Year of Publication

2016

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Julie Ossege

Clinical Mentor

Dr. Kim Tharp-Barrie

Committee Member

Dr. Sharon Lock

Abstract

Purpose: The purpose of this project and literature review was to determine provider documentation practices of colorectal cancer (CRC) screening, identify the percent of clinic patients who need to be screened, and develop a set of recommendations and targeted interventions which will increase CRC screening rates.

Methods: A retrospective chart review including males and females of all ethnicities between the ages of 45 and 80 was performed in one primary care practice. A randomized sample of 360 office visits between February and November of 2015 were selected, of which 281 met the inclusion and exclusion criteria. Patient demographics and characteristics were recorded in Excel. Data were exported to SPSS for analysis.

Results: At the time of the chart review, 37% (n=105) of patients were determined to be either not up-to-date with screening or the screening status was not documented. A t-test assuming equal variances was used and determined that those who were offered screening tended to be younger, with a mean age of 60. This is in comparison to those who were not offered screening who demonstrated a mean age of 67 (p=0.001). Provider documentation practices demonstrated use of the electronic medical record health maintenance tracking module 63% of the time. A Chi-Square test confirmed that use of the health maintenance module increases the likelihood of patients being up-to-date with screening (p = 0.000).

Conclusion: The findings of this project indicate that interventions such as a tracking tool similar to the health maintenance module are effective at improving cancer screening rates. Recommended interventions include provider and patient education, the implementation of a screening navigator, and timely software updates which impact automated features of the electronic medical record.

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