Date of Conferral
10-27-2026
Date of Award
October 2026
Degree
Doctor of Nursing Practice (DNP)
School
Nursing
Advisor
Mary Verklan
Abstract
The Doctor of Nursing Practice organizational change project addressed low colorectal cancer (CRC) screening rates among adults aged 45–75 years at a neighborhood health center, which is a Federally Qualified Health Center (FQHC). Low screening presented a nursing practice concern because of missed opportunities for early detection. The practice-focused question asked whether an evidence-based CRC screening intervention, compared with usual care, improved screening completion within 6 weeks. The purpose was to improve screening through manual electronic health record (EHR) alerts, standardized medical assistant workflows, patient reminders, ColoFIT kit distribution, and navigation. The Johns Hopkins nursing evidence-based practice model guided evidence synthesis. I compared de-identified organizational Unit Data System (UDS) report percentages using percentage-point differences. Between March and September 2026, CRC screening increased from 35.47% to 46.91%, or 11.44 percentage points, and fecal occult card returns increased from 28% to 31%. During the 6-week implementation period between March and May, 696 patients were screened; postimplementation assessment occurred in September. Continued alerts, performance monitoring, adequate kit supplies, staff education, and patient outreach were recommended. Potential implications included strengthening evidence-based nursing practice; improving screening access for underserved populations; and promoting positive social change, diversity, equity, and inclusion. Causation and reductions in disparities were not established.
Recommended Citation
Thornton, Angela A., "Improving Colorectal Cancer Screening Rates Among Adults Ages 45–75 at a Neighborhood Health Center Through Electronic Health Record Alerts and Provider Workflow Intervention" (2026). Walden Dissertations and Doctoral Studies. 20968.
https://scholarworks.waldenu.edu/dissertations/20968
