A chart audit was completed in a central Ohio primary care office to evaluate the compliance of lung cancer screening according to guidelines set forth by the USPSTF

MacDonald, Ellen

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Otterbein University

Otterbein University Digital Commons @ Otterbein Masters Theses/Capstone Projects Student Research & Creative Work Spring 2023 Lung Cancer Screening in Primary Care Ellen MacDonald Follow this and additional works at: https://digitalcommons.otterbein.edu/stu_master  Part of the Family Practice Nursing Commons, Higher Education Commons, and the Medical Sciences Commons Otterbein University Digital Commons @ Otterbein Nursing Student Class Projects (Formerly MSN) Student Research & Creative Work Spring 2023 Lung Cancer Screening in Primary Care Ellen MacDonald ellen.macdonald@otterbein.edu Follow this and additional works at: https://digitalcommons.otterbein.edu/stu_msn  Part of the Nursing Commons Recommended Citation MacDonald, Ellen, "Lung Cancer Screening in Primary Care" (2023). Nursing Student Class Projects (Formerly MSN). 528. https://digitalcommons.otterbein.edu/stu_msn/528 This Project is brought to you for free and open access by the Student Research & Creative Work at Digital Commons @ Otterbein. It has been accepted for inclusion in Nursing Student Class Projects (Formerly MSN) by an authorized administrator of Digital Commons @ Otterbein. For more information, please contact digitalcommons07@otterbein.edu. •••Otterbein University, Westerville, OhioEllen MacDonald, BSN, RN Lung Cancer Screening in Primary CareImportance of Lung Cancer Screening Cancer	is	the	second	leading	cause	of	death	in	the	United	States	in	2021	(Centers	for	Disease	Control	and	Prevention,	2023)Lung	cancer	is	the	leading	cause	of	cancer	death	in	the	United	States	(American	Cancer	Society,	2022)	Early	detection	best	allows	for	surgical	tumor	resection	which	is	associated	with	best	patient	outcomes	(deKoning,	et	al.,	2020)	0100000200000300000400000500000600000700000800000Heart DiseaseCancerCOVID-19AccidentsStrokeChronic Respiratory…Alzheimer'sDiabetesLiver DiseaseKidney DiseaseLeading Causes of Death in the U.S. in 2021Figure	1.	Leading	causes	of	mortality	according	to	the	Centers	for	Disease	Control	and	Prevention020000400006000080000100000120000140000LungColorectalPancreaticBreastProstateLiverLeukemiaNon-Hodgkin LymphomaBrainOvarianLeading Causes of Cancer Death in 2021Figure	2.		Leading	causes	of	cancer	death		according	to	the	American	Cancer	SocietyCurrent Lung Cancer Screening Guidelines• According	to	the	US	Preventative	Services	Taskforce,	patients	should	be	screened	for	lung	cancer	yearly	with	LDCT	scan	of	the	chest	if	they	meet	the	following	criteria:• Ages	50-80• Have	a	20-pack	year	smoking	history• Currently	smoke	cigarettes	• Quite	smoking	cigarettes	within	the	past	15	years• Do	not	have	a	current	or	former	lung	cancer	diagnosis• Does	not	have	a	limited	life	expectancy	or	inability	to	undergo	lung	surgery	(USPSTF,	2021)	Figure	3.	Sample	visual	aid	to	place	in	patient	exam	rooms	in	an	adult	primary	care	officeResearch Design and Methods• Primary	care	office	located	in	central	Ohio• 10	charts	were	selected	for	audits	of		patients	scheduled	for	annual	well-visit• Outcomes	to	be	measured• Was	LDCT	scan	ordered	in	compliance	with	guidelines• Was	LDCT	scan	completed• Were	any	abnormal	findings	identified	via	LDCTSummary of Findings• Of the patient charts that were audited 20% were screened with a LDCT but did not meet the USPSTF guidelines due to having quit smoking more than 15 years prior• 100% of these patients had negative LDCT scan results• 10% of patient charts that were audited were not screened with a LDCT scan despite being a current cigarette smoker with more than 20-pack year history• 10% of patient charts that were audited had a LDCT scan ordered according to guidelines and had a pulmonary nodule detected and subsequent pulmonology referral for further evaluation and treatmentPractice Recommendations• The	providers	may	benefit	from	a	visual	aid	in	their	exam	rooms	detailing	the	decision-making	tree	that	goes	into	ordering	a	low-dose	CT	scan	for	routine	lung	cancer	screening	based	on	current	guidelines• Having	this	easy-to-read	visual	aid,	as	seen	in	Figure	3,	in	the	exam	rooms	may	also	prompt	some		patients	to	inquire	about	the	screening	themselves	therefore	improving	both	patient	and	provider	compliance	with	testingView	References	Via	QR	Code:

Lung Cancer Screening in Primary Care

https://digitalcommons.otterbein.edu/cgi/viewcontent.cgi?article=1126&context=stu_master

Lung Cancer Screening in Primary Care

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