Impact of a Nurse Navigator on Genomic Testing and Timely Treatment Decision Making in Patients With Breast Cancer

Kelly A. McAllister, RN, BSN, OCN, CBCN; Mary L. Schmitt, MS, APRN, FNP-BC, AOCNP


Clin J Oncol Nurs. 2015;19(5):510-512. 

In This Article


The implementation of the APN-RN navigator practice model has led to improvements in timeliness of care (ordering and reporting turnaround times), and better compliance with the NCCN (2015) recommendations for genomic testing. With the implementation of the new practice model, ordering turnaround time was reduced from 26.3 days to 11 days. Reporting turnaround time was reduced from 38 days to 20 days. Compliance with NCCN's (2015) recommendations to perform Oncotype DX tests for eligible patients improved from 26% to 88% (see Figure 2). These outcomes show the impact an RN navigator can have in expediting testing to ensure timely initiation of treatment and demonstrate the importance of this role within the team.

Figure 2.

Percentage Compliance With National Comprehensive Cancer Network Guidelines for Oncotype DX® Testing

The role of the navigator was that of a bachelor's-prepared RN. Through a team effort, the RN navigator and APN improved the care of their patients. Throughout this experience, the team concluded that the navigator should be an APN. The success of this project has led to a proposal to redesign the current RN Breast Care Center Navigator role to that of an APN. The APN can order the test and communicate the results to the patient and the medical oncologist.