Digital Commons Network^™

Patient And Clinician Characteristics That Predict Breast Cancer Screening Behavior In 40–49-Year-Old Women, Sarina Schrager, Claudia Evaristo, Terry Little, Lori Dubenske, Elizabeth S. Burnside

Journal of Patient-Centered Research and Reviews

Guidelines recommend that clinicians practice shared decision-making (SDM) with women in their 40s to discuss breast cancer screening. Traditionally, SDM includes discussion of values and preferences to help determine a decision that is congruent with what the patient desires. We analyzed 54 women’s breast cancer screening decisions after a SDM conversation with their clinician. We looked at both patient and clinician characteristics that predicted whether or not a woman would get a screening mammogram. Women with a family history of breast cancer or who had a previous abnormal mammogram had higher rates of screening. Screening rates also varied widely between …

The Impact Of An Evidence-Based Multi-Component Intervention On Colorectal Cancer Screening In Primary Care At A Healthcare System, Ahnnya Slaughter

Student Scholarly Projects

Practice Problem: Colorectal cancer is the second leading cause of cancer death in the United States; many of the deaths are preventable with early detection. Adherence rates for colorectal cancer screening with fecal immunochemical test kits (FIT) was below the national benchmark at this facility.

PICOT: The PICOT question that guided this project was: Among veterans 50 – 75 years old requiring average risk colorectal cancer screening (CRCS) seen in primary care at a veterans affairs healthcare system facility (P), how does the use of a multi-component intervention (I), compared to the usual care (C), affect the number of …

Reflections Of An Earliest Established Screening And Testing Facility For Covid-19 In The Largest Metropolis, Pakistan, Fatima Kanwal, Karishma Kanhya Lal, Asra Qureshi

Department of Family Medicine

As the world struggles to deal with the COVID-19 pandemic, this article talks about the experience and findings of the first COVID-19 screening facility in a tertiary care hospital in Karachi, Pakistan. Department of Family Medicine at Aga Khan University (AKU) took initiative where COVID-19 screening of stable patients first began in a dedicated area. Since testing kits were limited and community spread had not started, nurses would screen every walk-in patient based on the presence of fever, cough, travel history and exposure to COVID-19 positive patient in the last 14 days, and advise swab testing if indicated. Out of …

Anal Cancer Screening At Truman Health Services, Peter D. Tran, Harshdeep Babbar

Quality Improvement/Patient Safety Symposium

Anal Papanicoloau Screening at Truman Clinic

Anal cancer is a squamous cell cancer associated with human papillomavirus (HPV), the same virus that is associated with cervical cancer. Although vaccination against HPV has been shown to be effective in reducing overall rates of infection, the number of new anal cancer cases has been rising for many years. In HIV-infected men and women, the incidence is even higher of anal cancer than in the general population. Current rates in an HIV-infected MSM population have been estimated to be as high as 70-144 per 100,000, with some studies of HIV-infected individuals showing that …

Technology-Based Advance Care Planning Education For Primary Care Patients, Taryn Achong

Doctor of Nursing Practice (DNP) Projects

Background: Advance Care Planning (ACP) encompasses a multidisciplinary, collaborative process that allows patients to understand their health and make informed decisions in their treatment plans. Considering the COVID-19 pandemic and recent research, ACP is considered imperative for all patients. Evidence-based approaches include supplemental group sessions, case manager interventions, and provision of at-home resources. Within the pandemic, there has also been a rapid shift to telemedicine, restricting most ACP efforts. Therefore, the utilization of technology-based ACP resources and telemedicine is highly supported.

Purpose: This DNP project serves to assist an internal medicine practice located in Hawaii’s metropolitan area. Although the …

A Tailored Multicomponent Intervention In Primary Care For Survivors Of Adverse Childhood Experiences (Aces), Rebecca L. Peterson

Evidence-Based Practice Project Reports

Adverse childhood experiences (ACEs) include 10 traumatic events of abuse, neglect, and household dysfunction that occur before 18 years of age. Adverse childhood experiences affect greater than 60% of the population, and approximately one in six individuals affirm that they have experienced four or more types of ACEs. They are associated with negative, long-term health outcomes in adults, including 9 out of the 10 leading causes of death in the United States (Centers for Disease Control and Prevention, n.d.; Felitti et al., 1998). The purpose of this evidence-based practice project was to implement a tailored, multicomponent intervention to mitigate the …

Keeping Primary Care Providers Informed About Detecting Skin Cancer In Young Adults, Riley J. Spears

Evidence-Based Practice Project Reports

Skin cancer is a common, life-threatening disease that affects anyone, regardless of age or skin color (American Cancer Society [ACS], 2020). The incidence of melanoma is on the rise for young adults, with an estimated 2,400 new cases for individuals aged 15 to 29 (ACS, 2020). Although skin cancer is highly preventable, clinical guidelines are inconsistent regarding skin cancer screening. The purpose of this evidence-based practice (EBP) project was to determine if the implementation of the INternet curriculum FOR Melanoma Early Detection (INFORMED) program would improve primary care providers’ (PCPs’) confidence about skin cancer and the number of completed and …

The Primary Care Provider’S Role In Screening And Intervening In The Human Trafficking Of Adolescents: A Systematic Literature Review, Brittany Schmid

All Graduate Theses, Dissertations, and Other Capstone Projects

Human trafficking (HT) is a growing concern within the United States (U.S.) and internationally. With the alarming number of HT victims presenting for medical care, primary care providers (PCPs) are in a unique and privileged position to encounter HT victims within the healthcare system. Adolescents, in particular, are vulnerable to HT because of minimal life experiences, inadequate social support, and limited coping mechanisms (Ertl et al., 2020). Failure to recognize and intervene in cases involving HT victims who are minors is detrimental to the individual’s health, wellbeing, and safety. With the assistance of education and training, community resources, guideline adoption, …

Devoloping A Primary Care Screening Protocol For Post-Miscarriage Depression, Sean Muniz

Family Medicine Clerkship Student Projects

Spontaneous abortions occur in 20-33% of pregnancies, and 10-30% of these women have clinically significant depression. These women are often unscreened by either PCPs or OBs for depressive symptoms. We developed a screening protocol using the PHQ-2 to assess for depression in patients who have had a spontaneous abortion. The protocol utilizes a nursing care manager to follow up with patients who either were seen in the ED or self report spontaneous abortions to the PCP office. Follow up phone calls should be made within 2 weeks and at 6 weeks post spontaneous abortion, with offers for in-person follow-up given …

Non-Medical Cannabis Use Screening And Advising, William Dean Brown

Family Medicine Clerkship Student Projects

No abstract provided.

Improving Identification Of Ldct Lung Cancer Screening Eligible Patients, Mckenna L. Schimmel

Family Medicine Clerkship Student Projects

USPSTF updated lung cancer screening guidelines this year to include all patients 50-80 years old who have 20+ pack years of smoking history and are active smokers or who have quit within the last 15 years. While providers and patients both support lung cancer screening efforts, only a small fraction of eligible patients end up getting screened annually. One way we can improve this metric is by making sure we are correctly identifying which patients meet screening criteria.

Assessing Patient Perceptions Of Pre-Visit Methods To Reduce Wait Time And Provider Burden, Vinh H. Le

Family Medicine Clerkship Student Projects

Due to multiple factors, patients at ambulatory settings tend to experience long appointment wait times, negatively impacting patient satisfaction and overall well-being. One proposed solution is to use pre-visit data collection to simplify check-in and screening processes at the office. This project surveyed patients at Brookfield Primary Care & Pediatrics regarding quantitative wait time data and qualitative perceptions on the proposed solution. It was found that a majority of patients are open to using pre-visit online forms to reduce wait times.

Psa Screening - Patient Decision Aid, Michael Brown

Family Medicine Clerkship Student Projects

PSA screening decision aid

Screening For Disordered Eating Among High-Risk Groups, Julia B. Purks

Family Medicine Clerkship Student Projects

Many patients with disordered eating will not present with objective manifestations such as low BMI, physical exam findings, or electrolyte abnormalities. Among patients that meet DSM-V criteria for an eating disorder, the majority do not fit criteria for anorexia nervosa or bulimia nervosa, but instead fall into a category known as "Otherwise specified feeding and eating disorders." As such, it can be difficult to identify these patients. This project proposes adding 2 validated screening questions to outpatient intake forms, or incorporating them into patient visits, to identify disordered eating among high-risk groups.

Dietary Health Screening, Luke Hallgarth

Family Medicine Clerkship Student Projects

Dietary recall by patients is time consuming & inefficient. This project aims to develop a screening tool to accurately and efficiently track patient's diets over the course of multiple healthcare visits.