Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

11-28-2025

Graduate Advisor

Paula Prouhet

Co-Advisor

Brittania Phillips

Committee

Marilyn Schallom

Abstract

Abstract

Problem: The impact of a cancer diagnosis is multifaceted, affecting all aspects of the patient's social, financial, physical, and psychological well-being. Related literature states that the cancer experience can decrease mental well-being, spark new-onset mental health conditions, and increase mortality rates. Cancer patients often experience distress that goes underreported. This quality improvement project aims to educate, implement, and use best practice guidelines for distress management to perform and evaluate the impact of initiating routine distress screening using the National Comprehensive Cancer Network (NCCN) Distress Thermometer on adult oncology patients with hematological cancer diagnoses.

Methods: This quality improvement project utilized a descriptive and cross-sectional design with retrospective chart reviews. The electronic health record was searched for patients who matched the study criteria for follow-up office visits three months prior to the implementation of the intervention to assess a baseline understanding of screening and referral practices within the clinic. Following the intervention of routine distress screenings utilizing the NCCN Distress Thermometer, a secondary chart review was conducted to assess the impact of both routine screenings and interdisciplinary referral practices. A data collection tool was developed and utilized to collect all further demographic data.

Results: The initial chart review, conducted prior to implementation, involved 120 participants (n = 120), revealed that 10% of these patients had been screened using the NCCN Distress Thermometer, and no interdisciplinary referrals were made. The secondary chart review status post-intervention consisted of 145 participants (n = 145), and revealed that 53.1% of this sample was screened. This quality improvement project resulted in a 431% increase in distress screening. However, no interdisciplinary referrals were made.

Implications for Practice: Further research and future endeavors should be explored to promote a more accurate understanding of routine distress screenings and the related impact of interdisciplinary referrals. After the systematic barriers have been addressed, recommendations include employing in-depth clinical education, an electronic screening process, and sitewide implementation to increase the generalizability of future studies.

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