| Sumario: | Significance & Background: A 28-bed medical/surgical (M/S) and oncology inpatient unit faced a shortage of chemotherapy/immunotherapy (C/I) credentialed nurses (CCN) to deliver care for an increasing number of C/I admissions. The unit created a quality improvement initiative to structure a formal pathway to develop their own CCNs. Shortages in the workforce exist because oncology nurses require advanced training in chemotherapy, symptom management, and palliative care, which they may not receive in a traditional M/S role. Barriers to recruiting oncology nurses exist due to perceptions of complex care, hazardous work environments, and burnout (Challinor et al., 2020). As a result, organizations need strategic investments in workforce development (Ajayi, 2023). Purpose: A structured pathway facilitates proficiency in C/I administration. The aim of the pathway is to have 100% of the unit's 38 nurses as of September 2025 C/I credentialed within one year. With a full complement of proficient C/I administrators, the organization can meet the increased treatment demand without delay. Interventions: The intervention is a structured pathway using pre-requisites, classroom didactics, and administration training (Figure 1). The hallmark of the pathway a two-day comprehensive, interdisciplinary chemotherapy course. The pathway also leverages the ONS Fundamentals of Chemotherapy and Immunotherapy course and collaborates with outpatient infusion for precepted administration training. Some elements of the pathway existed in late 2023. The formal pathway was implemented Summer 2025. Results: The results of the pathway are strong as of September 1, 2025. Of 38 nurses, * 15 (39%) are pathway complete * 8 (21%) are on the pathway * 8 (21%) are starting the pathway in Q4 2025 * 7 (18%) are newly hired and Graduate Nurses eligible for administration training within the year Additionally: * 3 have attained OCN certification * Oncology knowledge improved at the end of the pathway. The pre-test mean score was 77.2 and the mean post-test score was 95.03. This is a 23% improvement as a result of knowledge gained along the pathway. Discussion: The pathway builds strong CCN bench strength, providing benefits at both the organizational and the population-health levels. This bench strength decreases treatment delays often incurred because of a lack of oncology-trained nurses (Catania et al., 2025). Furthermore, a strong oncology workforce is needed to achieve the World Health Organization's goal of reducing non-communicable disease morbidity by a third by 2030 (Challinor et al., 2020).
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