Nursing certification and education play a critical role in ensuring high-quality care for oncology patients. Oncology certified nurses (OCNs) are crucial members of the cancer team who provide skilled care for patients and help support their families at the same time. Specialty certification in health care is not required to care for specialty patients like those being treated for cancer. However, these certifications can set a cancer program apart from others, since many accreditation agencies recognize OCNs as experts in the field and do not require added continuing education if staff members hold this certification. Achieving a specialty certification such as an OCN demonstrates clinical expertise and commitment to that field of nursing, as well as competence in the latest cancer treatments and adverse effects.

The ThedaCare Regional Cancer Center Experience

In preparation for reapplying for American College of Surgeons Commission on Cancer (COC) reaccreditation in 2023, ThedaCare Regional Cancer Center in Appleton, Wisconsin, aimed to increase OCN certification among its nursing team by 10% by the end of 2023. Prior to this goal, 30 of 62 registered nurses on the team held a specialty certification specific to oncology.

Cancer programs that obtain specialty accreditation meet rigorous regulations focused on safety and quality. Requirements stipulate that nurses must meet certain continuing education requirements unless they hold specialty certifications that are recognized by accreditation agencies. For COC Accreditation Standard 4.2 to be met, all registered nurses and advanced practice nurses providing direct oncology care must demonstrate 1 of the following:

• Current cancer-specific certification in the nurse’s specialty by an accredited certification program
• Ongoing education by earning 36 cancer-related nursing continuing professional development contact hours each accreditation cycle.

Identifying barriers and developing targeted interventions would help the cancer center work toward increasing specialty certification and enhance the quality of care provided to oncology patients.

To meet the established goal of increasing specialty certification in the cancer center by 10%, the cancer center deployed a survey to understand if nurses were interested in obtaining certification and, if not, what was holding them back. Thirty nurses were surveyed. Nineteen nurses were interested in testing in 2023, while only 2 nurses planned to take their OCN in 2023. Reasons given for not testing in 2023 by the remaining 17 nurses included the expense of the test, study materials, and review classes (Figure 1). The test fee for OCN certification for members is $300, with in-person OCN review classes ranging from $100 to $250. However, ThedaCare’s nurses are reimbursed for test fees after submitting a passing score. The OCN exam is a 3-hour test consisting of 165 multiple choice questions based on test content outline at oncc.org.

To increase specialty certification at ThedaCare Regional Cancer Center, it was crucial that the cancer center address barriers identified in the nurse survey. Although it was encouraging to see 19 nurses interested in testing in 2023, the low number of those planning to take the OCN exam showed the need for intervention. Cancer center staff researched possible effective strategies, such as where financial support for study materials could come from, how test fees could be taken out of the equation, and the possibility of supplying an OCN prep course. Providing this support could help nurses feel more confident and prepared to take the OCN exam. In addition, identifying barriers and developing targeted interventions would help the cancer center work toward increasing specialty certification and enhance the quality of care provided to oncology patients.

Interventions to Help Increase OCN Certification

ThedaCare Regional Cancer Center applied for the Oncology Nursing Certification Corporation (ONCC) voucher program and was accepted. This program allows nurses to take their OCN or breast care certification exam free of charge. If nurses pass, ThedaCare pays ONCC. If nurses fail, they are allowed to test again free of charge. To participate in this program, a minimum of 5 nurses from ThedaCare needed to take the certification exam in 2023.

The cancer center also applied for a ThedaCare Family of Foundations grant to cover the cost and supplies to run the OCN review class and was approved. Cancer center staff then developed an OCN certification review class with help from the Oncology Nursing Society (ONS). The class runs once a month every Tuesday for 2 hours over 3 months. The OCN review class covers all topics listed on the blueprint of the OCN test, which is available on the ONCC site. Table 1 illustrates the positive response the course received from participating nurses. Three nurse participants provided feedback to an open-ended question about improvements.

Outcomes

Each OCN review class had an average of 15 to 18 nurses in attendance. Over the course of 12 months, 10 ThedaCare nurses sat for their OCN exam. All 10 ThedaCare nurses passed this rigorous certification. By comparison, the 2022 pass rate for OCN certification nationally was 58%.

ThedaCare Regional Cancer Center is proud of these outcomes. Ten nurses taking and passing the OCN exam demonstrates the effectiveness of the cancer center’s interventions. The data presented enforces the importance of ongoing education and certification in improving patient safety and quality of care provided by oncology nurses. To increase specialty certification of staff, other cancer centers should consider offering similar support and education. Certification makes a difference; patients want knowledgeable nurses who are experienced and able to provide them with the best care.

Brenda Van Sambeek, MSN, RN, OCN, is clinical nurse educator at ThedaCare Regional Cancer Center in Appleton, Wisconsin.