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Fecal Occult Blood Tests

Valuable for Screening, Wasteful for Diagnostics

Danesh, Valerie PhD, RN, CCRP, CCRN-K; Gisi, Brittany BSN, RN; Narayan, Maitreyi BS; Yoder, Linda PhD, MBA, RN, AOCN, FAAN; Zad, Omid MD

doi: 10.1097/NUR.0000000000000460
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Purpose/Objectives The purpose of this program was to deimplement the use of fecal occult blood tests (FOBTs) for hospitalized patients.

Description of the Project/Program We used a multipronged multidisciplinary approach to deimplement the use of FOBT, including physician-nurse collaborations, data-based poster displays, and a review of test utilization and patient cost throughout all facilities.

Outcome Despite a downward trend in FOBT orders for hospitalized patients over 3 years, the inappropriate use of FOBT remains a cause of unnecessary delays of diagnostic workups and patient care and excess costs ranging from US $22 000 to $41 000 annually for each hospital.

Conclusion Clinical nurse specialists can question the empirical origin and patient outcomes associated with clinical practice and are positioned to assess and champion deimplementation processes.

Author Affiliations: Assistant Professor (Dr Danesh), Undergraduate Student (Ms Narayan), and Professor (Dr Yoder) University of Texas at Austin; Assistant Investigator (Dr Danesh), Baylor Scott & White Health, Dallas, Texas; Medical Student (Ms Gisi), University of Pittsburgh School of Medicine, Pennsylvania; and ICU Medical Director (Dr Zad), Dr. P. Phillips Hospital, Orlando Health, Florida.

The authors report no conflicts of interest.

Correspondence: Valerie Danesh, PhD, RN, CCRP, CCRN-K, 1710 Red River St, Mail Code D0100, Austin, TX 78712 (vdanesh@nursing.utexas.edu).

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