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

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.