Analyzing Psychosocial Distress Screenings: A Quality Improvement Project that Modifies the Frequency of Screenings

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Conrad, Kady
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Research Subject Categories::INTERDISCIPLINARY RESEARCH AREAS::Caring sciences::Nursing , Quality Improvement , Nursing Staff , Thermometers , Cancer Patients , Psychosocial Aspects of Illness
Background/Purpose: Distress is a multifactorial unpleasant experience that can interfere with the patients’ ability to cope with cancer. Research has recognized the effectiveness of interventions in the ability to reduce distress and positively impact patient outcomes. Therefore, the American College of Surgeon’s Commission on Cancer (ACSCoC) mandated that all cancer centers screen for distress to maintain and/or receive accreditation. The frequency of distress screening is up to the discretion of the cancer center; however, it is recommended to screen for distress at every medical visit. Due to this, cancer centers have implemented protocols that vary widely in their screening characteristics. This lack of consistency complicates the interpretation of research results that are intended to better understand and manage this issue. Therefore, more research is needed to determine the specific aspects of the distress screening process that need to be modified to achieve optimal patient outcomes. Methods: This quality improvement project (QI) took place at a local radiation therapy office in western North Carolina, where the facility’s protocol was to administer the National Comprehensive Cancer Network (NCCN) Distress Thermometer and Problem List only at the initial visit. In this project, the nursing staff administered the NCCN Distress Thermometer and Problem List once a week for a three-month period, to see if there would be improvement in the facility’s ability to recognize and address psychosocial distress among their patients. The results were then gathered from a retrospective chart review and compared to the existing documentation collected from a designated three-month period. Findings: The results of the two-tailed Mann-Whitney U Test were significant and indicate that increasing the frequency of psychosocial distress screenings does provide a significant improvement in the recognition of psychosocial distress. Conclusion: Despite the limitations, the study does provide evidence that increasing the frequency of psychosocial distress screenings can improve a facility’s ability to recognize and address patient distress.