Date Approved


Graduate Degree Type


Degree Name

Nursing (D.N.P.)

Degree Program

College of Nursing

First Advisor

Dr. Joy Turner Washburn, EdD, RN

Second Advisor

Dr. Marie VanderKooi, DNP, MSN, RN-BC

Academic Year



Background: Cancer is the second leading cause of death in the United States. Cancer screenings increase the detection of various cancers at an early more curable state, yet routine cancer screenings are still underperformed. The purpose of this quality improvement project was development and implementation of a standardized pre-visit checklist for identifying patients in need of routine cancer screenings at a Rural Health Clinic.

Methods: Medical assistants within the practice were asked to complete the pre-visit checklist and review it with the providers prior to each patient visit. The tool outlines cancer screening eligibility based on the United States Preventative Services Task Force guidelines and enables providers to identify when the patient’s previous screening(s) occurred, as well when the next screening(s) is/are due. Data regarding medical assistant and provider use of the pre-visit checklist was collected in January and February 2022, while post-implementation qualitative data was collected in March 2022.

Results: Medical assistants completed the checklists 90% of the time. Eighty percent of the screenings indicated by the checklists as due were appropriately ordered by the provider or documented as patient declined screening. Qualitative survey results indicate the medical assistants found the checklists easy to complete with minimal disruption to workflow. Providers indicated that the checklists provided an accurate and easily accessible resource to determine cancer screening eligibility and enhanced their ability to engage patients in discussion regarding the importance of cancer screening.

Conclusions: Medical assistants routinely completed the pre-visit checklists and most providers consistently ordered screenings indicated as due on the checklist. A pre-visit cancer screening checklist can improve provider identification of patients eligible for cancer screening.

Implications: Clinical Decision Support (CDS) tools in the form of a pre-visit checklist can promote congruence with evidence-based cancer screening guidelines. By using a pre-visit cancer screening checklist, patients eligible for cancer screening can be properly identified and referred for recommended cancer screening.

Keywords: Clinical decision support, cancer screening, standardized screening compliance, primary care.

Available for download on Monday, April 21, 2025