Date of Award

4-2020

Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Christina Cavinder

Abstract

The Centers for Disease Control and Prevention (CDC) (2017a) estimates that one-quarter of sexually active people are between 15 and 24 years old, but account for half of 20 million sexually transmitted diseases (STD) reported annually in the United States. Chlamydia trachomatis (CT) and Neisseria gonorrhea (NG) are the most common reportable STDs (CDC, 2018). The purpose of this project was to increase CT/NG screening rates among sexually active, nonpregnant women 15 to 24 years old within the primary care setting through colleague education, routine sexual history taking, and indicated testing. A 30-minute colleague in-service was provided to educate clinical colleagues on the significance of the problem and best practice intervention. During preventive office visit intake with the medical assistant (MA) over a 10-week intervention period, women 15 to 24 years old were asked about sexual activity. If a woman indicated she was sexually active, CT/NG testing via urine sample were offered. Ten-week pre-intervention and 10-week post-intervention data including demographics, number screened for sexual activity, number eligible for testing based on sexual activity, number tested for CT/NG, and number of positive results were collected via manual chart audit. Data between groups were analyzed using descriptive statistics and chi-square analyses. There were non-significant increases in number screened for sexual activity (61% vs. 79%) (𝝌2(1, N=32)=1.117, p>.05), number eligible for testing (45% vs. 64%) (𝝌2(1, n=22)=0.733, p>.05), and number tested for CT/NG (80% vs. 100%) (𝝌2(1, n=12)=1.527, p>.05). There was no significant difference between pre-intervention and post-intervention positive CT (20% vs. 14%) (𝝌2(1, n=12)=1.527, p>.05) or NG (20% vs. 0%) (𝝌2(1, n=12)=1.527, p>.05) results. A longer timeframe or larger sample sizes would further explore significance of the intervention. Based on current clinical guidelines provided by CDC (2014c) and USPSTF (2014), women 15 to 24 years old should be offered CT/NG screening annually.

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