A DNP Evidence-Based Quality Improvement Project to Guide Provider-Patient Discussions on Removing Barriers to Colorectal Carcinoma Screening
MetadataShow full item record
Publisher:The Ohio State University
Series/Report no.:The Ohio State University. College of Nursing Doctor of Nursing Practice Final Document Projects
Problem: Nurse Practitioners (NPs) need a standardized evidence-based approach to effectively and efficiently assess individual patient barriers to colorectal (CRC) screening. Purpose: The purpose of this DNP Final Project was to develop and implement an evidence-based quality improvement educational module and standardized counseling tool for NPs to support effectiveness and efficiency in addressing patient barriers to CRC screening during annual wellness visits for patients who are age 50-75 years and who are assessed as being at average-risk for CRC. Methods: NPs completed a 20-minute education module on CRC screening and strategies for addressing barriers to screening. Pre- and post-training surveys were used to evaluate changes in knowledge, confidence, anticipated frequency of use, and content usefulness. Descriptive statistics, χ² analyses, independent samples t-tests, and Cohen’s d effect size estimation were used in the applicable contexts. Findings: A majority of NPs (65.2%) reported challenges with addressing patient-specific barriers to CRC screening. A statistically significant improvement in knowledge from pre- to post-training occurred, t = - 7.58, p < 0.00001, means of 2.52 (SD = 0.963) to 5.67 (SD = 1.557), respectively, and with a large clinically meaningful effect size difference, Cohen’s d= 2.664. There was a statistically non-significant trend for a slight gain in NP confidence from pre- to post-training, means of 2.68 (SD = 0.852) to 2.24 (SD = 0.752), respectively. 94% of participants intend to incorporate the training information ‘often’ or ‘always’ during wellness visits. This brief training has significant promise for substantial return on investment for NPs. Conclusions: NPs participating in this project demonstrated a substantial gain in knowledge based on a brief educational intervention to improve standardization and use of evidence-based patient-centered strategies for effectively and efficiently assessing and addressing individual patient barriers to CRC screening. This quality improvement project, if sustained within the organization, could address key organizational goals to improve CRC screening rates and prevention of cancer, subsequently improving costs of care.
A five-year embargo was granted for this item.
Items in Knowledge Bank are protected by copyright, with all rights reserved, unless otherwise indicated.