Lung screening in head and neck cancer survivors.

Abstract

179 Background: Lung screening is a relatively new screening method to detect early lung cancers among current or former smokers (American Cancer Society, 2016). One quarter of head and neck cancer survivors succumb to second malignancies with lung cancer representing 53% of second cancers (Baxi et al, 2014). At one ambulatory cancer center rates of screening within the head and neck cancer population were low at 15% (Local Tumor Registry, "Head and Neck Cases,” 2016). Furthermore, smoking documentation, which is required for determining appropriateness of lung screening, was incomplete within 39% of audited head and neck cancer patient charts (Local Tumor Registry, "Head and Neck Cases,” 2016). The objective of this project was to identify the effect of education on prescribers’ intention to screen and on smoking documentation within the electronic medical record. Methods: An educational session addressing barriers to screening prescription was presented to prescribers (N = 12) and clinical staff nurses (N = 18). Using an evidence-based approach, a question/answer period plus an electronic health record demonstration were included within the session (The Community Guide, 2017). The study design used pre- and posttest methodology to evaluate the session’s impact on screening rates, with pretest represented by extant data. Posttest survey and chart audits were used to measure outcomes of education including intention to screen and rates of completed smoking documentation. Results: Rates of completed smoking documentation increased from 61% to 78% after the educational intervention. On prescriber surveys 88% of respondents (N = 8) indicated that as a result of the educational session they were more likely to order lung screening. Other findings from survey showed there might have been a high level of knowledge about lung screening prior to the session. Conclusions: Multicomponent educational sessions served as a useful reminder resulting in high rates of intention to screen. Providing background information about lung screening may be useful for clinical nursing staff in improving smoking documentation. Next steps include a 6-month post hoc analysis of lung screening rates as well as nursing remediation to further increase smoking documentation.