• On behalf of the AONN+ Foundation For Learning, a decision has been made to suspend the Thoracic Certification ONN-CG(T). As we proceed with achieving national accreditation for the ONN-CG and OPN-CG certifications, AONN+ FFL is focusing resources towards developing rigorous generalist exams to ensure that clinical nurse and patient navigators have the knowledge to competently demonstrate effective navigation services across the cancer care continuum within their scope of practice.

    At this juncture in our organization’s development, the Certification Advisory Commission is committed to creating a professional certification experience. We feel we can best achieve excellence for navigators seeking professional certification by creating a strong certification foundation within the generalist exams sustained by pursuing national accreditation standards.

    The decision to suspend the Thoracic Certification was not made lightly, thoughtfully considered and approved by the AONN+ FFL Certification Advisory Commission. We thank those who achieved the thoracic certification to date. Those currently holding the certification can retain this certification if they continue to meet the certification requirements and renew as outlined below.

    These requirements include:

    • Document participation in 15 continuing education hours in thoracic care every 36 months
    • Maintain ONN-CG Certification
    • Maintain direct thoracic navigation experience
    • Renewal fee of $50 due at time of recertification

  • Click the + to expand.

    1. 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

    2. 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 

    3. 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

    4. Psychosocial Support Services/Assessment – 10%

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

    5. 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?

    6. 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    

    7. Operations Management/Organizational Development/Healthcare Economics – 5%

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

    8. Nursing Research/Quality/Performance Improvement – 10%

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

  • 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

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