Date of Conferral



Doctor of Nursing Practice (DNP)




Mary Catherine Garner


Patients with a cancer diagnosis are counseled at length about the standard of care treatment options, which may include surgery, radiation, anticancer medications, and chemo/immunotherapy through an informed consent process. Unfortunately, the potential economic burden and the accompanying psychological burden is seldom discussed up front. There is a significant need for routine screening and a multidisciplinary approach to the prevention of financial toxicity for the oncology patient. The purpose of this doctoral project was to lead an interprofessional team in the development of a clinical practice guideline for routine financial screening using the Comprehensive Score for Financial Toxicity (COST) tool and a formal triage process for additional support from the organization’s financial counselor and social worker. Sources of evidence to support project initiatives are based on current, peer-reviewed, literature supporting best practices in improving financial toxicity for oncology patients. The clinical practice guideline development process uses RAND’s modified Delphi model and is based on the AGREE II criteria. The overall AGREE II summative evaluation based on guideline development scoring and recommendation for use in practice was reviewed by an interdisciplinary team in the academic cancer center and totaled 6.75. Development of the clinical practice guideline is based on the Walden University social change theory for strategies to improve human conditions. The project uses the person-centered care model, which emphasizes empowerment of patients through education and resource utilization and improves the ability to be an autonomous decision maker in individual health plans.

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Nursing Commons