Emergency Department Nurses Ideally Placed to Foster Mammography

ORLANDO—Nurse practitioners are in an ideal position to assess whether nonurgent emergency department patients are undergoing recommended mammography for breast cancer screening, a new study has found.

“Even though they know that breast cancer is a serious disease, many women are still not being screened with mammography,” said Karen Paraska, CRNP, PhD, assistant professor of nursing at Duquesne University, Pittsburgh, Pennsylvania, during her poster presentation.

“When women are in the emergency department for nonurgent problems, the nurse can form an alliance with them and become their advocate, creating a health promotion environment right there in the emergency department.”

Emergency department use for nonurgent problems has increased recently, and nurse practitioners have been enlisted to help deal with the extra patient population. “Since many patients use the emergency department as their primary care providers, the emergency department may be the only place women have for receiving information about mammography screening,” she said.

In her study, Paraska first determined whether it was feasible to have nurse practitioners collect information about mammography screening behaviors in the emergency department. Next, she determined the level of knowledge of the female patients in the emergency department regarding mammography screening.

The nurses administered the Breast Cancer Knowledge Test, which consists of true and false questions. This tool has been used for years to assess breast cancer and perceived risk among women in a primary care setting, Paraska noted.

The mean age of the women was 52, ranging from 40 to 70 years. Most were white, and most had 12 years of education or more.

The survey found that 78% of the women had been told at some time to get a mammogram, but only 56% actually underwent screening. On the test, the women scored low (66%) for knowledge but high (89%) about the seriousness of the disease, Paraska said.

“They didn’t get the mammogram because they just felt that it wasn’t necessary. They understood that breast cancer is a serious disease, as shown by the high seriousness score, but yet they did not think they were susceptible to it,” she said.

Paraska admitted she was surprised by her finding. “Even though we are located in a somewhat suburban area outside of Pittsburgh in Washington County, and the women predominantly had higher education—12 years and higher—they are still not getting mammograms,” she said.

She hopes her study will increase awareness that the emergency department can be an important place for educating women about the necessity for mammography screening for breast cancer.

“Hopefully after my intervention there will be a higher adherence to mammograms,” she said.