Question

Select one screening tool (NOT an assessment tool) that you use in clinical practice or have observed a colleague from another discipline using. If this is not possible, review the literature and select a screening tool that is relevant to FNP practice.

Research the important parameters of this tool: sensitivity, specificity, reliability, and validity. If you do not currently use any screening tool, select one that would be appropriate to your practice as an FNP.

Create a one-page summary about the tool, tool development, and the parameters of the tool.

Answer 1

Screening Tool is used in the nursing practice to assess the particular disease condition. Screening Tools are helpful in identifying the condition earlier, thereby improving the quality of life and survival. When evaluating the Screening Tool, the sensitivity, specificity, and validity must be assessed properly.

Characteristics of a good screening Tool:

• It should be inexpensive.
• It should be consistent (reliable).
• It distinguishes between the diseased and non-diseased people(valid).
• With minimal discomfort.

Here, the screening tool (mammography) is used to identify the breast cancer who ultimately developed the disease.

Tool Validity:

The validity is based on its accuracy. It identifies the gold standard of the disease condition (distinguishes between the diseased and non-diseased persons). The mammography screening test was done to determine the breast cancer. A contingency table is used to calculate the validity of the screening tool for evaluating of the breast cancer among 64,810 participants.

	Diseased	Non-diseased for breast cancer	Total
Positive	132	983	1115
Negative	45	63650	63695
Total	177	64633	64810

The table shows that 133 has true positive, and 63695 has true negatives and 983 has false positives. according to gold standard test, only 132 has diseased, but 45 people also diagnosed with cancer. Only, 64633 participants were free of cancer.

Sensitivity:

Sensitivity is a kind of tool to measure validity. Sensitivity is the identifying of participants who truly have the breast cancer. It focuses on the diseased people.

	Diseased	Non-diseased for breast cancer	Total
Positive	132	983	1115
Negative	45	63650	63695
Total	177	64633	64810

The probability of the sensitive test is determined by the percentage of the positive screening test for breast cancer.

Sensitivity = True Positive Fraction = P(Screen Positive / Disease)

= a/(a+c)

132/177 = 74.6%

The probability of screening test for the diseased person was 74.6%.

Specificity:

Specificity is the classification of non- diseased people. It focuses on the accuracy of the non-diseased people.

	Diseased	Non-Diseased for Breast Cancer	Total
Positive	132	983	1115
Negative	45	63650	63695
Total	177	64633	64810

Specificity = True Negative Fraction = P(Screen Negative / Disease Free)

= d/(b+d)

= 63650/64633 = 98.5%

The probability of the non-diseased person is 98.5%.