Verification of pregnancy status prior to initiating radiation treatment for cancer is important to preserve patient and fetal safety. However, many institutions lack clear guidelines for pregnancy screening prior to treatment initiation. A practice gap analysis conducted at an academic medical center revealed inconsistent pregnancy screening within the radiation oncology department, with 7% (N = 729) of eligible patients screened prior to initiating treatment. A nurse-driven policy was implemented based on recommendations from the American Society for Radiation Oncology and the National Comprehensive Cancer Network. Postimplementation, 78% (N = 364) of eligible patients received pregnancy screening prior to treatment.