Dissertation
Improve Patient Tobacco History Documentation
University of Iowa
Doctor of Nursing Practice (DNP), University of Iowa
Spring 2026
Abstract
Background: Lung cancer is the leading cause of cancer-related deaths in the United States (Iowa Cancer Registry, 2024). Cigarette smoke is considered the cause in 85% of diagnoses. Furthermore, when detected in the early stages, the 5-year survival rate is 59%; however, that drops to 9% when found in the late stages. Without documentation of a complete smoking history, the criteria for lung cancer screening, such as the tobacco product used, total pack years, and time since quitting, cannot be determined. By improving documentation of tobacco history, providers will have more information to determine whether patients are eligible for lung cancer screening. Purpose: The purpose of this project was to increase complete documentation of patient tobacco history in the electronic health record to increase identification of patients eligible for lung cancer screening. Methods: This quality improvement project, based on the Iowa Model, had the objective to increase staff knowledge, increase complete tobacco history documentation in the electronic health record, and improve identification of patients eligible for lung cancer screening. All patients were 18 years old or older with an obstructive pulmonary condition such as Asthma. The project occurred over 18 weeks. Quantitative data were collected through pre- and post-surveys, EHR reports, and manual chart reviews. This data was analyzed using counts, percentages, averages, and run charts programmed into Intellects. Findings: Following the intervention (educational training, site champion, and on-site visits), the percentage of complete tobacco history documented for positive tobacco history patients increased by 80%. Discussion: This project confirmed that staff education, site champion, on-site visits, and initiation of a self-administered survey improved documentation of a complete tobacco history and identification of patients eligible for lung cancer screening.
Details
- Title: Subtitle
- Improve Patient Tobacco History Documentation
- Creators
- Catrina Jargo Piper - University of Iowa
- Contributors
- Amalia Gedney-Lose (Chair) - University of Iowa
- Resource Type
- Dissertation
- Project Type
- Poster
- Degree Awarded
- Doctor of Nursing Practice (DNP), University of Iowa
- Degree in
- Family Nurse Practitioner
- Date degree season
- Spring 2026
- Publisher
- University of Iowa
- Number of pages
- 1 page
- Copyright
- Copyright © 2026 Catrina Jargo Piper
- Language
- English
- Academic Unit
- College of Nursing; Doctor of Nursing Practice Projects
- Record Identifier
- 9985217065302771
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