Date of Graduation

Winter 12-12-2014

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions



First Advisor

Stefan Rowniak

Second Advisor

Susan Prion

Third Advisor

Greg Crow


Screening has proven an effective strategy in the management of diseases that plague the population. This technique has proven to be most effective when screening is conducted with those who are most at risk for developing the targeted illness and when the frequency of screening follows set guidelines. Currently there are no nationally recognized screening guidelines for anal intraepithelial neoplasia (AIN). Screening for AIN stands to reduce overall incidence of anal squamous cell carcinoma through destruction of the dysplastic cells before they become cancerous. The goals of this project were to identify the patient population that stands to benefit the most from AIN screening, to identify the existing barriers to screening, and to educate primary care providers on methods to overcome these barriers. The results of this primary care practice improvement project show that with an educational forum for the providers, rates of AIN screening increased by as much as 89%. However, more attention still needs to be paid to the individual biases of providers regarding their views on AIN screening; also, more providers need training in high-resolution anoscopy, as this is the mainstay of follow-up.