Date
3-22-2024
Department
School of Nursing
Degree
Doctor of Nursing Practice (DNP)
Chair
Sherri Walker
Keywords
colorectal cancer, screening, value-based care, interventions, primary care
Disciplines
Medicine and Health Sciences | Nursing
Recommended Citation
McKithan, Stephanie, "Implementation of an Evidence-based Toolkit to Improve Colorectal Cancer Screening in a Federally Qualified Health Center" (2024). Doctoral Dissertations and Projects. 5308.
https://digitalcommons.liberty.edu/doctoral/5308
Abstract
The change in payor fee-for-service to value-based care is creating an opportunity for primary care clinics nationally to adjust their focus to meeting key clinical quality measures during patient encounters. Colorectal screening is one of such quality measures. Previous research has shown that early detection saves lives. The guidelines have lowered the recommended age of initial screening to 45 due to the incidence of colorectal cancer in younger patients. But with all the objectives that need to be met in the limited time of the visit, how can nurse practitioners improve their efficiency? This evidence-based project assessed the implementation of eleven interventions combined into a toolkit designed to increase the clinic’s compliance to federally qualified health center (FQHC) standards of care by increasing colorectal cancer screening in the primary care setting. These steps were aimed at identifying patients eligible for screening along with predisposing high-risk factors, arming them with education to understand the importance of screening and the various methods, and priming a shared decision-making conversation with the nurse practitioner on arrival to the exam room. An eight-week trial of the toolkit revealed a significant increase in screening participation of the pilot clinic over the cohort clinic. Additionally, there was an overall increase in a secondary measure of improving staff’s knowledge of colorectal cancer and a third measure of bringing screening rates up to North Carolina benchmarks. A multi-interventional toolkit can improve essential screening and early detection of colorectal cancer, thus meeting clinic goals and standards of care and ultimately improving patient outcomes in the form of quality and subsequent length of life.
