Award Date


Degree Type

Doctoral Project

Degree Name

Doctor of Nursing (ND)



First Committee Member

Kathleen Thimsen

Second Committee Member

Paul Thomas Clements

Third Committee Member

Soumya Upadhyay

Number of Pages



Screening rates for cancer related genetic mutations are low in the primary care setting, despite evidence-based guidelines recommending screening in all patients who meet criteria. Genetic mutations, such as the breast cancer susceptibility 1 and 2 (BRCA1/2) gene mutations, drastically increase breast and ovarian cancer risk in patients. The United States Preventive Services Task Force (USPSTF) and the National Comprehensive Cancer Network (NCCN) provide evidence-based guidelines on criteria for genetic testing in women at risk for breast and ovarian cancer related gene mutations. Primary care providers (PCPs), including advanced practice registered nurses (APRNs), are at the front lines of preventative care in the community and should participate in preventative genomic care. Increased adherence to evidence-based guidelines promotes improved patient safety and outcomes. The purpose of this Doctor of Nursing Practice (DNP) project was to increase genetic testing rates to improve early detection and prevention of breast and ovarian cancer in women. This was accomplished through a quality improvement project at a women’s health primary care outpatient clinic. A new practice protocol was introduced that incorporated evidence-based guidelines for both cancer risk assessment and genetic testing. After the Cancer Risk Assessment and Genetic Testing Protocol (CRA/GT- Protocol) was implemented, baseline genetic testing rates were compared to intervention phase genetic testing rates to evaluate usefulness of the protocol. Results demonstrated that the protocol was successful at reducing practice barriers to genetic testing and created a more stable cancer risk assessment system. Further research and interventions are needed to continue to reduce barriers to genetic testing in primary care to promote early detection and prevention of cancer.


breast cancer; cancer risk; gene mutation; genetic testing; ovarian cancer; quality improvement


Genetics | Medical Sciences | Medicine and Health Sciences | Nursing

File Format


File Size

1378 KB

Degree Grantor

University of Nevada, Las Vegas




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