Document Type



Doctor of Nursing Practice



Date of Defense


Graduate Advisor

Nancy Magnuson


Nancy Magnuson

Cathy Koetting

Patricia Martin



Problem: Nearly seven million individuals will be struggling with both cancer and depression by 2040. Patients with cancer face a multitude of challenges. These challenges can impact a patient’s mental health and ability to cope with a cancer diagnosis. Currently, there is a large treatment gap among patients who are coping with both cancer and depression. Healthcare providers are neglecting to use evidence-based screening tools to assess patients for depression upon admission to inpatient treatment.

Methods: This quality improvement project took place at a large metropolitan comprehensive cancer center in the Midwest. A descriptive observational design was utilized. Prescreen-post screen data was compared to determine if there was a relationship between evidence-based PHQ-8 screenings and referrals to counseling. Convenience sampling was utilized for patients who were admitted to a medical oncology unit over two months.

Results: Overall, this quality improvement initiative did increase the number of referrals to counseling services (4.8% pre-screen vs. 5.2% post-screen), however the impact was not statistically significant (p = 0.43; CI = 95%). However, there may be positive qualitative outcomes.

Implications for practice: Recommendations for sustaining change include involving advanced practice providers in obtaining screenings on patients admitted to the medical oncology unit. Doctorally prepared nurses can also work with information technologists to generate a best practice advisory based on score. Areas for future studies include screening nurses, assessing provider attitude toward mental health screening for oncology patients, and evaluating patient’s pre-counseling and post-counseling PHQ-8 scores.