Aims:
To describe and evaluate the Integrated Advanced Nursing Practice Model of Care (IANP-MoC), a collaborative framework integrating Clinical Nurse Consultants (CNCs), Nurse Practitioners (NPs) and Senior Medical Officers (SMOs) for patients receiving concurrent systemic anti-cancer therapy and radiotherapy (CCRT).
Methods
We undertook a retrospective descriptive evaluation of consecutive patients managed within the IANP-MoC between January and July 2026 at Sunshine Coast Health. Demographic and clinical data were extracted from the electronic medical record. Descriptive statistics characterised model delivery, treatment-related toxicities, advanced nursing interventions and clinical outcomes. Within the IANP-MoC, SMOs initiated and supervised treatment through scheduled consultant reviews and ongoing clinical governance. Between consultant appointments, CNCs and NPs delivered structured advanced practice clinical reviews, with additional NP or SMO reviews provided when clinically indicated.
Results
Seventy patients were managed within the IANP-MoC; 67 had completed or discontinued CCRT at analysis. Median age was 64 years, 56.1% were male, and predominant tumour streams were head and neck (33.3%) and thoracic (28.8%) malignancies. Patients remained within the model for a median of 6 weeks, receiving 367 patient episodes of care (308 face-to-face; 59 telephone), equating to a mean of 5.6 episodes per patient. CNCs undertook interval clinical reviews, including comprehensive assessment, education, supportive care and toxicity management. NPs complemented this care by managing higher-acuity presentations requiring prescribing, supportive care optimisation, advanced clinical decision-making, or review following CNC consultation. The most common toxicities were fatigue (76%), constipation (51%), nausea (38%), mucositis (37%), diarrhoea (32%) and odynophagia (32%). Overall, 98.5% of patients completed the planned IANP-MoC review pathway, and 84.8% completed concurrent treatment.
Conclusions
The IANP-MoC provides a sustainable, collaborative framework that enables advanced practice nurses to work to full scope within SMO-led governance, supporting coordinated care throughout CCRT and offering a transferable workforce model for contemporary oncology services.