Recognition of an ongoing transition of oncology care to the ambulatory setting, as well as the critically important role played by nurses in the provision of safe, quality outpatient oncology care, were 2 of the factors underlying the issuance of a position statement from the Oncology Nursing Society (ONS) on ambulatory oncology care treatment centers.

In their statement, ONS defined ambulatory oncology care settings as infusion centers where nonchemotherapy products (eg, blood products) and chemotherapy treatments are administered, as well as centers involving the outpatient administration of radiation therapy.

The position statement authors highlighted that, unlike inpatient oncology care, there is currently no standard staffing model in place for nurses (defined as nonadvanced practice nurses working in a clinical role) in the setting of ambulatory oncology care.

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Based on member feedback, survey data, and a review of the literature, the ONS position statement was developed “to provide recommendations and guidance for ambulatory centers as they develop their specific staffing plans.”

Rooted in the conclusion that decisions related to the determination of appropriate nurse staffing can be complex, a central recommendation focused on the need to consider a number of patient-, personnel-, and institution-based variables, in order to determine optimal nurse staffing levels at an ambulatory oncology care center.

These variables included characteristics of the patient population (eg, educational and care needs, potential language barriers), the type of treatment administered (eg, required observation period), details related to the current nursing and non-nursing staff (eg, level of education and experience, other resources), and logistical aspects of the institution at which ambulatory care is provided (eg, location, number of treatment units).

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With respect to patient characteristics, the position statement emphasized that patient acuity, an individualized measure of the intensity of nursing care needed, could not be determined solely by the amount of time a patient spent at the outpatient facility, and that “the care needs of the patient and his or her support system are complex and can fluctuate throughout the care spectrum.”

ONS also called for the education of nurse managers at ambulatory oncology care centers regarding “the use of data in the determination of and advocacy for staffing that supports quality care,” the need for collaboration between professional nursing associations and other institutions/agencies in the academic, healthcare, and government sectors on nurse staffing initiatives, and “ongoing analysis of appropriate staffing models” for the ambulatory oncology care setting.


Oncology Nursing Society. ONS staffing position statement: ambulatory treatment centers. Oncol Nurs Forum. 2020;47:1-2.