Date of Award


Degree Name

Nursing (D.N.P.)


College of Nursing

First Advisor

Jean Barry PhD, RN, NEA-BC

Second Advisor

Patricia Thomas PhD, RN, NEA-BC, ACNS-BC, CNL

Third Advisor

Geraldine J. Terry MD MSN RN


Adolescents are engaging in risky behaviors earlier contributing to 75% of adolescent morbidity and mortality with unintentional injuries listed as the most common cause of death among this population in the United States. It is reported that engaging in more than one risk behavior will lead to other risk behaviors resulting in the rise of indirect and direct costs in society today. The scholarly project was conducted in response to a midwestern Michigan primary care clinic need to improve the early identification and documentation of adolescent risk behaviors with evidence-based technology screening. The purpose of this quality improvement project was to improve the screening and identification of adolescent risk behaviors with the implementation of the RAAPS I-Cloud tool. The implementation and use of technology will facilitate the improvement of the documentation of risk categories, follow-up plan, and screening procedure billing codes into the electronic medical record (EMR) during the preventive adolescent visit. The objectives included multidimensional interventions that involved designing a workflow process with implementation and education using a new technology tool, customizing and integrating structured templates into the EMR for ease of documenting, developing a daily workflow process, and a policy and procedure for the RAAPS screening tool for the adolescent population in this organization. The post - implementation data results demonstrated an increase in the documentation practices among the providers in the structured preventive adolescent visit template and procedure coding (CPT) for the RAAPS screening tool in the visit billing encounter. Although the objectives of this project were achieved, the post technology survey results reported discrepancies in the usefulness and ease in the technology to motivate continued acceptance behavior for sustainability. Given the impact of adolescent risk behaviors on the long-term health and social outcomes, it is important for primary care providers to develop a process and system approach to screening of adolescent risk behaviors with adolescent friendly technology that ensures confidentiality and promotes engagement between the adolescents and the provider. Utilizing evidence-based preventive guidelines in the preventive adolescent visit with technology will facilitate electronic documentation of the risks, interventions, and follow-up for tracking risk trends and performance.

Additional Files

D. Rinker PP.pdf (2678 kB)