Year of Publication

2019

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Sharon Lock

Clinical Mentor

Jessica Sass

Committee Member

Dr. Elizabeth Tovar

Abstract

BACKGROUND: Colorectal cancer is one of the most common and deadly cancers, particularly in persons greater than 50 years of age. Most colorectal malignancies are slow-growing, making regular screening increasingly important to decrease morbidity, mortality, and cost of treatment. Cologuard® serves as an effective and non-invasive colorectal cancer screening modality for average-risk adults.

PURPOSE: The purpose of this study was to evaluate the impact of a provider-based educational intervention on the knowledge, attitudes, self-efficacy, and ordering rates of Cologuard® among primary care providers.

METHODS: This study was a single-center, pre/post implementation study of the effectiveness of a provider-based educational intervention using a validated resource tool from the American Cancer Society. The first stage of the project featured a pre/post-test examination of the knowledge, attitudes, and self-efficacy related to Cologuard® of 14 primary care providers before and after an educational intervention for providers in November 2018. The second stage of the project included a separate pre/post-test design to determine the effect of the educational intervention on provider order rates of Cologuard® using 200 randomly selected charts prior to the intervention during the months of August through October 2018, and 200 randomly selected charts after the intervention during the months of December 2018 through February 2019 for patients meeting screening qualifications.

RESULTS: Of the 18 providers who attended the educational program, 14 completed and returned pre- and post- tests. There was a statistically significant increase in provider knowledge (p<0.001) and self-efficacy (p=0.002) from the pre- to post- intervention periods. There was no statistically significant difference in attitudes (p=0.142) or Cologuard® order rates (p=0.660) from the pre- to post- intervention periods.

CONCLUSION: Provider-based educational programs serve as an effective intervention to address certain measures in practice. Increases in provider knowledge and self-efficacy related to Cologuard® were seen in the post-intervention period, and while there was not a statistically significant difference in provider attitudes, it is important to note an increase on the measurement scale did occur. Future implications for practice may involve alternate solutions to improving Cologuard® order rates, though this initiative may provide necessary first-steps to facilitate organizational changes that would lead to an increase in Cologuard® orders.

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