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Advanced Practice Nursing Toolkit

This toolkit was developed and evaluated within a collaborative research study involving Cancer Care Ontario, McMaster University, Laurentian University and regional cancer centres in Sudbury and Hamilton.

The toolkit uses the PEPPA Framework, a participatory, evidence-informed patient-focused process for promoting the effective introduction and evaluation of advanced practice nursing (APN) roles.

The purpose of the advanced practice toolkit is to help a wide range of organizations and healthcare teams design and deliver high-quality, cost-effective and patient-centred cancer services that may use advanced nursing or other health provider roles.

What Is Included In the Toolkit

The toolkit includes a variety of resources, tools and activities to guide healthcare teams through the PEPPA Framework. Although the design focuses on APN roles, the same framework can be applied to various nursing roles and healthcare providers in other disciplines.

Who the Toolkit Is Designed For

The toolkit is a comprehensive guide designed for:

  • government policy makers
  • healthcare planners
  • healthcare administrators and managers
  • nursing leaders
  • advanced practice nurses
  • healthcare teams and providers
  • educators and researchers


Why Use the Toolkit

The toolkit helps healthcare teams:

  • identify and recruit key stakeholders to participate in healthcare planning and implementation
  • build an effective healthcare planning team
  • design models of cancer care that maximize the use of healthcare provider roles and services
  • determine if a new APN role or modifications to an existing APN role are required to enhance cancer services
  • design the appropriate APN role to address patient, healthcare provider, organization and healthcare system needs
  • create a business case and a budget for an APN role
  • develop strategies to successfully recruit and hire the best candidate for an APN role
  • establish a plan to support the optimal implementation of an APN role
  • develop a plan to evaluate the impact of an APN role and other changes to the model of care


The PEPPA Framework defines 9 key steps for effectively assessing the need for an advance practice nurse and for developing and implementing this role within the practice setting. A core component of this step-by-step approach is the collective involvement of key stakeholders, including patients, in the planning and evaluation process. The Ontario Oncology APN Role Implementation Toolkit includes the process for working through the steps and numerous activities, and resources to guide the members of APN role implementation teams.



Take the Advanced Practice Nursing Toolkit Survey

Fill out our brief survey to tell us:

  • if you found the toolkit helpful in designing APN or other new health provider roles
  • how you have used the toolkit in role implementation
  • how we can improve the toolkit



Take APN Toolkit Survey



Share Your Experience

Tell us how you used this toolkit and/or the PEPPA Framework to improve the delivery of cancer services. Contact the OAPN Program Coordinator at

Have Questions? Email Us

Denise Bryant-Lukosius
Assistant Professor, School of Nursing and Department of Oncology, McMaster University/Director, Canadian Centre of Excellence in Oncology APN (OAPN), Juravinski Cancer Centre


Program Coordinator


Lorraine Martelli
Provincial Head, Oncology Nursing
Cancer Care Ontario