Document Type
DNP Project
Publication Date
4-2024
Degree Name
Doctor of Nursing Practice
Faculty Advisor
Susan DeNisco DNP, APRN, FNP-BC, FAANP, Constance Glenn CNP APRN FNP-BC CNE
Practice Mentor
Richard Wintermute, MD
Abstract
Significance and Background: Breast cancer is the most common cancer in women throughout the United States. Specifically, the state of Connecticut has one of the highest rates of breast cancer in the country. Multiple evidence-based organizations have developed specific guidelines for screening in clinical practice. These guidelines specify when a woman should be screened and how frequently. A project was put in place at a FQHC in Connecticut to increase the number of breast cancer screenings ordered, based on clinical guidelines. Evidence supported the use of provider education to increase the number of mammograms ordered (Marks,2022).
Purpose: Increase the number of mammograms ordered by Internal Medicine and OBGYN providers across the health system. Deliver education to providers and nursing staff regarding breast cancer screening guidelines.
Methods: Plan-Do-Study-Act. Plan: Identify the stakeholders and people involved in the process, as well as identify the scope and scale of the project. Do: Educational sessions were conducted followed monthly check-ins with the organization. PowerPoint educational materials were disseminated to providers and nursing staff. Study: Data was gathered on the number of mammograms ordered by Internal Medicine and OBGYN providers as well as follow-up phone calls were placed to patients who were ordered mammograms. Act: Present data to organizational stakeholders.
Outcome: Over the twelve- week implementation period, there were a total of 663 mammograms ordered. 374 (56.4%) of them were ordered by OBGYN providers and 289 (43.6%) were ordered by Internal Medicine providers. This reflected an overall 18% decrease in mammograms ordered by primary care providers compared to those ordered by OBGYN providers. Of the seventy patients that received follow- up phone calls, because of lack of knowledge regarding their screening appointments, seventeen had already attended their mammogram screening. Twelve patients had their mammograms scheduled and the dates were upcoming. Six patients canceled original appointments because they wanted to reschedule in more convenient locations. Two patients never scheduled their mammograms due to financial situations. Two patients planned to attend their mammogram appointment later in the spring and one person missed their appointment due to being ill. The remaining thirty patients were unable to be contacted by the project leader.
Discussion: The implementation of a project to increase the number of screening mammograms ordered by Internal Medicine and OBGYN providers by educating providers and staff did not increase the number of mammograms ordered. Although educational sessions were geared towards the importance of screening guidelines and breast cancer rates, the project team leader speculated additional time allowed on provider and staff education would have resulted in additional mammogram screenings for this patient population.
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Recommended Citation
Manzella, A. (2024). Improving provider ordered annual breast cancer screening in primary care [Unpublished DNP project]. Sacred Heart University.
Comments
A DNP project submitted in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice, Sacred Heart University Davis & Henley College of Nursing.