Year of Publication

2019

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Lynne Jensen

Clinical Mentor

Dr. Chris Yost

Committee Member

Dr. Julianne Ossege

Abstract

Abstract

BACKGROUND: Colorectal cancer is the second leading cause of cancer related death in the US. Kentucky has one of the highest rates of the disease. Approximately 1/3 of the population has not completed screening for colon cancer as recommended by guidelines. Patient navigation is a strategy proposed to increase completion of screening in the primary care setting.

PURPOSE: The purpose of this quality improvement pilot project was to provide preliminary data on the impact of a patient navigation strategy to improve colon cancer screening completion in low risk individuals.

METHODS: Colon cancer screening completion using Colonoscopy or Cologuard testing was compared between 30 navigated patients and 30 routine care patients in a women’s health primary care clinic. The prevalence and prevalence odds ratios were computed to measure the association between patient navigation and the project outcome measures. The barriers to non-completion of screening were also assessed. The overall results were compared to findings in the New Hampshire Colorectal Cancer Screening Program PN protocol endorsed by the CDC.

RESULTS: Patients in the PN intervention group were 5 times more likely to complete colon cancer screening than control patients (P = .021) and 2.7 more likely to also have had a Colonoscopy date scheduled (P = .015). In addition, 55.5% of navigated patients completed screening after receiving mailed screening enrollment forms versus 23.8% completion whose enrollment was on an online ordering portal alone.

CONCLUSION: Patient navigation can be used as strategy for increasing colon cancer rates in low risk individuals. Other contributors to increases in screening included having designated personnel for enrollment processes, offering a choice in screening test, mailed reminders for enrollment in screening, and access to an online ordering portal.

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