Using a nursing protocol to assure equitable delivery of cancer-related prevention services.
A nurse-administered, protocol-driven model (NP) for preventive services delivery was compared with a traditional physician reminder (PR) model with nursing back-up among 473 patients attending Internal Medicine and Family Medicine clinics. A total of 240 patients were randomized to the NP group and 233 to the PR group. Demographic characteristics including gender [71% female (NP) and 71% female (PR)], race (78% and 75% African American, respectively) and age (numbers of persons aged 18-54, 55-64 and 65+ years) were similar in each group. In the NP group 244/244 screening tests for breast, cervical and colon cancers and alcohol abuse were initiated or completed by nurses, while in the PR group 110/215 (51%) were initiated or completed by physicians. The NP group received 552/552 counseling services from nurses for tobacco, alcohol, nutrition, exercise and prostate screening, while in the PR group, physicians delivered 10% of the needed services (56/560). Aside from counseling for prostate cancer screening, which was 100% in both the NP and PR groups, all other between-group differences for each service were significant at the level of p<0.001. Results show the feasibility of a nursing protocol for initiating equitable cancer prevention services in a primary care setting.
Meharry Medical College, Department of Internal Medicine, Division of Preventive Medicine, 1005 D.B. Todd Jr. Blvd., Nashville, TN 37208, USA. rlevine@mmc.edu
R S
RS
Levine
B A
BA
Husaini
J S
JS
Emerson
P C
PC
Hull
N C
NC
Briggs
C J
CJ
Moriarty
V A
VA
Cain
D000293:Adolescent; D000328:Adult; D000368:Aged; D003376:Counseling / Q000458:organization & administration; D003695:Delivery of Health Care / Q000941:ethics / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000451:nursing; D008875:Middle Aged; D016294:Models, Nursing; D009369:Neoplasms / Q000517:prevention & control*; D009730:Nursing Assessment / Q000941:ethics / Q000379:methods*; D010820:Physicians