Date of Award
Summer 2025
Document Type
DNP Executive Summary
Degree Name
Doctor of Nursing Practice (DNP) in Adult-Gerontology Acute Care Nurse Practitioner
Department
Nursing
Faculty Chair
Dr. Douglas Stephens, DNP
Preceptor
Dr. Jeremy V. Stidham, MD
Abstract
Background: Colorectal cancer is a leading cause of cancer-related death in the United States (U.S.), ranking as second most prevalent overall. Despite many initiatives, screening rates remain low, especially among clinic patients without insurance. The lack of an evidence-based screening protocol exacerbates these issues and increases the risk of advanced cancer and death. Initial data showed that 0% of patients were screened according to recommended guidelines.
Purpose: The project implemented a standard screening protocol to increase colorectal cancer screening rates in a rural Alabama free clinic for patients ages 45-64 lacking insurance.
Project Design: This quality improvement project aimed to implement a colorectal cancer screening protocol based on the U.S. Preventive Services Task Force guidelines. Using screening criteria, appropriate patients received test instructions and guaiac fecal occult blood test kits to be completed either in the clinic or at home. If tests were positive, patients were referred for colonoscopy. Pre- and post-implementation data was reviewed and compared to identify efficacy of the evidence-based protocols. Project sustainability included increased provider buy-in, designated funding, increased referral sources, patient callbacks, increased support for the provider in identifying screening needs, and increased staff education.
Results: During the 10-week implementation period, 29.03% of the patients meeting the criteria were screened by the standard evidence-based protocol; however, 22.58% of patients were screened with a non-evidence-based approach.
Conclusion: Implementing a standard screening protocol increased screening rates, but protocol non-adherence by the provider and patient refusal remain key barriers to address in future efforts.
Recommended Citation
Day, Andrea F., "Increasing Colorectal Cancer Screening Rates for Patients Without Insurance" (2025). Doctor of Nursing Practice Projects. 137.
https://digitalcommons.jsu.edu/etds_nursing/137
DNP Project Poster
DNP Project Slides Final_Andrea Day.pptx (3972 kB)
DNP Project Powerpoint
Included in
Community Health and Preventive Medicine Commons, Digestive System Commons, Digestive System Diseases Commons, Family Medicine Commons, Family Practice Nursing Commons, Gastroenterology Commons, Health Services Research Commons, International Public Health Commons, Interprofessional Education Commons, Neoplasms Commons, Oncology Commons, Other Nursing Commons, Primary Care Commons, Public Health and Community Nursing Commons, Public Health Education and Promotion Commons, Quality Improvement Commons