caregivers to help
overcome health care system barriers and facilitate timely access to quality health and
psychosocial care is which one of the following types of navigators?
A. Lay
B. Novice
C. Expert
D. Community clinic - answerA. Lay
Rationale: The Cancer Care Continuum Model has created navigator definitions to
describe differences based on job description, certification/schooling, and other skills.
Other definitions of navigator include novice ONN and expert ONN. Lay navigators do
not have a professional degree, medical licensure, or credentials, and education at or
below a bachelor's degree. Allied health navigators have professional backgrounds (i.e.
medical assistants), educational degrees higher than bachelor's degree but not clinically
focused. Nurse Navigators have a 2-year or BSN, RN, APN, NP and other nursing
backgrounds. Social work navigators have education with a least a BS in social work
and may have an MS in counseling. The ONN facilitates and appropriate and efficient
delivery of health services, both within and across systems, and serves as the key
contact to promote optimal outcomes while delivering patient-centered care. The expert
ONN is proficient 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. Both the novice and expert ONN
roles are professional roles. There is no community clinic navigator.
The first navigation program in 1990 started by Harold Freeman in the Harlem
neighborhood of New York City focusing on a underserved population of women with
breast cancer demonstrated an increase in 5-year cancer demonstrated an increase in
5-year cancer survival rates from which of the following ranges?
A. 10% to 17%
B. 25% to 49%
C. 39% to 70%
D. 75% to 92% - answerC. 39% to 70%
Rationale: There was a significant increase in 5 year survival rates by 39% to 70%. The
goal of the program was to reduce cancer mortality by improving access quality care.
The Academy of Oncology Nurse and Patient Navigators (AONN +) was incorporated in
which one following years?
A. 1990
B. 2000
C. 2009
D. 2018 - answerC. 2009
Continuum
Harold Freeman, in 1990, developed the first patient navigation program for
underserved patients in the Harlem neighborhood of New York City. The goal of the first
patient navigation program was to reduce mortality in women with which of the following
types of cancer?
A. Breast
B. Cervical
C. Colon
D. Melanoma - answerA. Breast
Rationale: Created by D. Harold Freeman in New York City in 1990, the first patient
navigation program targeted women with breast cancer. Fifty percent of these women
were uninsured. Many of these women were black. Today navigators work with
oncology patients with a variety of diagnoses.
Which of the of the following is a goal of a patient navigation service?
A. Identify and resolve barriers to care
B. Care of patients at end of life
C. Supply medical advice by phone
D. Provide telehealth services - answerA. Identify and resolve barriers to care
Rationale: The goals are to: serve as a patient's advocate, identify and resolve barriers
to care, provide education about treatment plan that empowers patients to actively
engage in decision-making and self-care, provide education on symptom and side effect
management to reduce early and late treatment associated complications, reduce
distress, and provide psychosocial support. This care can occur throughout the cancer
trajectory and can be in person or by other communication methods. Only answer A
represents a goal of care.
In 2012, a role delineation study (RDS) was conducted by the Oncology Nursing Society
(ONS) to clearly define the role of the nurse navigator. This study led to the
development of which one of the following?
A. The study led to changes to breast screening guidelines.
B. The study led to improved guidelines for the use of personal protective equipment.
C. The study lead to improved staffing ratios on inpatient bone marrow transplant (BMT)
units
D. The study led to the development of the oncology nurse navigator (ONN) core
competencies. - answerD. The study lead to the development of the oncology nurse
navigator (ONN) core competencies.
Rationale: The ONN Core Competencies describe the role of the navigator in five
categories: coordination of care, communication, education, professional role, and
oncology nurse navigator and core competencies. In 2016, a second RDS identified
, differences between a clinical oncology nurse and an ONN. Navigators help assure
screening guidelines are implemented but do not change the guidelines. The same is
true of guidelines for protective equipment. While navigators might support improved
staffing rations, they are not responsible for implementing them.
According to the Cancer Care Continuum Model, a trained non professional or volunteer
who provides individualized assistance to patients, families and caregivers to help
overcome health care system barriers and facilitate timely access to quality health and
psychosocial care is which one of the following types of navigators?
A. Lay
B. Novice
C. Expert
D. Community clinic - answerA. Lay
Rationale: The Cancer Care Continuum Model has created navigator definitions to
describe differences based on job description, certification/schooling, and other skills.
Other definitions of navigator include novice ONN and expert ONN. Lay navigators do
not have a professional degree, medical licensure, or credentials, and education at or
below a bachelor's degree. Allied health navigators have professional backgrounds (i.e.
medical assistants), educational degrees higher than bachelor's degree but not clinically
focused. Nurse Navigators have a 2-year or BSN, RN, APN, NP and other nursing
backgrounds. Social work navigators have education with a least a BS in social work
and may have an MS in counseling. The ONN facilitates and appropriate and efficient
delivery of health services, both within and across systems, and serves as the key
contact to promote optimal outcomes while delivering patient-centered care. The expert
ONN is proficient 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. Both the novice and expert ONN
roles are professional roles. There is no community clinic navigator.
The first navigation program in 1990 started by Harold Freeman in the Harlem
neighborhood of New York City focusing on a underserved population of women with
breast cancer demonstrated an increase in 5-year cancer demonstrated an increase in
5-year cancer survival rates from which of the following ranges?
A. 10% to 17%
B. 25% to 49%
C. 39% to 70%
D. 75% to 92% - answerC. 39% to 70%
Rationale: There was a significant increase in 5 year survival rates by 39% to 70%. The
goal of the program was to reduce cancer mortality by improving access quality care.
The Academy of Oncology Nurse and Patient Navigators (AONN +) was incorporated in
which one following years?
A. 1990
B. 2000
C. 2009
D. 2018 - answerC. 2009
