A prospective quality improvement project using a mammography risk assessment tool to increase screening mammogram use with low-income Hispanic women


2018-08, 2018-082018-08


Walker-Smith, Tammy L.
Walker-Smith, Tammy L.


Journal Title

Journal ISSN

Volume Title




Breast cancer is the second leading cause of cancer mortality among U.S. women. Hispanic women experience a lower 5-year survival rate of 79% compared to 91% among non-Hispanic White women. The purpose of this DNP project was to design an evidence-based quality improvement (QI) project to improve the screening mammogram completion rates by implementing concurrent educational and clinic referral tool systemic strategies in a primary care clinic. Medline, CINAHL, and the Cochrane Collection, databases were used to identify key studies between 2013-2018 that addressed the disparity of low-income Hispanic women, and evidence-based practice breast cancer risk assessments based on risk factors and current screening guidelines. The evidence-based tools used were the Breast Cancer Risk Assessment Tool and the National Health Interview Survey, available in English and Spanish. Once the tools triggered a nurse referral, health providers determined if a screening mammogram order was needed. This provided a systematic change process for early detection and improved screening mammogram rates for women between the ages of 50-74. The QI project findings addressed evidence-based interventions that improved screening mammogram rates 7.21% in a three-month period. The outcomes discussed in this report provide guidance for new policy considerations and clinical protocols.



Breast cancer risk assessment, breast cancer risk factors, evidence-based breast cancer screening tools, Hispanic, primary care, screening mammogram



Attribution 3.0 United States, This material is made available for use in research, teaching, and private study, pursuant to U.S. Copyright law. The user assumes full responsibility for any use of the materials, including but not limited to, infringement of copyright and publication rights of reproduced materials. Any materials used should be fully credited with its source. All rights are reserved and retained regardless of current or future development or laws that may apply to fair use standards. Permission for publication of this material, in part or in full, must be secured with the author and/or publisher.