Date of Award

2023

Document Type

Doctor of Nursing Practice (DNP)

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

Committee Chair

Melissa Foster

Committee Member

Rachel Winston

Subject(s)

Chlamydia infections--Diagnosis, Medical screening, College students--Health and hygiene

Abstract

Chlamydia is the most common bacterial sexually transmitted infection (STI) in the world. The asymptomatic presentation of the disease, complications of untreated infection, and the lack of screening make routine screening for at-risk individuals necessary. The University Health Services (UHS) clinic is a not-for-profit university health clinic in Florence, Alabama. There was no protocol in place for routine chlamydia screening within the clinic. The project leader worked to implement a sustainable clinical practice change consistent with the US Preventative Services Task Force (USPSTF) guidelines related to chlamydia screening in female clients to increase chlamydia screening rates within the clinic. Following staff training, a sexual health history questionnaire was completed by all female clients who reported to the clinic, regardless of chief complaint. All women found to be sexually active and 18-24 years old whom had not been tested in the last 12 months were offered testing for chlamydia. Patients who tested positive were notified via telephone to return to the clinic and were treated according to the guidelines. After 12 weeks, the clinic staff was given the opportunity to complete the Clinical Sustainability Assessment Tool (CSAT) to assess the sustainability of the practice. Descriptive statistics in the form of sums and percentages were used to analyze the data collected. As a result, 182 female clients were surveyed, 93 were identified to be at risk for chlamydia and offered testing, 14 clients agreed to proceed with testing for chlamydia, and one tested positive and was treated. When compared to the traditional screening within the clinic, the practice increased the number of individuals tested and treated for chlamydia. The clinical staff identified that the workflow integration of the practice change was an area of weakness and did not align well with the electronic health record. Significant needs were identified regarding education for students on campus related to the need for chlamydia testing, the importance of health professionals integrating sexual health discussions into everyday care, and the value of updating electronic health record capabilities to support the clinical practice change.

Available for download on Wednesday, June 11, 2025

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