Improving Effective Chlamydia Screening for Women at Risk at a Rural Family Planning Clinic

Abstract

Background:Chlamydia is the most common bacterial sexually transmitted infection (STI) in the United States, with an incidence of 1.7 million infections annually. It results in an estimated $691 million in lifetime medical costs.Objective:The objective of the project was to improve effective care for women at risk of chlamydia infection in a rural family planning clinic to 80% in 90 days.Methods:The Plan-Do-Study-Act process of quality improvement (QI) was implemented over four 2-week cycles. Qualitative and quantitative data were collected and analyzed iteratively and informed tests of change for each cycle.Results:Results indicated an improvement in effective care from a baseline of 42%–81%. Patient visit time decreased from 38 minutes at baseline to 23 minutes. Compared with pre-implementation, the number of positive chlamydia test results went from three to six, doubling the positivity rate, while the number of chlamydia tests billed increased by 32%.Conclusions:This project was successful in improving effective care. Implementing a standardized risk assessment decreased patient visit time.Implications for nursing:QI projects directed at meeting national standards for STI screening can be implemented in rural health clinics at low cost and with high impact.