Date of Award


Degree Name

Nursing (D.N.P.)


College of Nursing

First Advisor

Sandra Spoelstra, PhD, RN, FGSA, FAAN

Second Advisor

Marie VanderKooi, DNP, MSN RN-BC

Third Advisor

Mary Dougherty, DNP, RN, AOCNS, NE-BC


Cancer related distress has the potential to negatively impact the health of the patient and their treatment outcome (Grassi, Spiegel, & Riba, 2017). As identification and treatment of distress has a positive impact on patient outcomes; the Commission on Cancer (2016) required distress screening for accreditation. Key stakeholders within a Midwest hospital system expressed a desire for the improvement in the current state of the distress screening. Thus, the scholarly paper describes the key attributes of the organizational assessment, a literature review on evidence-based distress screening tool and a quality improvement project. The Promoting Action on Research Implementation in Health Services (PARIHS) framework (1998) and Plan Do Study Act (PDSA) cycle guided evaluation and implementation of the education based intervention and standardized work plan. The project aimed to increase knowledge about distress screening and competency in the standard work as through increased rates of patient distress screens. Findings indicated a 23% increase in nurse knowledge (77% to 100%). Survey of 20 nurses found 100% provided patients the information handout about distress screening; and those 20 patients verified receipt. Distress screen completion rates pre- post-implementation were 25% (68 of 271) and 52% (44 of 85), a 27% improvement; and 15% (40 of 273) and 10% (8 of 83), a decline of 5% on the two units. Nurses understood the importance and provided distress screening information to patients. The standardized workflow needs additional follow-up to ensure all cancer patients are screened and treated for distress, when needed.