Improving STI Detection
Margaret Keenan, DNP, APRN, FNP-BC Heading link
Project Title: Improving STI Detection Via Extra-Genital Site Self-Swabbing
Clinical issue/practice problem: Rates of sexually transmitted infections (STIs), especially chlamydia and gonorrhea, are rising. More than 70% of gonorrhea infections and over 85% of chlamydia infections are missed without universal screening at extra-genital sites. The aim of this quality improvement initiative was to decrease STIs by improving universal testing practices in primary care.
Summary of supporting literature: Universal screening with patient self-collection is one method to improve screening and increase detection among sexually active adults at an urban clinic. Self-obtained samples are acceptable and patients are more likely to be screened with this method. Self-collection demonstrates a 96% accuracy rate.
Project implementation: Guided by the Knowledge Transfer Framework, academic detailing sessions were completed with providers and algorithms and handouts were provided. Patients were educated on universal screening and how to perform self-collection.
Outcomes: Retrospective chart reviews were completed comparing pre and post-implementation data to gauge effectiveness. Data included patient characteristics, results and if self-collection was completed. Barriers faced included lack of consistent provider uptake, lack of documentation and patient refusal. Chart reviews demonstrated increased screening and self-collection uptake.
Clinical implications for practice: This quality improvement intervention implemented self-screening methods and improved STI detection in a primary care setting.