Date of Award

Fall 12-7-2023

Degree Type


Degree Name

Doctor of Nursing Practice (DNP)


Leadership and Advanced Nursing Practice

Committee Chair

Dr. Carolyn Coleman

Committee Chair School

Leadership and Advanced Nursing Practice

Committee Member 2

Dr. LaWanda Baskin

Committee Member 2 School

Leadership and Advanced Nursing Practice


Lung cancer is the leading cause of cancer-related death in both men and women in the United States. By the end of 2023, lung cancer will have been diagnosed in approximately 238,000 Americans and claimed the lives of about 127,000 of those that are diagnosed.(American Cancer Society, 2023) Currently lung cancer accounts for more deaths among Americans than breast, prostate, and colon cancers combined (Centers for Disease Control and Prevention [CDC], 2019). Despite being one of the most preventable cancers in the world, lung cancer continues to be the leading cause of cancer-related death among Americans and more so in the Veteran population. The diagnosis of lung cancer can be attributed to the fact that a significant number of military personnel utilized tobacco products or were subjected to considerable levels of toxic environmental risks such as burn pits, jet fuel, and other airborne environmental exposures. According to Kinsinger et al. (2017), nearly 900,000 of a population of 6.7 million Veterans Health Administration (VHA) Veterans meet the criteria for lung cancer screenings (LCS).

The goal of this Doctoral of Nursing Practice (DNP) project was to enhance the understanding of lung cancer screening among primary care providers and nurses at the Jackson VA. The DNP project was intended to facilitate the identification and referral of a greater number of eligible Veterans to be screened for lung cancer. Based on the available data, it is possible to implement a clinical reminder tool that facilitates communication of eligible individuals on an annual basis, as well as at other designated intervals, in accordance with the Lung Rads staging system for follow-up purposes. A comprehensive understanding of lung nodules and cancers, coupled with a collaborative decision-making approach involving healthcare providers, has the potential to expedite and enhance the precision of diagnosis and treatment.

The DNP project employed the Population/Patient Problem, Intervention, Comparison, Outcome, Time (PICOT) format to formulate a clinical question for Veterans who are seeking care in the primary care clinic with a history of tobacco use over 20 packs per year. (P) In Veterans who have appointments in Primary Care Clinics at VAMC, how does (I) Implementing a protocol for early lung cancer screening, compared to (C) not completing annual screening (O) Increase the likelihood of lung cancer in Veteran’s who use tobacco (T) during a four-week time frame. During the time of using the clinical reminder and education of lung cancer screening, data showed that without updated knowledge of lung cancer and the screening process, many veterans would be lacking proper follow-up and possible early intervention.