Date of Degree


Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)




Michael D. Moon


Joaquin V. Littlejohn


Colorectal cancer (CRC) is the third most common cancer and the second most common cause of cancer-related deaths worldwide (World Health Organization, 2019a). In the United States, CRC was the fourth most common cancer in 2016 (Centers for Disease Control and Prevention, 2019a). The American Cancer Society (2020a) estimated that there will be 147,950 estimated new cases and 53,200 estimated deaths of CRC in the U.S. in 2020. The purpose of the project was to improve CRC screening completion rates and follow up referrals from 27.5% to 35% for adult patients, 50-75 years of age, within a family medicine clinic using the U.S. Preventive Services Task Force (USPSTF) (2016) and Health Resources & Services Administration (HRSA) (2018b) clinical practice guidelines utilizing fecal immunochemical tests (FIT) kits. FIT is a huge benefit to the underinsured, uninsured, and underserved populations in detecting CRC (Riehman et al., 2018). The objectives were to increase the percentage of patients meeting screening guidelines who receive an order for CRC screening through staff and patient education made readily available; increase the percentage of FIT results through FIT kit distribution within the clinic and live communication follow up for those with no results in the EHR; and increase the percentage of those with a positive FIT who receive a referral for follow up testing within two weeks through standardized EHR communication process and use of clinic tracking sheets. HRSA provides funding to the organization for preventive services based on performance on CRC screening. CRC is 100% treatable and the impact of improving CRC screening will improve patient outcomes by preventing and decreasing disability and mortality from CRC.