Title

Expansion of a Comprehensive and Standardized Well-Woman Exam Program in a University-Based Clinic

Date of Degree

12-2021

Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)

Program

Nursing

Advisor

Jean Dols

Abstract

Background. Well-woman exams are an opportunity for women to receive focused screening, counseling, education, and care from a healthcare provider. Studies have found that 68% of women received well-woman exams between 2010 and 2016. During COVID-19 well-woman exams decreased by 80% in the United States. Standardized, comprehensive exams facilitate identification of the need for lifesaving care. Objective(s). The purpose of this quality improvement project was to expand a comprehensive and standardized well-woman exam program in a university-based clinic. Methods. Processes were implemented to promote well-woman exams, patient comfort measures, and completion of an evidence-based standardized comprehensive exam with appropriate follow-up. Following project implementation patients are now screened when calling the clinic to schedule an appointment. If appropriate, a well-woman exam is scheduled with a provider. During the appointment, the provider uses patient comfort measures and the newly developed Woman Preventive Services Initiative chart to complete the exam to ensure comprehensive components are included. The laboratory results of the exam are given to the patient via telephone call and, if needed, a referral is also made. Results. The number of well-woman exams increased by 900% from January 31, 2021 to April 16, 2021. The key elements that increased women’s comfort with well-woman exams including providers introducing themselves and the chaperone, as well as verbal checks of the patient during the pelvic exam, were incorporated in 94.44% of the exams. Weeks nine and ten showed 95.45% completion of the WPSI components. Of the patients who responded to a post-exam survey, 96% of the patients reported a positive experience. Implications. Expansion of standardized well-woman care facilitated comprehensive evidence-based care. Standardized electronic documentation tools designed and employed should maintain the consistency of the exam and assist in identification of need for follow-up testing and care. New processes reversed the decline of well-woman exams completed during the 2019-2020 COVID-19 pandemic at the university-based clinic and the increase should be maintained through the patient satisfaction achieved.

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