Nurse-Initiated Health Promotion Prompting System in an Internal Medicine Residentsʼ Clinic

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Abstract
Although cure of many diseases depends on early detection, screening schemes have been difficult to implement in busy clinic environments. We describe the testing of a nurse-initiated prompting system for six health promotion and disease prevention procedures in an internal medicine residents'' clinic at a university-affiliated community program. Maneuvers investigated were breast examination, pelvic examination and Pap smear, rectal examination in men, mammogram, stool guaiac test, and blood glucose determination. A nurse reviewed the charts and used a list in the front of each chart to prompt residents in the experimental group. Residents in the control group were not prompted. A significant improvement (P < .05) in performance was seen in the prompted group. Performance of rectal examination and mammograms improved most, increasing from 41% to 93% and 18% to 64%, respectively. There were no significant changes in the control group. This simple nurse-initiated prompting system improved the performance of healthy promotion and disease prevention maneuvers.

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