Date Available

12-9-2016

Year of Publication

2016

Degree Name

Doctor of Nursing Practice

Advisor

Dr. Sharon Lock

Committee Member

Dr. Julianne Ossege

Co-Director of Graduate Studies

Dr. Martin Ozor

Abstract

Objectives: The overall objective of this practice inquiry project was to evaluate whether providers in a primary care clinic in Louisville, KY were following the United States Preventive Services Task Force (USPSTF) screening guidelines regarding colorectal cancer for patients aged 50 -75. The study examined the types of screening recommended, and whether completion of screening was documented in the medical record. Finally in this study, provider recommendation for Colorectal Cancer Screening (CRC) was evaluated to determine if types of screening recommended, and documentation varied based on the ethnicity of the patients.

Methods: This was a descriptive study using a retrospective chart review of patient medical records (n= 200) in a primary care office located in Louisville, Kentucky. Charts were reviewed and data collected for male and female patients ages 50-75, who were seen in the primary care office between January 1, 2015 and December 31, 2015. Data was also collected and charts examined on whether CRC screening was recommended, the type of screening that was recommended, whether recommendation was based on ethnicity, and whether completion of screening was documented.

Results: There was no statistically significant difference in gender by CRC screening recommendation. According to the data, females were as likely to be recommended for CRC screening as their male counterparts. There was no statistically significant relationship between ethnicity and the recommendation of CRC screening. The data did reveal however, that the providers overwhelmingly chose to recommend one type of screening (colonoscopy) over the other types of screening, (e.g., Fecal Occult Blood, Fecal immunochemical test, Cologuard, Flexible sigmoidoscopy). This might be due to the high predictive value of colonoscopy compared to the other types of CRC screening processes. Also the data revealed that, while there was no statistically significant difference by age (p=.52), those recommended for CRC screening were slightly older. (Mean=59.1) as compared to those not recommended 56.6 for screening. This is older than what USPSTF recommends.

Conclusion: In this clinic, providers were as likely to recommend CRC screening for women as for men. In addition, the CRC screening did not differ based on race or ethnicity. Notwithstanding, it was apparent that younger patients were not screening for CRC at the same rate compared to the older patients. There is need for provider improvement in recommendation of CRC screening for the patients starting at age 50, in line with the USPSTF guidelines. This is critical as new research has found colon cancer rates rising among individuals under 50.

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