The Oncology Advanced Practice Registered Nurse (APRN) provides high quality, comprehensive, accessible and cost effective oncology patient care through clinical expertise, role modeling, mentoring, consultation, interdisciplinary collaboration and utilization of research. The APRN will provide supervision consistent with their privileges for patients receiving infusion and/or chemotherapy in an outpatient setting. The APRN scope of practice is determined by state and federal regulations, the professional code of ethics, professional practice standards and hospital/department policies/ procedures. The scope of advanced practice registered nursing is distinguished by autonomy and a high degree of independent judgment. This level of clinical decision-making is a sophisticated, innovative synthesis of knowledge, clinical evidence, research, scientific theory and nursing process. The APRN honors the patient’s mind, body and spirit in support of a caring environment focused on healing and wellness.

CHI Saint Joseph Medical Group now part of CommonSpirit Health formed between Catholic Health Initiatives (CHI) and Dignity Health includes 275 providers delivering quality care to patients across 88 locations in central and eastern Kentucky. Our full service network delivers a variety of Primary Care Services including Family Internal Geriatric and Pediatric Medicine in addition to several specialties to deliver custom care based on the unique needs of our patients.

1. Assessment of patient’s needs
1. Performs a comprehensive assessment in accordance with established professional standards, hospital policy, national core measures and other quality indicators. 
2. Considers the patient’s culture, age and developmental level. 
3. Uses research and knowledge as the basis for assessment techniques
4. Initiates and interprets relevant diagnostic tests and procedures in conjunction with Attending MD. 
2. Determination of diagnoses 
1. Critically analyzes assessment data obtained during interview, physical examination, diagnostic tests and/or diagnostic procedures 
2. Derives and prioritizes diagnoses using clinical reasoning.
3. Support MD plan of care 
3. Identification of expected outcomes
1. Individualizes identified outcomes derived from assessment data and diagnoses
2. Considers associated risk, benefits and cost
3. Modifies goals for care based on changes in the patient’s health status 
4. Communicates care interventions to MD and Nursing Staff. 
5. Identifies appropriate quality indicators to support care of each patient. 
4. Development of comprehensive plan for care
1. Designs plan describing assessment/ diagnostic strategies and interventions that address the promotion/restoration of health and the prevention of illness/ disease.
2. Applies current health care knowledge, research and practice. 
3. Demonstrates independent clinical decision-making.
4. Documents plan in accordance with hospital policies/procedures
5. Collaborates with attending MD and if applicable Internists or Hospitalists as well as other disciplines in development of plan as appropriate.
5. Implementation of interventions and treatments in conjunction with a collaborating physician
1. Provides direct supervision of patient receiving treatments in Outpatient Infusion care setting.
2. Performs interventions and treatments within the scope of advanced practice registered nursing defined by ANA standards, Kentucky Nurse Practice Act and Collaborative practice agreement.
3. Performs simple to complex interventions and treatments reflecting knowledge of health care research findings, scientific theory and evidenced base practice.
4. Documents patient assessments and responses to therapy in the medical record.
5. Considering patient’s complex needs and desired outcomes, provides clinical coordination of care. 
6. Monitors accuracy and completeness of patient care provided by other team members. 
7. Provides theory-based consultation to influence the plan of care and enhance the abilities of others according to evidenced based practice. 
8. Involves the patient and family in decision-making.
9. Identifies educational needs of patient related to prioritized diagnoses.
10. Employs appropriate teaching strategies based on assessment of risks, learning theory, epidemiological principles and the client’s health beliefs, health practices, developmental level, learning needs, readiness and ability to learn and culture. 
11. Uses prescriptive authority, procedures and treatments in accordance with the Kentucky Nurse Practice Act and hospital policies/procedures with collaborative practice agreement on file. 
12. Monitors effects of pharmacologic, non-pharmacologic and other interventions.
13. Initiates interventions in response to changes in patients conditions related to infusions and medication administrations. 
14. Communicates changes in condition and relevant patient information to attending MD.
15. Makes referrals for additional care as needed.
16. Implements recommendations from referring sources as indicated.
6. Evaluation of patient’s progress 
1. Assesses diagnoses and effectiveness of interventions toward plan of care.
2. Revises diagnoses, expected outcomes and plan of care based on advanced knowledge, practice and research 
3. Assures compliance of recommended standards of care. 
7. Commitment to professional role 
1. As the clinical expert, assumes a leadership role in establishing standards of practice and plan of care to improve patient care.
2. Acquires and maintains knowledge and skills appropriate to oncology practice specialty.
3. Utilizes research to evaluate knowledge and develop creative approaches to care. 
4. Disseminates relevant research findings through practice, education and/or consultation.
5. Maintains professional certification in area of expertise.
6. Evaluates to improve own performance according to standards of practice and patient outcomes.
7. Seeks feedback regarding own role performance from peers, colleagues, patients and others. 
8. Serves as a role model for the professional development of peers, colleagues and others. 
9. Fosters a learning environment when mentoring staff and students.
10. Participates in professional activities both inside facility and in community.
11. Informs the patient and documents the risks, benefits and outcomes of health care regimens. 
12. Works collaboratively with other disciplines to enhance patient care.
13. Demonstrates support of unit/house-wide shared governance activities.
14. Promotes a positive group dynamic and healing environment through actions and attitude. 
15. Demonstrates recognition of integration of mind, body, and spirit of each patient.
8. Support for quality care through positive customer relations and creation of a healing environment
1. Assures practice excellence in accordance with accepted standards, 
2. current research findings and nursing services’ caring philosophy. 
3. Minimizes costs and unnecessary duplication of testing or other diagnostic activities
4. Uses performance improvement data and national care standards to initiate changes in plan of care as appropriate. 
5. Uses caring perspective in regard to patient care interventions.
6. Displays respect, compassion, empathy and trust in relation to others.
7. Ensures positive customer relations through caring behaviors. 
8. Uses sensitivity in managing difficult or emotional situations.
9. Responds promptly and courteously to patient requests. 
10. Promotes trust by meeting commitments and excellent communication.