Year of Publication

2022

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Elizabeth Tovar

Clinical Mentor

Sara Reno

Committee Member

Dr. Julianne Ossege

Committee Member

Dr. Julianne Ewen

Abstract

Background: Malignant melanoma has become an increasingly prevalent problem in the United States. The earlier a skin cancer is identified, the better the outcome. There are conflicting recommendations about screening for skin cancer but in general identifying high risk patients is important and it is not being achieved in primary care.

Purpose: The purpose of this study is to evaluate use of the SAMScore Questionnaire to determine high risk patients at adult annual visits.

Methods: This was a multi-phased study with a quasi-experimental design that took take place at a family and community primary care clinic in central Kentucky. Baseline assessment of skin cancer screening frequency and education during annual exams was obtained with a medical record review. Providers were then educated on the use of the SAMScore and asked to start using with adult patients during annual exams. After a period of 3 weeks, a post-intervention review of medical records was completed to assess provider documentation related to skin cancer screening risk using SAMScore and education. Inclusion criteria involved patients aged 18-64 years old of all genders, races, and ethnicities.

Results:The phase one chart audit included 30 patient charts and the phase three chart audit included 48 patient charts. There was a significant increase in screening completion from pre- to post-intervention. None of the participants were screened pre-intervention, and more than half (56%) were screened post (p

Conclusion: One hundred percent of the patients identified as high risk at this clinic were educated on skin protection, but only about half of the eligible patients were indeed screened. Further research should be done to address barriers to screening and continued efforts should be made to ensure our primary care providers are identifying those at high risk for skin cancer.

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