First Advisor

Hessler, Karen

Degree Name

Doctor of Nursing Practice

Document Type

Capstone

Date Created

8-2017

Department

College of Natural and Health Sciences, Nursing, Nursing Student Work

Abstract

Primary care clinics are often the first stop when a patient has a question regarding health, needs screening for health conditions, and/or needs to complete maintenance healthcare items such as mammograms or colonoscopies. As such, primary care providers are in prime position to screen for possible diseases that could poorly affect health for their patients. These screenings are usually directed by guidelines and policies published through the National Guideline Clearinghouse (NGC) and the Agency for Healthcare Research and Quality (AHRQ; 2013). One such guideline is entitled Screening for hepatitis C virus infection in adults: U.S. Preventive Services Task Force (2013) recommendation statement. This guideline recommends that all persons born between 1945 to 1965 be screened once in a lifetime for the Hepatitis C virus (HCV). The recommendation is because chronic HCV infection can lead to decreased quality of life and high cost of care for the individual and the healthcare system if left untreated. Untreated HCV can lead to liver cirrhosis and hepatocellular carcinoma. A person who screens positive for infection with HCV can be appropriately treated and, in most cases, have complete disease eradication. From the researcher’s clinical experiences, the screening processes in many primary care clinics in northern Colorado were lacking in numbers of patients screened iv and provider knowledge of when to screen their patients. The researcher developed a capstone project to implement at a primary care clinic through the use of three objectives: 1. Increase screening rates for HCV at a primary care clinic 2. Identify a barrier preventing providers from screening patients for HCV 3. Overcome the barrier preventing screening for HCV Objective 1 was met through the use of an electronic medical record (EMR) review of patients who completed well-visits at the clinic before and after an educational seminar with the providers and staff at the clinic. Objectives 2 and 3 were met through an educational seminar to identify and overcome barriers through the use of surveys and handouts, respectively. The educational seminar allowed the researcher to offer screening coding tips to help with insurance coverage (as this was the barrier identified that prevented screening) and also to refresh providers and staff on the importance of HCV screening per the guideline for the birth cohort born from 1945 to 1965. The EMR reviews of well-visits showed a 30% increase in screening rates for HCV at this clinic- the pre-seminar rate was 37.8% and the post-seminar rate was 68.89%. This shows the capstone project was a success to increase screening rates, identify a barrier preventing screening, and overcome this barrier. Success of this capstone will have effects into the future as hopefully, the providers and staff continue to increase HCV screening rates for patients at the clinic. The continued increase in screening rates could insure proper offering of treatment to patients identified as having positive HCV status to increase quality of life by preventing worse negative sequalae associated with chronic HCV infection.

Keywords

Hepatitis C; Primary care; Health screening

Extent

78 pages

Local Identifiers

CirboCapston2017

Rights Statement

Copyright is held by the author.

Digital Origin

Born digital

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