Date on Paper


Document Type

Doctoral Paper

Degree Name




Committee Chair

Nash, Whitney

Committee Member

Hayden, Dedra

Author's Keywords

educational intervention; electronic health record; electronic medical record; lung cancer screening; primary care; smoking history documentation


Lung cancer is the leading cause of cancer related deaths in the United States, and Kentucky leads the nation in lung cancer deaths. Lung cancer care also contributes billions of dollars a year to the cost of health care in this country. The U.S. Preventive Services Task Force (USPSTF) recommends low-dose computed tomography (LDCT) for lung cancer screening with a grade B recommendation, which is a covered service under the Centers for Medicare and Medicaid Services (CMS) guidelines. In order to qualify, patients must have an appropriately documented smoking history. A primary care office was identified within a major healthcare system in Northern Kentucky that has an existing lung cancer screening program. It was found that patient smoking history information was not being properly documented in the electronic medical record (EMR). A quality improvement program was implemented. The program included a lunchtime educational presentation regarding lung cancer screening requirements and appropriate smoking history documentation in the EMR. Analysis revealed that staff members had a high rate of satisfaction with the program overall but were not as satisfied with implementing the educational program during their lunch break. The impact on smoking history documentation rates was unable to be interpreted due to an unforeseen change in the process for entering referrals into the EMR, which occurred 14 days after implementation of this educational intervention.

Included in

Nursing Commons