Evaluating Advanced Practice Nursing Implementation and Activity Indicators in Oncology and Haemato-Oncology

To describe the 2024 clinical activity of advanced practice nurses in oncology and haemato-oncology across a national cancer network, identify barriers to collecting activity indicators and propose improvements.

National descriptive cross-sectional survey.

An anonymous electronic questionnaire was administered in February 2025 to all advanced practice nurses working in 20 comprehensive cancer centres. It collected 2024 activity volumes based on predefined indicators, along with perceptions of their relevance and feasibility. The survey also included optional free-text fields to contextualise responses. Quantitative data were analysed descriptively, and free-text comments were reviewed to complement and clarify the quantitative findings.

Fifty-three of 69 nurses responded (77%). Most qualified between 2020 and 2023. On average, 68% of time was devoted to direct clinical care, 15% to administration/coordination, 10% to teaching and 7% to research. The median number of distinct patients followed per nurse in 2024 was 266. Inpatient interventions remained limited. Respondents considered current indicators useful to quantify activity but insufficient to assess care quality; they prioritised adding patient-centred outcomes (satisfaction, adherence, unplanned hospitalisations) and harmonising/automating data capture. Main barriers were heterogeneous information systems and reliance on manual collection.

Clinical activity expanded markedly and nurses play a central role in coordination and follow-up. Existing indicators are predominantly quantitative and should be complemented with outcome measures and automated capture.

Enriching indicator sets with patient-reported experience and outcome measures and integrating automated collection into hospital systems will strengthen evaluation, visibility, and sustainability of advanced nursing roles.

Problem: Lack of consolidated, comparable indicators to evaluate advanced nursing practice in oncology at scale.

High activity volumes; barriers to indicator capture; strong demand for patient-centred outcomes and automation. Who/where it impacts: Oncology services and patients managed by advanced practice nurses across comprehensive cancer centres.

The study adhered to the STROBE checklist for cross-sectional studies.

This study did not include patient or public involvement in its design, conduct, or reporting.