Addressing the Gap in Genetic Testing Rates for Ovarian Cancer Patients

Abstract

Ovarian cancer remains a leading cause of cancer-related mortality in women, with genetic testing playing a crucial role in guiding treatment and identifying hereditary risks. Despite professional guidelines recommending universal genetic testing for patients with ovarian cancer, provider adherence remains suboptimal, contributing to missed therapeutic and preventive opportunities. This Doctor of Nursing Practice (DNP) project aimed to address this gap by implementing an evidence-based intervention to improve genetic testing referral rates among newly diagnosed ovarian cancer patients. This evidence-based practice (EBP) implementation project utilized nudge theory to enhance provider adherence to genetic testing guidelines within an electronic health record (EHR) system. The intervention was conducted in a Mid-Atlantic women’s cancer center and targeted gynecologic oncology providers. The primary outcome was an increase in documented genetic testing referrals within a 3-month implementation period compared to baseline practice. The Iowa Model of Evidence-Based Practice guided the project implementation. Nudges included EHR-based SmartPhrases for documentation, peer comparison emails, and educational resources for providers. Data from the pre-implementation and implementation phases were analyzed using descriptive and inferential statistics. Referral rates increased significantly from 14% in the pre-implementation group to 67% post-intervention. However, completed genetic counseling and testing rates remained unchanged. These findings support the sustainability of the intervention but highlight persistent systemic barriers requiring institutional and policy-level changes. Future efforts should explore expanded genetic counseling access to enhance patient follow-through.