Background/Review of Literature: A new cancer diagnosis is overwhelming and stressful. A multitude of information will be shared, and treatment initiated quickly. To prepare patients for chemotherapy, a comprehensive and systematic education program should be utilized. Combining written instructions and supportive material with nurse-led teaching sessions have been found to be most beneficial. Well prepared patients have been shown to have less anxiety, more confidence to handle adverse effects at home, and improved quality of life. Purpose: The quality improvement (QI) project purpose was to explore the effect of a nurse-delivered, enhanced education intervention on distress among older adults receiving chemotherapy in an outpatient setting. Design/Methods: The enhanced chemotherapy education intervention consisted of a 1-hour educational class facilitated by an oncology nurse, PowerPoint presentation, and written materials. A quasi-experimental, pretest-posttest design was used to compare outcomes across two groups of patients. Procedures: Group 1 received whatever pre-chemotherapy educational materials usually offered to patients by the unit (usual care). Group 2 received enhanced educational intervention prior to their first cycle of treatment. Both groups completed a Distress Thermometer and Problem List prior to Cycle 1, and prior to Cycle 2. All participants completed an investigator-designed patient satisfaction survey. Results/Interpretation: Both groups reported less distress prior to Cycle 2. Group 2 reported higher satisfaction scores (100% vs. 89%), called/came to office with fewer concerns (2 vs. 7), and fewer Emergency Room and hospital visits (1 vs. 2). The QI project resulted in improved patient satisfaction, decreased need for intervention with side effects, and fewer hospital visits among adult cancer patients receiving chemotherapy in an outpatient community setting.