Decreased time-to-treatment delay through clinical guideline implementation for image-guided image biopsies in cancer diagnosis

dc.contributor.advisorChairperson, Graduate Committee: Molly Secoren
dc.contributor.authorO'Dell, Meghan Marieen
dc.contributor.otherThis is a manuscript style paper that includes co-authored chapters.en
dc.date.accessioned2024-11-01T14:02:08Z
dc.date.issued2024en
dc.description.abstractBackground: International guidelines have been established defining the ideal period from referral to diagnosis of malignancy as two weeks. Increased time-to-treatment initiation is associated with a one to three percent increased mortality risk for each week of delayed treatment. Image-guided biopsy has emerged as a transformative tool in cancer diagnosis, impacting the rapid identification and treatment of malignancy. Clinical Problem: A rurally based oncology institute associated with a larger non-profit healthcare system in Montana identified concerns with extended time-to-treatment initiation related to delayed image-guided biopsy. The average wait time for image-guided biopsy was sixty-seven days. Methods: Utilizing the Replicating Effective Programs (REP) Implementation framework, an evidence-based clinical practice guideline was developed to define optimal referral-to-diagnosis timeframe for diagnosis or rule-out of malignancy via image-guided biopsy using the second edition of the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool. Interventions: A guideline advisory committee including individuals from relevant professional groups was recruited to act as expert appraisers. Four-phase appraisal of the clinical practice guideline using the AGREE II tool took place over six weeks. The guideline was rated for overall quality based on a seven-point rating scale and appraisers were asked if they would recommend the guideline for use in the target facility. Results: The guideline received an average rating of 6.2 and was recommended for use by 100% of appraisers, with 18% recommending modifications during pre-implementation. During implementation, the guideline received an average rating of 6.7 and was recommended for use by 100 % of appraisers. The final guideline and appraisal data were presented to health system leadership and the guideline was successfully adopted into facility policy. Conclusion: Quality improvement initiatives will need to be implemented to identify and address systems-based complexities that could pose barriers to meeting the goal timeframe as defined by the guideline.en
dc.identifier.urihttps://scholarworks.montana.edu/handle/1/18548
dc.language.isoenen
dc.publisherMontana State University - Bozeman, College of Nursingen
dc.rights.holderCopyright 2024 by Meghan Marie O'Dellen
dc.subject.lcshCanceren
dc.subject.lcshDiagnosisen
dc.subject.lcshBiopsyen
dc.subject.lcshTime managementen
dc.subject.lcshOutcome assessment (Medical care)en
dc.titleDecreased time-to-treatment delay through clinical guideline implementation for image-guided image biopsies in cancer diagnosisen
dc.typeDissertationen
mus.data.thumbpage110en
thesis.degree.committeemembersMembers, Graduate Committee: Carrie W. Milleren
thesis.degree.departmentNursing.en
thesis.degree.genreDissertationen
thesis.degree.nameDoctor of Nursing Practice (DNP)en
thesis.format.extentfirstpage1en
thesis.format.extentlastpage115en

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