Date of Conferral
9-16-2026
Date of Award
9-16-2026
Degree
Doctor of Nursing Practice (DNP)
School
Nursing
Advisor
Sandra Wise
Abstract
In this quality improvement project, I evaluated a pilot implementation of a standardized bioidentical hormone replacement therapy (BHRT) screening and monitoring tool embedded within the electronic health record (EHR) at an integrative medicine practice in the southeastern United States. Grounded in the Johns Hopkins evidence based practice (EBP) model, the project addressed a documented gap in consistent screening, initiation, and monitoring of hormone replacement therapy (HRT) for women ages 35 to 50 presenting with menopausal symptoms. The practice focused question examined whether a standardized, EHR embedded BHRT screening and monitoring tool could improve screening rate compliance, laboratory monitoring adherence, and dosing compliance. I used a pre and postimplementation chart audit design to evaluate changes in screening rates, laboratory monitoring, and dosing recalculation practices. Quarter 1 (Q1) 2026 data (i.e., January 1–March 31, 2026) captured 337 unique patients, more than 220 individual laboratory draws, and 56 dosing safety flags across three hormone markers. The findings from this project demonstrate that implementing a structured, EHR embedded BHRT monitoring process has the potential to create meaningful and measurable improvements in clinical practice. By standardizing screening consistency, strengthening laboratory monitoring adherence, and guiding accurate dosing recalculation practices, the initiative directly enhances the quality and safety of hormone management. These improvements translate into clear benefits for multiple groups. Patients experience safer care, fewer avoidable dosing complications, and more reliable symptom relief. Providers gain a consistent workflow that reduces uncertainty, supports evidence based decision making, and improves confidence in treatment adjustments. The organization benefits from more accurate documentation, stronger quality metrics, and a reproducible model that can be scaled across additional sites. Collectively, these outcomes position the project as a practical and transferable approach to improving hormone management for a population that has historically been underserved.
Recommended Citation
Hampton, Amanda Ellen, "Standardized Screening and Monitoring of Bioidentical Hormone Replacement Therapy in Women Ages 35–50" (2026). Walden Dissertations and Doctoral Studies. 20766.
https://scholarworks.waldenu.edu/dissertations/20766
