DNP Essential VII focuses on the DNP prepared nurse's ability to interpret data as it applies to health promotion and population health. This assignment aligns with Essential VII by requiring the DNP student to investigate journals to disseminate the DNP research project findings, research the journal's impact factor, and author guidelines. This assignment also requires the DNP student to write a practice submission according to the proposed journal author guidelines. Dissemination of DNP research findings ultimately aid in the improvement of population health and health promotion.

The journal I intend on submitting to is the Nurse Practitioners in Women’s Health. I chose this journal due to the specificity to women’s health related to nurse practitioners. This journal also welcomes DNP students or recent graduates to submit quality improvement projects under their “Spotlight on Practice” section. Specific author guidelines are required if submitting as a DNP student/recent grad. See attached guidelines. The acceptance rate for submissions could not be found. It does state that each submission is reviewed by blind reviewers and the process takes up to 4-6 weeks. The impact factor for 2019-2020 was 0.307.

The author guidelines for DNP recent grad submissions state to put in abstract format with no keywords listed. For full article authorship it requests a 3-4 sentence abstract. For this assignment, I did include that below:

Abstract: Barriers surrounding breast and cervical cancer screening rates are multifactorial and include patient and provider issues. Among provider barriers is low utilization rates of provider reminder tools for health maintenance screenings and lack of familiarity to new screening guidelines. To overcome these barriers and increase screening rates for cervical and breast cancer, a provider reminder flow sheet which includes current guidelines may be of benefit.

Keywords: provider reminders, cervical and breast cancer screening, women’s health maintenance, barriers, screening guidelines, education.

Purpose: The purpose of this quality improvement project is to increase breast and cervical cancer screening among women aged 21-65 in an Upstate SC free medical clinic. This project aims to identify barriers providers and nurses face during office visits which cause missed screening opportunities and implement a reminder tool to increase screening opportunities.

Background: Poor breast and cervical cancer screening rates are relevant to nursing and healthcare providers as a whole and are quality measures which impact ratings for practitioners. Low screening rates have shown poor outcomes with cervical and breast cancer. By increasing breast and cervical cancer screening, patients will have earlier diagnosis and treatment, if necessary, leading to improved clinical outcomes. This project was asked to be addressed by the Greenville Free Medical Clinic due to low participation rates in the My Best Chance Network state funded program.

Using CINAHL and MEDLINE databases with the key words: (MH "Reminder Systems") or reminder system) AND ((MH "Cervix Neoplasms") OR cervic* cancer OR (MH "Breast Neoplasms") OR breast cancer), a total of 150 articles were yielded. After narrowing the search to include publications from the years 2016-2021, 38 articles remained. Due to the small number of articles pertaining to provider reminder tools, an additional database, MEDLINE, was used. The same search criteria of ((“MH "Reminder Systems") or reminder system) AND ((MH "Cervix Neoplasms") OR cervic* cancer OR (MH "Breast Neoplasms") OR breast cancer), was used and a total of 238 articles were yielded. After narrowing the search criteria to include publications from the years 2016-2021, a total of 54 articles remained. Literature shows that cervical and breast cancer screening is not offered as often as it should be due to providers forgetting to offer screening discussion during routine office visits and/or not utilizing some of the reminder systems in place with current EMR systems due to difficulty. Gaps in literature include no discussion of cost savings over time for catching positive screenings early.

Study Aims: By implementing a provider reminder flow sheet, the researcher anticipates an increase in the number of female patients screened for cervical and breast cancer. With earlier cancer detection, patient outcomes are improved, and health care systems show a cost savings by providing appropriate and timely care (Schapiro, 2016).

Methods: Project implementation is cheap and easy, only requiring receptionist to place provider/nurse flow sheet to all female patient charts. Once the patient comes in for their appointment, the nurse will initially ask the questions on the flow sheet and the provider will review and sign off after speaking with patient. Although the information is intended for females aged 21-65, all female patients will have the flow sheet attached. This form will be used at the Greenville Free Medical Clinic downtown location only. The number of patients completing breast and cervical cancer screening within 3 months of implementation will then be compared with the previous year’s data. Data will be collected for 3 months (January, February, and March 2022) by performing a retrospective chart review of completed breast and cervical cancer screenings compared with 2021 screening data.

Limitations: This researcher anticipates non-adherence with utilization of the provider flow sheet, lack of patient consent for screening, and inaccurate documentation due to the use of paper charting.

Implications for Practice: This project hopes to increase breast and cervical cancer screening through the My Best Chance Network within the Greenville Free Medical Clinic. An increase in participation in this program will increase early detection rates among these types of cancers leading to better patient outcomes and an overall cost savings.

The remaining three sections, Outcomes; Discussion; and Conclusion will be completed after the results are collected and analyzed.

Discussion: Utilization of provider reminder systems with current guidelines may be beneficial in cervical and breast cancer screening rates. Reminder flow sheets are inexpensive and can be implemented in practices using electronic health records and paper charts. These flow sheets can be customizable to accommodate any clinic needs for quality improvement projects.

Conclusion: The use of provider reminder tools in combination with academic detailing have been proven to increase health maintenance screenings for patients in a primary care setting. Due to time constraints in most clinics, academic detailing may not be widely accepted. Combining guidelines with a reminder flow sheet may help the practitioner quickly identify patient specific needs.