Date Approved


Graduate Degree Type


Degree Name

Nursing (D.N.P.)

Degree Program

Health Professions

First Advisor

Dr. Amy Manderscheid

Second Advisor

Dr. Anne McKay

Academic Year



Background: Health prevention screening has recently been highlighted in many initiatives from leading countries around the world. Breast cancer screening, cervical cancer screening and osteoporosis screenings are among the highest objectives for many of these initiatives as national health agencies focus on reducing morbidity and mortality by early detection.

Local problem: Baseline quality metrics reported for one clinic show the appropriate ordering of these health screenings is below the national benchmarks and the organizational benchmarks.

Methods: The project was designed as a quality improvement project based in a critical access region serving a rural population.

Interventions: The project intervention was designed using evidence-based literature analysis and input from stakeholders. The intervention facilitated use of the existing electronic health record to incorporate a passive clinical prompt and identify needed health screenings for the patient during the scheduled visit.

Results: Outcomes showed a statistically significant increase in the amount of breast cancer and osteoporosis screenings that were ordered at the clinic during the post-implementation data collection period. However, there was no change noted in cervical cancer screenings during the same period.

Conclusion: The interventions used in this quality improvement project are generalizable to many primary care settings and may easily be incorporated into established workflows to improve appropriate health screening recognition during a patient visit.