Certification Criteria

In addition to achieving a passing score on the Oncology Nurse Navigator–Certified Generalist℠ (ONN-CG℠) certification exam, candidates must meet the following criteria to be eligible to take the ONN-CG(T)℠ exam:

• Provide your job description inclusive of thoracic navigation
• Submit documentation of at least 1200 thoracic navigation hours over the past 2 years, verified by reference letter signed and dated by employer
• Upload documentation of at least 5 additional continuing education units related to thoracic care

Testing Blueprint

Community Outreach/Prevention – 5%

1. Community outreach/awareness
2. Prevention
3. Early detection (CT screening)
4. Smoking cessation
5. Lung cancer prevention
6. Risk factors

Coordination of Care/Care Transitions – 45%

1. How is the diagnosis made?
2. Where are lung navigators located in continuum?
3. Diagnostic tests (NCCN; NCI)
4. Staging measures
5. Clinical trials
6. Molecular and genetic testing
7. Surgery
8. Chemotherapy (targeted therapies)
9. Radiation therapy
10. Symptom control
11. Paraneoplastic syndrome
12. Radiation pneumonitis
13. Superior vena cava syndrome
14. Pleural effusion
15. Spinal cord compression
16. Pericardial effusion 

Patient Advocacy/Patient Empowerment – 10%

1. Lung Cancer Alliance
2. Lung Cancer Foundation of America
3. Lung Cancer Research Foundation
4. Dusty Joy Foundation
5. Addario Lung Cancer Foundation
6. Global Lung Cancer Coalition, American Lung Association, etc
7. Tobacco control issues
8. Addiction of nicotine

Psychosocial Support Services/Assessment – 10%

1. Lung statistics
2. Signs and symptoms
3. Caregiver issues
4. Stigma of diagnosis
5. Social issues
6. Sexuality   

Survivorship/End of Life – 10%

1. Survivorship care, including long-term side effects and late effects
2. Metastatic disease—end of life
3. Hospice care
4. Nutrition
5. Hydration
6. Which type has best survival stats?

Professional Roles and Responsibilities – 5%

1. Treatment modalities, including do no harm
2. Genetics
3. Recurrences—local and distant
4. Tumor board
5. Resource use for side effects of radiation therapy and chemotherapy
6. NCCN guidelines to steer practice    

Operations Management/Organizational Development/Healthcare Economics – 5%

1. Financial toxicity
2. Evidence-based algorithms
3. Gap analysis

Nursing Research/Quality/Performance Improvement – 10%

1. Early detection (CT screening)
2. Palliative care clinic
3. Evidence-based algorithms
4. Metrics

Recommended Study Materials

• Kunos CA, Olszewski S, Espinal E. Impact of nurse navigation on timeliness of diagnostic medical services in patients with newly diagnosed lung cancer. J Community Support Oncol. 2015;13(6):219-224.
• Houlihan NG, Tyson LB, eds. Site-Specific Cancer Series: Lung Cancer (Second Edition). Pittsburgh, PA: Oncology Nursing Society; 2004.
• Fujinami R, Otis-Green S, Klein L, et al. Quality of life of family caregivers and challenges faced in caring for patients with lung cancer. Clin J Oncol Nurs. 2012;16(6):E210-E220. doi: 10.1188/12.CJON.E210-E220.
• Lobchuk MM, McClement SE, McPherson C, Cheang M. Does blaming the patient with lung cancer affect the helping behavior of primary caregivers? Oncol Nurs Forum. 2008;35(4):681-689. doi: 10.1188/08.ONF.681-689.
• Carter-Harris L, Hermann CP, Schreiber J, et al. Lung cancer stigma predicts timing of medical help-seeking behavior. Oncol Nurs Forum. 2014;41(3):E203-E210. doi: 10.1188/14.ONF.E203-E210.
• Kreamer K, Riordan D. Targeted therapies for non-small cell lung cancer: an update on epidermal growth factor receptor and anaplastic lymphoma kinase inhibitors. Clin J Oncol Nurs. 2015;19(6):734-742. doi: 10.1188/15.CJON.734-742.
• Fouladbakhsh JM, Davis JE, Yarandi HN. A pilot study of the feasibility and outcomes of yoga for lung cancer survivors. Oncol Nurs Forum. 2014;41(2):162-174. doi: 10.1188/14.ONF.162-174.
• Dean GE, Redeker NS, Wang YJ, et al. Sleep, mood, and quality of life in patients receiving treatment for lung cancer. Oncol Nurs Forum. 2013;40(5):441-451. doi: 10.1188/13.ONF.441-451.
• Skrutkowski M, Saucier A, Eades M, et al. Impact of a pivot nurse in oncology on patients with lung or breast cancer: symptom distress, fatigue, quality of life, and use of healthcare resources. Oncol Nurs Forum. 2008;35(6):948-954. doi: 10.1188/08.ONF.948-954.
• Seek A, Hogle WP. Modeling a better way: navigating the healthcare system for patients with lung cancer. Clin J Oncol Nurs. 2007;11(1):81-85. doi.org/10.1188/07.CJON.81-85.
• Gentry S, Sellers J. Navigation considerations when working with patients. In: Blaseg KD, Daugherty P, Gamblin KA, eds. Oncology Nurse Navigation: Delivering Patient-Centered Care Across the Continuum. Pittsburgh, PA: Oncology Nursing Society; 2014:71-120.
• Shih YC, Chien CR, Moguel R, et al. Cost-effectiveness analysis of a capitated patient navigation program for Medicare beneficiaries with lung cancer. Health Serv Res. 2016;51(2):746-767.
• Ludman EJ, McCorkle R, Bowles EA, et al. Do depressed newly diagnosed cancer patients differentially benefit from nurse navigation? Gen Hosp Psychiatry. 2015;37(3):236-239.
  Persistent link to this record (Permalink):
  http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=103803548&site=ehost-live
• Buckley T. Does lung cancer provide a new role for respiratory therapists? AARC Times. 2016;40(7):14-16.
• Seldon LE, McDonough K, Turner B, Simmons LA. Evaluation of a hospital-based pneumonia nurse navigator program. J Nurs Adm. 2016;46(12):654-661.
  Persistent link to this record (Permalink):
  http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=119931422&site=ehost-live
• Zibrik K, Laskin J, Ho C. Implementation of a lung cancer nurse navigator enhances patient care and delivery of systemic therapy at the British Columbia Cancer Agency, Vancouver. J Oncol Pract. 2016;12(3):e344-e349.
• McPhillips D, Evans R, Ryan D, et al. The role of a nurse specialist in a modern lung-cancer service. Br J Nurs. 2015;24(4):S21-S27.
  Persistent link to this record (Permalink):
  http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=103766573&site=ehost-live
• Edwards R. The RT as lung cancer navigator. AARC Times. 2015;39(11):23-25.
• Building a healthy America: nurse-run programs provide the framework for prevention-focused healthcare. NurseWeek. (15475131) 2009;16(8):18-23.
• Wilkie D, Berry D, Cain K, et al. Effects of coaching patients with lung cancer to report cancer pain. West J Nurs Res. 2010;32(1):23-46.
• Hunnibell LS, Slatore CG, Ballard EA. Foundations for lung nodule management for nurse navigators. Clin J Oncol Nurs. 2013;17(5):525-531.
  Persistent link to this record (Permalink):
  http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=104235996&site=ehost-live
• Wilson B, Holder R, Torres M. Nurse navigator: clinical leader in patient-centric stat lung cancer clinic. Presented at: Oncology Nursing Society 31st Annual Congress; May 4-7, 2006; Boston, MA.
• Hunnibell LS, Rose MG, Connery DM, et al. Using nurse navigation to improve timeliness of lung cancer care at a veterans hospital. Clin J Oncol Nurs. 2012;16(1):29-36.
  Persistent link to this record (Permalink):
  http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=104510892&site=ehost-live
• Irwin KE, Freudenreich O, Peppercorn J, et al. Case records of the Massachusetts General Hospital. Case 30-2016. A 63-year-old woman with bipolar disorder, cancer, and worsening depression. N Engl J Med. 2016;375(13):1270-1281.
• Lorhan S, Dennis D, van der Westhuizen M, et al. The experience of people with lung cancer with a volunteer-based lay navigation intervention at an outpatient cancer center. Patient Educ Couns. 2014;96(2):237-248.
• Dajczman E, Robitaille C, Ernst P, et al. Integrated interdisciplinary care for patients with chronic obstructive pulmonary disease reduces emergency department visits, admissions and costs: a quality assurance study. Can Respir J. 2013;20(5):351-356.
• Wuyts WA, Peccatori FA, Russell AM. Patient-centred management in idiopathic pulmonary fibrosis: similar themes in three communication models. Eur Respir Rev. 2014;23(132):231-238.
• Islam KM, Opoku ST, Apenteng BA, et al. Engaging patients and caregivers in patient-centered outcomes research on advanced stage lung cancer: insights from patients, caregivers, and providers. J Cancer Educ. 2014;29(4):796-801.
• Mollberg NM, Ferguson MK. Postoperative surveillance for non-small cell lung cancer resected with curative intent: developing a patient-centered approach. Ann Thorac Surg. 2013;95(3):1112-1121.
• Tsianakas V, Robert G, Maben J, et al. Implementing patient-centred cancer care: using experience-based co-design to improve patient experience in breast and lung cancer services. Support Care Cancer. 2012;20(11):2639-2647. Erratum in: Support Care Cancer. 2012;20(11):2649.
• Ouwens M, Hermens R, Hulscher M, et al. Development of indicators for patient-centred cancer care. Support Care Cancer. 2010;18(1):121-130.
• Wouters EF, Vanderhoven IM. Pulmonary rehabilitation and integrated care. Semin Respir Crit Care Med. 2009;30(6):713-720.
• Hauser J, Sileo M, Araneta N, et al. Navigation and palliative care. Cancer. 2011;117(15 Suppl):3583-3589. doi: 10.1002/cncr.26266.
• Smith CB, Nelson JE, Berman AR, et al. Lung cancer physicians’ referral practices for palliative care consultation. Ann Oncol. 2012;23(2):382-387. doi: 10.1093/annonc/mdr345.
• Smith TJ, Temin S, Alesi ER, et al. American Society of Clinical Oncology provisional clinical opinion: the integration of palliative care into standard oncology care. J Clin Oncol. 2012;30(8):880-887. doi: 10.1200/JCO.2011.38.5161.
• Morrison RS, Penrod JD, Cassell JB, et al; for the Palliative Care Leadership Centers’ Outcomes Group. Cost savings associated with US hospital palliative care consultation programs. Arch Intern Med. 2008;168(16):1783-1790. doi: 10.1001/archinte.168.16.1783.
• Gade G, Venohr I, Conner D, et al. Impact of an inpatient palliative care team: a randomized control trial. J Palliat Med. 2008;11(2):180-190. doi: 10.1089/jpm.2007.0055.
• Granda-Cameron C, DeMille D, Lynch MP, et al. An interdisciplinary approach to manage cancer cachexia. Clin J Oncol Nurs. 2010;14(1):72-80. doi: 10.1188/10.CJON.72-80.
• Quist M, Rørth M, Langer S, et al. Safety and feasibility of a combined exercise intervention for inoperable lung cancer patients undergoing chemotherapy: a pilot study. Lung Cancer. 2012;75(2):203-208. doi: 10.1016/j.lungcan.2011.07.006.

Maintaining Certification

Your ONN-CG(T)℠ is valid for 3 years from the date of testing. To maintain your Oncology Nurse Navigator–Certified Generalist Thoracic℠ [ONN-CG(T)℠] credential, you must document participation in 15 continuing education hours in thoracic care every 36 months.

Thank you for your patience as we establish a portal where your credits will be uploaded.

Additional requirements:

• Maintain ONN-CG Certification
• Maintain direct thoracic navigation experience
• Renewal fee of $50 due at time of recertification