Abstract
The quality of cancer care may be compromised in the near future because of work force issues. Several factors will impact the oncology health provider work force: an aging population, an increase in the number of cancer survivors, and expansion of health care coverage for the previously uninsured. Between October 2014 and March 2015, an electronic literature search of English language articles was conducted using PubMed®, the Cumulative Index to Nursing and Allied Health Sciences (CINAHL®), Web of Science, Journal Storage (JSTOR®), Google Scholar, and SCOPUS®. Using the scoping review criteria, the research question was identified “How much care in oncology is provided by nurse practitioners (NPs)?” Key search terms were kept broad and included: “NP” AND “oncology” AND “workforce”. The literature was searched between 2005 and 2015, using the inclusion and exclusion criteria, 29 studies were identified, further review resulted in 10 relevant studies that met all criteria. Results demonstrated that NPs are utilized in both inpatient and outpatient settings, across all malignancy types and in a variety of roles. Academic institutions were strongly represented in all relevant studies, a finding that may reflect the Accreditation Council for Graduate Medical Education (ACGME) duty work hour limitations. There was no pattern associated with state scope of practice and NP representation in this scoping review. Many of the studies reviewed relied on subjective information, or represented a very small number of NPs. There is an obvious need for an objective analysis of the amount of care provided by oncology NPs.
Highlights
The quality of cancer care may be compromised in the near future because of work force issues
The diverse range of variables examined demonstrates the need for a comprehensive assessment of the oncology care currently provided by nurse practitioners (NPs)
The sample of NPs included in the scoping review ranged from one to 111, and of the seven studies that reported the number of NPs, six had 37 NPs or fewer in their sample
Summary
The quality of cancer care may be compromised in the near future because of work force issues. Several factors are poised to significantly impact the oncology health provider work force: an aging population, an increase in the number of cancer survivors, and expansion of health care coverage for the previously uninsured. As a large proportion of the United States grows older, cancer incidence and prevalence rates are expected to rapidly increase [1]. Cancer is the second leading cause of death in the United States [2], and disproportionately affects adults aged 65 years and older [3]. The increased risk of developing cancer with age is linked to deoxyribonucleic acid (DNA) methylation changes that impact gene silencing and activation with age;[5] unlike other cancer risk factors, DNA methylation changes are not greatly affected by behavioral change. As a result of the Affordable Care Act (ACA), millions of previously uninsured Americans have insurance and access to health care increasing the demand for services [7]
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