Author ORCID Identifier


Date Available


Year of Publication


Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Julianne Ossege

Clinical Mentor

Dr. Sharon Lock

Committee Member

Dr. Elizabeth Tovar



BACKGROUND: Primary care providers (PCPs) are poised across healthcare settings to reduce the leading cause of preventable morbidity and mortality, cigarette smoking. However, their patients may not be screened for tobacco use and miss cessation counseling, thus increasing tobacco-related diseases, and incurring costs to healthcare payers.

PURPOSE: This project seeks to identify the documentation process in a new electronic health record (EHR), communicate efficacy barriers, administer an educational intervention regarding the new process for PCPs, and measure its impact on performance of tobacco use screening and cessation counseling.

METHODS: This project was a quasi-experimental, single center, pre- and post-interventional design quality improvement study conducted from June 2021 to March 2022. Five PCPs participated in the chart review, academic detailing intervention, and follow-up reporting. Fifty patient encounters were randomly selected for evaluation.

RESULTS: There was no statistically significant difference in tobacco use screening after the intervention.

DISCUSSION/CONCLUSION: This project determined the optimal documentation process in the new EHR and measured performance of tobacco use screening in an outreach clinic without previous benchmarks. These baseline data points are useful to trend future performance reporting and frame expectations for further documentation improvement.