The Implementation of a CDC Guideline Using an Evidence-Based Risk Assessment Tool to Increase Colorectal Cancer Screening in Primary Care Patients.

Abstract

Background: Over the years, colorectal cancer (CRC) has been diagnosed in younger adults less than 50 years of age, most common in those with Lynch syndrome. In turn, CRC has become the fourth leading cause of cancer deaths. According to Sinicrope et al. it is imperative in identifying inherited syndromes, Lynch syndrome being the most recurrent. Objective: This quality improvement project aimed to increase colorectal cancer screening in primary care patients by implementing a CDC guideline and risk assessment tool. The implementation of an evidence-based risk assessment tool during primary care visits will improve the identification of patients who should be referred for CRC screening. Methods: For this quality improvement project, 25 patients were selected at random during their well-visit encounter, between the ages of 45 and 50, male or female, who did not have a current diagnosis or history of CRC. Over a 2-week period, the Centers for Disease Control and Prevention guideline and the evidence-based risk assessment tool were implemented during these patient encounters. Following implementation, there was a vigorous chart review to further determine which of those individuals were at risk for CRC based on the risk assessment tool. If the evidence identified a patient at risk for CRC, a colonoscopy was ordered. Results: The following week after implementation, a chart review was performed on all 25 of these individuals, which further identified who was at risk for CRC. The female patient accounted for only 4% of the total charts reviewed, whereas the remaining 24 male patients were calculated at 96% of the total. The only female patient indeed had CRC risk factors based on the risk assessment tool; in turn, a colonoscopy was ordered. For the remaining 24 male patients, it was identified that 7 of these individuals had CRC risk factors based on the risk assessment tool, and the remaining 17 did not. It was further identified that three out of the seven male patients, or 42.86%, were overdue for a colonoscopy. Conclusion: This means that approximately 29.167% of the male patients were identified as having CRC risk factors, and 70.833% were not. After patient discussion, a colonoscopy was ordered for all seven male individuals. Implications for Nursing: In relation to these project findings, it is imperative that the nursing community continues to have leaders who will educate and promote the health and well-being of patients. As nurses continue to provide effective patient education, this will positively impact the overall patient health care delivery. By using risk assessment tools, such as the tool used for this project, nurses have the ability to prevent cancers and other disease states.