Year of Publication

2020

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Karen Stefaniak

Clinical Mentor

Dr. Judith Daniels

Committee Member

Dr. Karen Butler

Abstract

Colorectal cancer accounts for 8% of all cancer deaths and can be prevented through timely removal of colon polyps. Despite recommendations for routine screening, approximately 31.2% of patients go unscreened for this disease (Centers for Disease Control and Prevention, 2018). The purpose of this project was to determine screening rates and documentation mechanisms for colorectal cancer in an urban primary care practice, to determine how many patients completed the screening, and to present findings to the practice providers along with exploring ways to increase screenings. An additional purpose of this project was to determine and identify patient demographics which can impact rates of screening. A retrospective chart review was conducted of patients aged 50 to 75 years old in an urban primary care clinic from January 1, 2019 to March 31, 2019. Charts were reviewed to determine if colorectal cancer screening was recommended and documented per screening guidelines and whether patients completed the screening. Overall rate of screening was 61%, which did not meet the national goal but was within the meaningful use measures. Of the 120 charts reviewed, 72 patients had completed colorectal cancer screening. There were no significant differences within demographic variables and provider screening rates. Results from the chart review were then presented via focus group to two providers from the clinic. Three strategies were discussed during the meeting: delegating a clinic support staff to identify scheduled patients who need screening, having the provider document when screening is due on the patient’s problem list, and adding an alert on the patient “dashboard” to provide an immediate alert when screening is due. Race, gender, location of residence, and provider type did not yield statistical difference in screening rate. Future benefit may be seen by repeating the chart review now that the information has been presented to providers and specific strategies are being planned.

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