Graduation Semester and Year
Fall 2025
Language
English
Document Type
DNP Project
Degree Name
Doctor of Nursing Practice
Department
Kinesiology
First Advisor
Kirsten Drake
Abstract
Abstract
Background: Colorectal cancer (CRC) remains the second leading cause of cancer-related deaths in the United States, despite being preventable through timely screening. National guidelines recommend regular screening for adults aged 45 to 75; (American cancer Society (ACS), 2025) however, screening rates remain suboptimal, particularly in primary care settings serving diverse and high-volume populations. Local Problem: At the project site, a community-oriented primary care clinic in North Texas, baseline data revealed CRC screening completion rates were below benchmarks set by the organization. Barriers included limited patient awareness, inconsistent provider reminders, and workflow challenges in distributing and tracking fecal immunochemical test (FIT) kits. Methods: A quality improvement (QI) project using the Plan-Do-Study-Act (PDSA) model was implemented to increase CRC screening rates. Data was collected from electronic medical records and daily tracking logs over an 8-week intervention period. Interventions: A bundled approach was introduced that included provider and staff education, standardized workflow for FIT kit distribution reminder calls to patients in week 1 and week 3. Results: The interventions improved both FIT kits return rates and overall CRC screening completion. Patients reported increased understanding of the importance of screening, and staff expressed improved efficiency in workflows. A chi-square test of independence was conducted to examine the relationship between timing of intervention (pre- vs. post-) and colorectal cancer (CRC) screening completion. Results revealed a statistically significant association between screening completion and intervention period, χ² (1, N = 768) = 49.85, p < .001. In the pre-intervention group, 64.7% (n = 321) of patients had not completed screening compared to 38.2% (n = 104) in the post-intervention group. Conversely, completion rates increased from 35.3% (n = 175) pre-intervention to 61.8% (n = 168) post-intervention. These findings indicate that CRC screening completion rates significantly improved following the intervention. Factors during the post-intervention phase that may have positively influenced patient participation include enhanced patient education, reminder calls, streamlined kit distribution, and increased provider engagement, which collectively reduced barriers to screening and facilitated adherence.
Keywords: Colorectal cancer screening; FIT screening; Patient reminders; Colorectal cancer screening education; Primary care; Quality improvement
Keywords
Colorectal cancer screening; FIT screening; Patient reminders; Colorectal cancer screening education; Primary care; patient navigation; barriers and facilitators; Quality improvement
Disciplines
Community Health and Preventive Medicine | Family Medicine | Family Practice Nursing | Gastroenterology | Geriatric Nursing | Geriatrics | Health and Physical Education | Internal Medicine | Interprofessional Education | Oncology | Preventive Medicine | Primary Care | Public Health and Community Nursing | Public Health Education and Promotion
License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Recommended Citation
Reddiar, Elizabeth, "Bundled Approach to Improve Colorectal cancer in Primary care" (2025). Doctor of Nursing Practice (DNP) Scholarly Projects. 111.
https://mavmatrix.uta.edu/nursing_dnpprojects/111
Included in
Community Health and Preventive Medicine Commons, Family Medicine Commons, Family Practice Nursing Commons, Gastroenterology Commons, Geriatric Nursing Commons, Geriatrics Commons, Health and Physical Education Commons, Internal Medicine Commons, Interprofessional Education Commons, Oncology Commons, Preventive Medicine Commons, Primary Care Commons, Public Health and Community Nursing Commons, Public Health Education and Promotion Commons