Date of Award
Summer 8-15-2026
Document Type
Scholarly Project
Degree Name
Doctor of Nursing Practice (DNP)
Department
Nursing
First Advisor
Dr. Kristi Frisbee
Second Advisor
Dr. Cheryl Gieffer
Third Advisor
Dr. Chris Spera
Abstract
Alcohol Screenings: Enhancing Patient Assessment and Care
Abstract
Alcohol use is a modifiable risk factor for multiple cancers, yet screening and follow-up interventions remain inconsistently implemented in primary care. Providers may encounter system- and workflow-related barriers that limit advanced assessment and clinical action following positive alcohol and substance use screening results. The purpose of this Doctor of Nursing Practice (DNP) quality improvement project was to evaluate outcomes of universal alcohol and substance use screening using the CAGE-AID tool in adult primary care encounters and to examine the extent to which positive screening results were followed by documented clinical action, with a secondary aim to identify provider-perceived barriers to follow-up care.
Guided by a Plan–Do–Study–Act framework, a retrospective chart review of 400 adult primary care encounters across two clinic locations was conducted. Electronic health record data included patient demographics, visit type, screening outcome, and documentation of post-screening assessment, intervention, or referral. Descriptive statistics were used to summarize screening outcomes and follow-up actions. A provider survey was developed to assess perceived barriers to advanced assessment and management of positive screens; however, survey data collection and analysis are ongoing and not included in the current results.
Universal CAGE-AID screening identified alcohol and substance use risk across diverse visit types, including encounters not typically targeted for screening. Chart review demonstrated variability in documentation of follow-up assessment or intervention after positive screens, indicating an action gap between identification of risk and clinical response. These findings highlight the need for system-level strategies to support consistent clinical action following positive screening results. Completion of the provider survey will inform targeted interventions to strengthen preventive care and cancer risk reduction in primary care.
Recommended Citation
Johnston, Melissa K., "Alcohol Screenings: Enhancing Patient Assessment and Care" (2026). Doctor of Nursing Practice Scholarly Project. 129.
https://digitalcommons.pittstate.edu/dnp/129
