Enfermeiro de práticas avançadas no Brasil: Navegação de pacientes oncológicos em transplante de células-tronco hematopoéticas (TMO)

Hematopoietic stem cell transplantation (HSCT) involves a long and fragmented trajectory with multiple care transitions, and Brazilian Federal Nursing Council Resolution No. 735/2024 recognized nurse navigators and clinical nurse specialists as advanced practice professionals. This study aimed to analyze the evidence published between 2021 and 2026 on the role of advanced practice nurses in navigating cancer patients undergoing HSCT, with emphasis on the Brazilian context. This is an integrative review conducted with the PICO strategy and reported according to PRISMA 2020, with 13 searches in an academic search engine and open-access portals plus a complementary search. Level of evidence, methodological quality (Joanna Briggs Institute tools) and risk of bias were assessed separately. Of 118 records identified, 17 studies were included, organized into three categories: advanced nursing practice in Brazil; cancer patient navigation; and nursing care coordination in HSCT. Navigation was effective in reducing cancer care intervals, and advanced practice in oncology was associated with better symptom control and satisfaction. In Brazil, advanced practice is at an early stage, with limited knowledge among nurses. In HSCT, evidence was limited to international feasibility studies on survivorship clinics, caregiver support and remote monitoring. No study evaluated navigation by advanced practice nurses in HSCT in Brazil. There is regulatory support and plausibility, but an empirical gap. A six-phase navigation pathway and a competency matrix are proposed.