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Purpose This study aimed to develop Collaborative Practice and Clinical Judgment Competency (CPCJC) for oncology nurses and reach a consensus on the validity, importance, and feasibility of an indicator of CPCJC for certified nurse specialists in cancer nursing and graduate students. Methods The indicator of CPCJC for oncology nurses enables nurses to identify the challenges faced by patients in cancer wards and their families. This indicator contains 39 items in 13 categories, which correspond to the elements of Tanner’s Model of Clinical Judgment. A two-round modified Delphi study was completed by Japanese certified nurse specialists and graduate students in the Graduate School of Nursing. The first indicator was created by performing a content analysis using case studies and focus group interviews. Panels evaluated the validity, importance, and feasibility of 39 items in 13 categories in Round 1 (R1) and Round 2 (R2) using a 4-level Likert-type scale. Results The total number of participants was 46 in R1 and 35 in R2. The Scale-Content Validity Index/Ave values in R1 were 0.98, 0.99, and 0.94 for validity, importance, and feasibility, respectively. Conclusion This structured indicator will enable nurses with short clinical experience to collaborate with multidisciplinary teams and provide patient-centered care. This indicator can be used as a consultation tool for nurses belonging to the palliative care team or advanced practice nurses in the oncology team.

Prognoses for cancer patients have been extended due to advances in medical treatments, and end-of-life care has shifted from acute medical institutions to the community, through outpatient clinics and home-based care. Transitional care is necessary, depending on the patient’s condition, and has been recommended for chronically ill patients and the elderly. However, transitional care should also be provided for cancer patients. Especially in transitional care, information is important when cancer patients are discharged from the hospital or deciding where to stay at the end of their life. During cancer recurrence and terminal stages, patients and their families face psychological distress regarding prognosis and changes in the patient’s condition; thus, support from health care professionals is important. Further, decision-making support is important in choosing treatments and where patients should stay at the end of life. In Japan, a long-term care insurance system for elderly people and a community-based comprehensive care system have been established since 2007, and visiting nurses provide end-of-life care for cancer patients within this system’s framework. Visiting nurses provide a wide range of support, not only for cancer patients but also for elderly individuals and people with mental disabilities. Visiting nurses need to accumulate advanced knowledge and experience to provide highly specialized care. Further, nurses and certified nurse specialists need to cooperate with visiting nurses when discharging patients from hospitals and contribute to advanced cancer care in the community. In this paper, we discuss issues of the medical and welfare systems in Japan, as well as nursing practices related to the shift from medical treatment in hospitals to community-based palliative care. Additionally, we discuss the current status of Western-medicine-centered practice in relation to complementary and alternative medicine.