Conduct a collaboration interview with two or three key leaders in your practice setting to determine the measures for your practice problem (increasing chlamydia screening in patients under 25) and associated challenges to obtaining data impacting measurement for your practice problem (include confidentiality, anonymity, access issues, etc.). Write a summary of how this quality indicator is measured in existing literature and search for evidence that demonstrates how your practice problem is measured across the country. Discuss any gaps in the data that were identified and additional sources that might be needed to obtain this data. Be sure to support your practice problem with the literature that indicates the relevance of this problem for nursing practice. Provide evidence from practice and data that is available.
Choose a Quality Improvement Model PDSA (Plan Do Study Act) and apply this model to your practice problem. Describe the model that you selected and how each step of the model will be used to develop the plan. (2pages)
The practice problem is to increase chlamydia screening in females less than 25 years old. This problem was brought to my attention when the family planning coordinator proposed testing patients who walked in to the clinic for pregnancy test. I realized that there are so many missed opportunities to screen patients for chlamydia. Since the hospital is located in an area with high prevalence rate we need to increase the frequency of chlamydia screenings. Daily patients walk in to the clinic for pregnancy test, HPV vaccine and Depo-provera injections and they are typically not screened for any STI’s. The visit type is usually a nurse visit so patients are seen by a nurse not a physician. Patients coming for these services have to provide a urine sample for the pregnancy test. The physician in charge enters the orders in advance and place orders for patients that walk in. In order to increase screening, these providers are asked when entering order for Depo, HPV or pregnancy test to place an order for GC/chlamydia if the patient does not have a screening on file in the past six months. According to CDC guidelines, more STI testing is needed in areas with a high prevalence of chlamydia.
Literature shows that one method used to measure the quality indicator of STI screening is……,. (HEDIS?)
The data collection used in my facility is the Family planning/STI tab in the EMR and the information gets sent to the Department of Health to generate monthly reports that can be assessed by the Family planning counselor. Prior to switching to the Family planning tab in the EMR the nurse was required to fill out Ahlers forms manually and the information was placed into Ahlers database by the data clerk.
The barriers to proper measurement of the problem is data entry. Now that the information goes directly in to the EMR by provider If providers does not fill out the family/ STI tab in the EMR the data does not accurately reflect the number of patients screened. Also accessing the monthly reports can be challenging because an official request has to be made to the DOH to access the screening report and they usually take 3-5 business days.