September 2011 VOL 2, NO 5

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Nurse Management and Evaluation of a Computed Tomography Lung Screening Program in a Community Hospital Setting

Pamela C. Matten, RN, BSN, OCN 

Background: As the most lethal cancer in the world, lung cancer presents an enormous healthcare challenge. Recent research from the National Lung Screening Trial indicates “Screening with the use of low-dose CT [computed tomography] reduces mortality from lung cancer.” 1 Evidence indicates diagnosis of lung cancer through CT lung screening may require community hospitals to implement CT lung screening programs.

Objectives: Nurse navigators are involved directly in development and enhancement processes aimed at improving clinical outcomes for oncology patients. The nurse navigator educates patients about cancer prevention, screening, diagnosis, treatment options, and the importance of early detection of cancer.

Methods: St. Joseph Hospital, Orange, California, has maintained a CT lung screening program since 2004. The thoracic nurse navigator is responsible for implementation, management, and evaluation of the program. She tracts suspicious nodules, facilitates case presentations at weekly multidisciplinary conferences, and coordinates additional testing. She participates in marketing strategies to bring screening awareness to the community.

Results: The nurse navigator faces significant challenges with patient compliance to repeat scans at 3, 6, or 12 months. Interventional tactics to encourage patient compliance need to be implemented. Strategic planning should include expansion and flexibility to modify screening programs as evidence points toward national screening guidelines.

Conclusions: The widespread adoption of CT lung screening at community hospitals is forthcoming. The nurse navigators’ role, experience, and ability to act as the liaison between patient and physicians make them ideal candidates to implement and manage a CT screening program in a community hospital setting.


1. National Lung Screening Trial Investigators. Reduced lung cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365:395-409.

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