Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-10-2020

Graduate Advisor

Susan Dean-Baar, Ph.D, RN, FAAN

Committee

Debra Connell-Dent, DNP, FNP-C

Michele Tanz, DNP, FNP-BC

Abstract

Abstract

Problem. Patients in rural or medically underserved areas (MUAs) with inflammatory bowel disease (IBD) have limited access to primary care preventative services, making them even less likely to obtain preventative care, placing them at even greater risk for adverse health outcomes.

Methods. A two-phase retrospective chart review utilizing a convenience sample of patients diagnosed with IBD from a privately-owned gastroenterology office to evaluate the effectiveness of increasing preventative screenings for IBD patients. The first review included 53 patients seen from January to April 2019. A preventative screening

evaluation tool (PSET) was developed based on literature recommendations, including the American College of Gastroenterology (ACG) and the Crohn's and Colitis Foundation guidelines and implemented prior to the second review of 57 patients during the same time frame in 2020.

Results: The results of this study indicated that the use of a preventative screening evaluation tool does increase preventative screenings in patients with IBD. The findings of this study demonstrated a statistically significant difference for 17 of the 25 variables pre- and post-implementation of the evaluation tool.

Implications. Due to immunosuppressant medications, IBD patients are already at an increased risk for infections and cancers (Long et al., 2010; Melmed et al., 2006). Screenings for chronic conditions like heart disease, cancer, and vaccination-preventable infections decrease the probability of complications from chronic conditions and reduce the burden that patients face associated with the management of their disease.

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